Key points
Key findings and implications
Background
Methods
Study population
Self-reported morbidity
Medication-based measures of morbidity – Rx-risk and Rx-risk-V
Comparison of self-reported morbidity with Rx-risk and Rx-risk-V
Patient-level characteristics associated with discordance between the two measures of morbidity
Statistical methods
Results
Study population
< 65 years (N = 1095) | ≥ 65 years (N = 1830) | |
---|---|---|
Age | 56.22 (55.9–56.54) | 73.9 (73.67–74.2) |
Gender | ||
Male | 417 (38.08) | 839 (45.85) |
Female | 678 (61.92) | 991 (54.15) |
Marital Status | ||
Married | 705 (64.38) | 991 (54.15) |
Never Married | 126 (11.51) | 189 (10.33) |
Separated/Divorced | 163 (14.89) | 63 (3.44) |
Widowed | 101 (9.22) | 587 (32.08) |
Education | ||
Primary/none | 431 (39.36) | 941 (51.42) |
Secondary | 489 (44.66) | 570 (31.15) |
Third/Higher Level | 175 (15.98) | 317 (17.32) |
Poor delayed recall (Yes) | 177 (16.16) | 560 (30.60) |
Depression (Yes) | 262 (23.93) | 210 (11.48) |
Polypharmacy (Yes) | 301 (27.49) | 733 (40.05) |
Agreement between self-reported morbidity and medication-based measures of morbidity (Rx-risk and Rx-risk-V)
TILDA | Rx-Risk Pharmacy Claims | Kappa (κ) | Standard Error | ||||
---|---|---|---|---|---|---|---|
Self-reported morbidity | N | % | Medication-based Morbidity (ATC) | N | % | ||
Diabetes or high blood sugar | 110 | (10.05) | Diabetes (A10AB01-A10BG03, A10BH, A10BX) | 98 | (8.95) | 0.81 | 0.03 |
Glaucoma | 25 | (2.28) | Glaucoma (S01EA01-S01EB03, S01EC03-S01EX) | 19 | (1.74) | 0.58 | 0.03 |
High Cholesterol | 458 | (41.83) | Hyperlipidaemia (C10AA01-C10BX17) | 454 | (41.46) | 0.52 | 0.03 |
Asthma | 133 | (12.15) | Asthma (R03AA-R03AL, R03BA-R03BX, R03CA-R03CC, R03DA-R03DX) | 278 | (25.39) | 0.47 | 0.03 |
High blood pressure or Hypertension | 438 | (40.00) | Hypertension (C03AA01-C03BA11, C03DA01-C03EA01, C09BA02-C09BA09, C09DA01-C09DA07, C02AB01-C02AC05, C02DB02-C02KX01) | 190 | (17.35) | 0.40 | 0.03 |
Cancer or a malignant tumour | 80 | (7.31) | Malignancies (L01AA01-L01XX31) | 23 | (2.10) | 0.31 | 0.02 |
Depression | 129 | (11.78) | Depression (N06AA01-N06AG02, N06AX) | 282 | (25.75) | 0.24 | 0.03 |
Stroke (cerebral vascular disease) | 78 | (7.12) | Anti-platelet therapy (B01AC04-B01AC30) | 291 | (26.58) | 0.23 | 0.02 |
Parkinson | 3 | (0.27) | Parkinson’s disease (N04AA01-N04BX02) | 15 | (1.37) | 0.22 | 0.02 |
Heart attack (including myocardial infarction or coronary thrombosis) | 54 | (4.93) | Anti-platelet therapy (B01AC04-B01AC30) | 291 | (26.58) | 0.21 | 0.02 |
Manic depression | 12 | (1.10) | Bipolar disorder (N05AN01) | 12 | (1.10) | 0.16 | 0.03 |
Emotional nervous or psychiatric problem, such as depression or anxiety | 180 | (16.44) | Anxiety (N05BA01-N05BA12) | 252 | (23.01) | 0.15 | 0.03 |
