دورية أكاديمية
أعرض في EDS

The validity of the Rx-Risk Comorbidity Index using medicines mapped to the Anatomical Therapeutic Chemical (ATC) Classification System.

التفاصيل البيبلوغرافية
العنوان: The validity of the Rx-Risk Comorbidity Index using medicines mapped to the Anatomical Therapeutic Chemical (ATC) Classification System.
المؤلفون: Pratt NL; Quality Use of Medicines and Pharmacy Research Centre, University of South Australia, Adelaide, South Australia, Australia., Kerr M; Quality Use of Medicines and Pharmacy Research Centre, University of South Australia, Adelaide, South Australia, Australia., Barratt JD; Quality Use of Medicines and Pharmacy Research Centre, University of South Australia, Adelaide, South Australia, Australia., Kemp-Casey A; Quality Use of Medicines and Pharmacy Research Centre, University of South Australia, Adelaide, South Australia, Australia., Kalisch Ellett LM; Quality Use of Medicines and Pharmacy Research Centre, University of South Australia, Adelaide, South Australia, Australia., Ramsay E; Quality Use of Medicines and Pharmacy Research Centre, University of South Australia, Adelaide, South Australia, Australia., Roughead EE; Quality Use of Medicines and Pharmacy Research Centre, University of South Australia, Adelaide, South Australia, Australia.
المصدر: BMJ open [BMJ Open] 2018 Apr 13; Vol. 8 (4), pp. e021122. Date of Electronic Publication: 2018 Apr 13.
نوع المنشور: Journal Article; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: BMJ Publishing Group Ltd Country of Publication: England NLM ID: 101552874 Publication Model: Electronic Cited Medium: Internet ISSN: 2044-6055 (Electronic) Linking ISSN: 20446055 NLM ISO Abbreviation: BMJ Open Subsets: MEDLINE
أسماء مطبوعة: Original Publication: [London] : BMJ Publishing Group Ltd, 2011-
مواضيع طبية MeSH: Comorbidity* , Drug Therapy*, Aged ; Aged, 80 and over ; Cohort Studies ; Humans ; Logistic Models ; Veterans
مستخلص: Objectives: To provide a map of Anatomical Therapeutic Chemical (ATC) Classification System codes to individual Rx-Risk comorbidities and to validate the Rx-Risk Comorbidity Index.
Design: The 46 comorbidities in the Rx-Risk Index were mapped to dispensing's indicative of each condition using ATC codes. Prescription dispensing claims in 2014 were used to calculate the Rx-Risk. A baseline logistic regression model was fitted using age and gender as covariates. Rx-Risk was added to the base model as an (1) unweighted score, (2) weighted score and as (3) individual comorbidity categories indicating the presence or absence of each condition. The Akaike information criterion and c-statistic were used to compare the models.
Setting: Models were developed in the Australian Government Department of Veterans' Affairs health claims data, and external validation was undertaken in a 10% sample of the Australian Pharmaceutical Benefits Scheme Data.
Participants: Subjects aged 65 years or older.
Outcome Measures: Death within 1 year (eg, 2015).
Results: Compared with the base model (c-statistic 0.738, 95% CI 0.734 to 0.742), including Rx-Risk improved prediction of mortality; unweighted score 0.751, 95% CI 0.747 to 0.754, weighted score 0.786, 95% CI 0.782 to 0.789 and individual comorbidities 0.791, 95% CI 0.788 to 0.795. External validation confirmed the utility of the weighted index (c-statistic=0.833).
Conclusions: The updated Rx-Risk Comorbidity Score was predictive of 1-year mortality and may be useful in practice to adjust for confounding in observational studies using medication claims data.
Competing Interests: Competing interests: None declared.
(© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)
التعليقات: Erratum in: BMJ Open. 2020 Sep 6;10(9):e021122corr1. (PMID: 32895287)
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فهرسة مساهمة: Keywords: chronic disease burden; claims data; comorbidity; model validation; mortality prediction; weighting
تواريخ الأحداث: Date Created: 20180415 Date Completed: 20190307 Latest Revision: 20220330
رمز التحديث: 20221213
مُعرف محوري في PubMed: PMC5905736
DOI: 10.1136/bmjopen-2017-021122
PMID: 29654048
قاعدة البيانات: MEDLINE
الوصف
تدمد:2044-6055
DOI:10.1136/bmjopen-2017-021122