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Validity of self-report with respect to prescription medications among pregnant women

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Please use this identifier to cite or link to this item: http://hdl.handle.net/1928/11111

Validity of self-report with respect to prescription medications among pregnant women

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Title: Validity of self-report with respect to prescription medications among pregnant women
Author: Jaiswal, Pallavi
Advisor(s): Bakhireva, Ludmila
Committee Member(s): Khan, Nasreen
Dodd, Melanie
Department: University of New Mexico. College of Pharmacy
Subject(s): validity, agreement, sensitivity, specificity, prescription medications, pregnancy, kappa, inaccurate report, predictors
LC Subject(s): Pregnant women--Health risk assessment--New Mexico
Pregnant women--Drug use--New Mexico
Drug monitoring--Social aspects--New Mexico.
Medication abuse--New Mexico.
Degree Level: Masters
Abstract: Objectives: Accuracy of self-report regarding prescription medication use among pregnant women is largely unknown. Accurate self-reported information is needed for medication reconciliation purposes, clinical management, clinical teratology research, and monitoring of adherence. This study examined the accuracy of self-reported medication use by pregnant women for medications used chronically and episodically or intermittently during pregnancy. Further, predictors of inaccurate reporting regarding prescription medication use were also estimated. Methods: A cross-sectional analysis of data collected through the University of New Mexico (UNM) cohort study, “Safety of Medication and Perception of Teratogenicity” (SMART) was conducted. Pregnant women were recruited from UNM prenatal care clinics and were asked to report all medications they took since their last menstrual period. The analysis was limited to women enrolled in the first year of the study who had at least one prescription for diabetes or opioid analgesics medications (representative of chronic and acute medication use, respectively). The accuracy of agreement between self-report and medical records for each medication class was estimated by simple (κ) and prevalence and bias adjusted (PABAK) kappa. Information from the medical records was used as the ‘gold-standard’. Multivariate logistic regression analyses were used to determine predictors of inaccurate reporting of prescription medication use in this cohort. Results: A total of 92 pregnant women were included in the analysis. Agreement for diabetes medications was near perfect (κ=0.87; PABAK=0.91); whereas poor-to-moderate concordance was observed for opioid analgesics (κ=0.29; PABAK=0.57). Among antidiabetic medications, concordance was highest for biguanides (κ=0.90; PABAK=0.93) and lowest for sulfonylureas (κ=0.83; PABAK=0.87); whereas among opioid analgesics, highest agreement was observed for strong agonists (κ=0.51; PABAK=0.56) and lowest for moderate/low agonists (κ=0.06; PABAK=0.59). Women engaging in at least one episode of binge drinking were found to be inaccurate reporters of medication regarding prescription medication use (OR: 3.40, 95% CI: 1.13;10.29). Conclusions: This study suggests poor accuracy of self-report with respect to prescription medications used as short courses or intermittently during pregnancy. Therefore, in clinical studies assessing safety of such medications in pregnancy, self-reported information needs to be supplemented by other sources. Accuracy of self-report for medications used chronically is acceptable.
Graduation Date: July 2010
URI: http://hdl.handle.net/1928/11111

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