Anxiety | 101 | (9.22) | Anxiety (N05BA01-N05BA12) | 252 | (23.01) | 0.14 | 0.03 |
Cirrhosis or serious liver damage | 13 | (1.19) | Liver disease (A05AA01-A05BA08, J05AF05, J05AF07, J05AF11) | 1 | (0.09) | 0.14 | 0.02 |
Stomach ulcers | 119 | (10.87) | GORD & Peptic ulcer (A02B, A02BB, A02BC) | 518 | (47.31) | 0.13 | 0.02 |
Arthritis (including osteoarthritis or rheumatism) | 310 | (28.31) | Rheumatoid Arthritis (M01AA-M01CX, M02AA-M02AX, L01BA01, L04AB01-L04AB05, L04AD01, L04AX03) | 688 | (62.83) | 0.13 | 0.02 |
Any other heart trouble | 49 | (4.47) | Ischaemic heart disease/hypertension (C07AA01-C07FB07, C08CA01-C08DB01) | 303 | (27.67) | 0.09 | 0.02 |
Rheumatoid arthritis only | 119 | (10.87) | Rheumatoid Arthritis (M01AA-M01CX, M02AA-M02AX, L01BA01, L04AB01-L04AB05, L04AD01, L04AX03) | 688 | (62.83) | 0.06 | 0.02 |
Mini-stroke or TIA | 33 | (3.01) | Anti-platelet, Anti-coagulation therapya (B01AC04-B01AC30, B01AA03-B01AB06) | 335 | (30.6) | 0.05 | 0.01 |
TILDA | Rx-Risk-V Pharmacy claims | Kappa (κ) | Standard Error | ||||
---|---|---|---|---|---|---|---|
Self-reported morbidity | N | % | Medication-based Morbidity (ATC) | N | % | ||
Diabetes or high blood sugar | 222 | (12.13) | Diabetes (A10AB01-A10BG03, A10BH, A10BX) | 191 | (10.44) | 0.81 | 0.02 |
Glaucoma | 82 | (4.48) | Glaucoma (S01EA01-S01EB03, S01EC03-S01EX) | 104 | (5.68) | 0.69 | 0.02 |
Osteoporosis | 253 | (13.83) | Osteoporosis/Paget’s disease (M05BA01-M05BB09, M05BX03, G03XC01, A12AX92) | 306 | (16.72) | 0.61 | 0.02 |
Parkinson | 17 | (0.93) | Parkinson’s disease (N04AA01-N04BX02) | 40 | (2.19) | 0.56 | 0.02 |
Angina | 213 | (11.64) | Angina (C01DA02-C01DA14, C01DX16, C01EB17-C01EB18) | 194 | (10.60) | 0.51 | 0.02 |
High Cholesterol | 733 | (40.05) | Hyperlipidaemia (C10AA01-C10BX17) | 1002 | (54.75) | 0.44 | 0.02 |
Manic depression | 5 | (0.27) | Bipolar disorder (N05AN01) | 6 | (0.33) | 0.36 | 0.02 |
High blood pressure or Hypertension | 964 | (52.68) | Hypertension (C03AA01-C03BA11, C03DA01-C03EA01, C09BA02-C09BA09, C09DA01-C09DA09, C02AB01-C02AC05, C02DB02-C02KX01) | 591 | (32.30) | 0.36 | 0.02 |
Pain (taking pain medication) | 464 | (25.36) | Pain (Opioids) (N02AA01-N02AX02) Pain (Inflammation) (M01AB01, M01AH06) | 523 | (28.58) | 0.35 | 0.02 |
Pain | 726 | (39.67) | Pain (Opioids) (N02AA01-N02AX02) Pain (Inflammation) (M01AB01, M01AH06) | 523 | (28.58) | 0.27 | 0.02 |
Abnormal Heart Rhythm | 221 | (12.08) | Arrhythmia (C01AA05, C01BA01-C01BD01, C01BD07) | 103 | (5.63) | 0.26 | 0.02 |
Depression | 78 | (4.26) | Depression (N06AA01-N06AG02, N06AX) | 359 | (19.62) | 0.21 | 0.02 |
Dementia | 5 | (0.27) | Dementia (N06DA02, N06DA01) | 24 | (1.31) | 0.20 | 0.02 |
Chronic lung disease such as chronic bronchitis or emphysema | 97 | (5.30) | Chronic airways disease (R03AC02-R03DC03) | 457 | (24.97) | 0.19 | 0.02 |
