Empirical research
Comparing Prescribing and Dispensing Data of the PCORnet Common Data Model Within PCORnet Antibiotics and Childhood Growth Study
Authors:
Pi-I D. Lin ,
Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, US
About Pi-I D.
ScD
Matthew F. Daley,
Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO, US
About Matthew F.
Janne Boone-Heinonen,
Oregon Health and Science University, School of Public Health, Portland, OR, US
Sheryl L. Rifas-Shiman,
Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, US
L. Charles Bailey,
Applied Clinical Research Center, Children’s Hospital of Philadelphia, Philadelphia, PA, US
Christopher B. Forrest,
Applied Clinical Research Center, Children’s Hospital of Philadelphia, Philadelphia, PA, US
Casie E. Horgan,
Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, US
Jessica L. Sturtevant,
Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, US
Sengwee Toh,
Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, US
Jessica G. Young,
Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, US
Jason P. Block,
Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, US
on behalf of the PCORnet Antibiotics and Childhood Growth Study Group
For key investigators and stakeholders in the PCORnet Antibiotics and Childhood Growth Study Group, see the Appendix
Abstract
Researchers often use prescribing data from electronic health records (EHR) or dispensing data from medication or medical claims to determine medication utilization. However, neither source has complete information on medication use. We compared antibiotic prescribing and dispensing records for 200,395 patients in the National Patient-Centered Clinical Research Network (PCORnet) Antibiotics and Childhood Growth Study. We stratified analyses by delivery system type [closed integrated (cIDS) and non-cIDS]; 90.5 percent and 39.4 percent of prescribing records had matching dispensing records, and 92.7 percent and 64.0 percent of dispensing records had matching prescribing records at cIDS and non-cIDS, respectively. Most of the dispensings without a matching prescription did not have same-day encounters in the EHR, suggesting they were medications given outside the institution providing data, such as those from urgent care or retail clinics. The sensitivity of prescriptions in the EHR, using dispensings as a gold standard, was 99.1 percent and 89.9 percent for cIDS and non-cIDS, respectively. Only 0.7 percent and 6.1 percent of patients at cIDS and non-cIDS, respectively, were classified as false-negative, i.e. entirely unexposed to antibiotics when they in fact had dispensings. These patients were more likely to have a complex chronic condition or asthma. Overall, prescription records worked well to identify exposure to antibiotics. EHR data, such as the data available in PCORnet, is a unique and vital resource for clinical research. Closing data gaps by understanding why prescriptions may not be captured can improve this type of data, making it more robust for observational research.
How to Cite:
Lin P-ID, Daley MF, Boone-Heinonen J, Rifas-Shiman SL, Bailey LC, Forrest CB, et al.. Comparing Prescribing and Dispensing Data of the PCORnet Common Data Model Within PCORnet Antibiotics and Childhood Growth Study. eGEMs (Generating Evidence & Methods to improve patient outcomes). 2019;7(1):11. DOI: http://doi.org/10.5334/egems.274
