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. 2017 Aug;26(8):963-972.
doi: 10.1002/pds.4234. Epub 2017 Jun 12.

Agreement and validity of electronic health record prescribing data relative to pharmacy claims data: A validation study from a US electronic health record database

Christopher G Rowan  1 , James Flory  2 , Tobias Gerhard  3 , John K Cuddeback  4 , Nikita Stempniewicz  4 , James D Lewis  5 , Sean Hennessy  6
Affiliations

Agreement and validity of electronic health record prescribing data relative to pharmacy claims data: A validation study from a US electronic health record database

Christopher G Rowan et al. Pharmacoepidemiol Drug Saf. 2017 Aug.

Abstract

Background: Granular clinical and laboratory data available in electronic health record (EHR) databases provide researchers the opportunity to conduct investigations that would not be possible in insurance claims databases; however, for pharmacoepidemiology studies, accurate classification of medication exposure is critical.

Objective: The aim of this study was to evaluate the validity of classifying medication exposure using EHR prescribing (EHR-Rx) data.

Methods: We conducted a retrospective cohort study among patients with linked claims and EHR data in OptumLabs™ Data Warehouse. The agreement between EHR-Rx data and pharmacy claims (PC-Rx) data (for 40 medications) was determined using the positive predictive value (PPV) and medication possession ratio (MPR)-calculated in 1- and 12-month medication exposure periods (MEPs). Secondary analyses were restricted to incident vs prevalent EHR-Rxs, age ≥65 vs <65, white vs black race, males vs females, and number of EHR-Rxs.

Results: The validity metrics varied substantially among the 40 medications assessed. Across all medications, the period PPV and MPR were 62% and 63% in the 1-month MEP. They were 78% and 43% in the 12-month MEP. Overall, PPV and MPR were higher for patients with a prevalent EHR-Rx and age <65.

Conclusions: Despite substantial variability among different medications, there was very good agreement between EHR-Rx data and PC-Rx data. To maximize the validity of classifying medication exposure with EHR prescribing data, researchers may consider using longer MEPs (eg, 12 months) and potentially require multiple EHR-Rxs to classify baseline medication exposure.

Keywords: EHR prescribing records; medication possession ratio; positive predictive valuevalidity.

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