Cancer or a malignant tumour | 177 | (9.67) | Malignancies (L01AA01-L01XX31) | 62 | (3.39) | 0.19 | 0.02 |
Emotional nervous or psychiatric problem, such as depression or anxiety | 115 | (6.28) | Anxiety (N05BA01- N05BA12) | 327 | (17.87) | 0.15 | 0.02 |
Congestive heart failure | 31 | (1.69) | Chronic heart failure (C03CA01-C03CC01, C09AA01-C09AA10, C09CA01, C09CA03, C09CA06-C09CA07) | 269 | (14.70) | 0.13 | 0.01 |
Cirrhosis or serious liver damage | 10 | (0.55) | Liver disease (A05AA01-A05BA08, J05AF05, J05AF07, J05AF11) | 6 | (0.33) | 0.12 | 0.02 |
Heart attack (including myocardial infarction or coronary thrombosis) | 171 | (9.34) | Anti-platelet therapy (B01AC04-B01AC30) | 952 | (52.02) | 0.11 | 0.01 |
Anxiety | 66 | (3.61) | Anxiety (N05BA01-N05BA12) | 327 | (17.87) | 0.11 | 0.02 |
Stomach ulcers | 127 | (6.94) | GORD & Peptic ulcer (A02BA, A02BC) | 947 | (51.75) | 0.10 | 0.01 |
Alcohol or substance abuse | 28 | (1.53) | Alcohol dependence (N07BB01, N07BB04) | 1 | (0.05) | 0.07 | 0.01 |
Any other heart trouble | 101 | (5.52) | Ischaemic heart disease/hypertension (C07AA01-C07FB07, C08CA01-C08DB01) | 884 | (48.31) | 0.06 | 0.01 |
Stroke (cerebral vascular disease) | 61 | (3.33) | Anti-platelet therapy (B01AC04-B01AC30) | 952 | (52.02) | 0.04 | 0.01 |
Mini-stroke or TIA | 131 | (7.16) | Anti-platelet, Anti-coagulation therapya (B01AC04-B01AC30, B01AA03-B01AB06, B01AB10) | 1104 | (60.32) | 0.02 | 0.01 |
Incontinence | 313 | (17.10) | Neurogenic Bladder & Urinary Incontinence (V07AN) | 17 | (0.93) | 0.02 | 0.01 |
Psychosis | 1 | (0.05) | Psychotic illness (N05AA01- N05AX17) | 150 | (8.20) | 0.01 | 0.00 |
Patient-level characteristics associated with discordance between the two measures of morbidity
Hypertension | Heart Attack | Stroke | TIA | High Cholesterol | Heart Trouble | Cancer | Emotional Problems | Anxiety | |
---|---|---|---|---|---|---|---|---|---|
Age (years) | 1.01 (1.01–1.02)* | 1.04 (1.03–1.05)* | 1.04 (1.03–1.05)* | 1.00 (1.02–1.10) | 1.01 (1.00–1.01) | 1.04 (1.03–1.05)* | 1.02 (1.00–1.03) | 0.98 (0.97–0.99) | 0.99 (0.98–1.00) |
Gender | |||||||||
Male | |||||||||
Female | 0.94 (0.79–1.11) | 0.88 (0.74–1.04) | 0.62 (0.52–0.74)* | 0.60 (0.45–0.80)* | 0.68 (0.57–0.81)* | 0.92 (0.77–1.09) | 0.86 (0.65–1.14) | 1.57 (1.29–1.92)* | 1.66 (1.35–2.04)* |
Marital Status | |||||||||
Married | |||||||||
Never Married | 1.04 (0.79–1.37) | 0.69 (0.52–0.92)* | 0.69 (0.52–0.92)* | 0.88 (0.54–1.42) | 0.89 (0.67–1.10) | 0.85 (0.65–1.13) | 1.00 (0.65–1.55) | 0.98 (0.72–1.35) | 0.95 (0.69–1.32) |
Separated/Divorced | 0.97 (0.69–1.35) | 0.83 (0.59–1.17) | 0.77 (0.55–1.08) | 1.34 (0.76–2.36) | 0.94 (0.67–1.30) | 0.85 (0.61–1.19) | 0.79 (0.44–1.40) | 1.15 (0.82–1.61) | 1.04 (0.73–1.47) |
Widowed | 1.04 (0.84–1.30) | 1.08 (0.86–1.34) | 1.11 (0.89–1.38) | 1.03 (0.72–1.48) | 1.09 (0.87–1.37) | 0.91 (0.73–1.14) | 0.94 (0.65–1.33) | 1.06 (0.82–1.35) | 0.94 (0.73–1.22) |
Education | |||||||||
Primary/None | |||||||||
Secondary | 0.93 (0.78–1.13) | 0.91 (0.83–1.20) | 0.95 (0.78–1.15) | 0.88 (0.64–1.20) | 1.17 (0.97–1.40) | 0.99 (0.82–1.19) | 1.42 (1.04–1.92) | 1.02 (0.83–1.25) | 0.97 (0.78–1.20) |
Third/Higher Level | 0.75 (0.59–0.96)* | 1.13 (0.89–1.43) | 1.14 (0.90–1.44) | 0.78 (0.52–1.17) | 1.12 (0.87–1.00) | 0.91 (0.72–1.15) | 1.37 (0.95–2.00) | 0.86 (0.65–1.13) | 0.83 (0.63–1.10) |
Poor Delayed Recall (Yes) | 0.97 (0.79–1.17) | 1.04 (0.86–1.27) | 0.98 (0.81–1.20) | 0.75 (0.54–1.04) | 0.99 (0.81–1.20) | 0.90 (0.75–1.10) | 1.00 (0.73–1.37) | 1.18 (0.95–1.48) | 1.22 (1.62–2.59) |
Depression (Yes) | 0.97 (0.77–1.23) | 1.08 (0.85–1.36) | 1.03 (0.81–1.30) | 1.20 (0.82–1.75) | 0.98 (0.77–1.20) | 0.92 (0.73–1.16) | 1.36 (0.96–1.94) | 2.15 (1.71–2.70)* | 2.05 (1.62–2.59)* |
Polypharmacy (Yes) | 1.81 (1.52–2.14)* | 3.12 (2.64–3.70)* | 4.13 (3.47–4.90)* | 3.60 (2.69–4.79)* | 1.40 (1.18–1.60)* | 3.50 (2.97–4.17)* | 1.28 (0.97–1.69) | 1.16 (0.96–1.41) | 1.20 (0.98–1.46) |
Depression only | Stomach ulcers | Asthma | Arthritis (general) | Rheumatoid Arthritis only | Angina | Congestive Heart Failure | Abnormal Heart Rhythm | Lung Disease | |
Age | 0.99 (0.98–1.00) | 1.01 (1.00–1.02) | 1.02 (0.99–1.06) | 1.00 (0.98–1.02) | 1.00 (0.98–1.03) | 1.03 (1.02–1.05)* | 1.06 (1.04–1.09)* | 1.03 (1.00–1.06) | 0.10 (0.97–1.02) |
Gender | |||||||||
Male | |||||||||
Female | 1.46 (1.19–1.79)* | 1.09 (0.92–1.27) | 0.77 (0.54–1.09) | 1.02 (0.78–1.32) | 1.11(0.86–1.44) | 1.13 (0.91–1.4) | 1.00 (0.73–1.34) | 0.74 (0.54–1.03) | 1.17 (0.91–1.50) |
Marital Status | |||||||||
Married | |||||||||
Never Married | 1.04 (0.75–1.43) | 0.97 (0.75–1.25) | 1.10 (0.65–1.87) | 0.95 (0.64–1.41) | 0.94(0.63–1.39) | 1.01 (0.72–1.43) | 1.26 (0.76–2.06) | 0.64 (0.36–1.13) | 1.09 (0.74–1.60) |
Separated/Divorced | 1.24 (0.88–1.76) | 1.01 (0.75–1.37) | 1.28 (0.80–2.06) | 0.94 (0.66–1.35) | 0.79(0.55–1.14) | 1.19 (0.68–2.07) | 1.43 (0.64–3.21) | 0.83 (0.34–2.02) | 1.00 (0.53–1.89) |
Widowed | 1.00 (0.77–1.29) | 0.97 (0.79–1.20) | 1.65 (0.96–2.82) | 0.93 (0.60–1.44) | 0.73(0.47–1.13) | 0.86 (0.67–1.11) | 1.06 (0.74–1.53) | 0.88 (0.60–1.27) | 0.81 (0.61–1.09) |
Education | |||||||||
Primary/None | |||||||||
Secondary | 1.05 (0.85–1.30) | 1.12 (0.94–1.33) | 0.90 (0.62–1.30) | 0.98 (0.74–1.29) | 1.04(0.78–1.37) | 0.89 (0.71–1.13) | 0.75 (0.53–1.06) | 1.24 (0.89–1.75) | 0.70 (0.53–0.92) |
Third/Higher Level | 0.80 (0.60–1.07) | 0.89 (0.71–1.11) | 0.79 (0.48–1.33) | 0.70(0.48–1.02) | 0.74(0.51–1.07) | 0.87 (0.65–1.15) | 0.59 (0.37–0.95) | 0.99 (0.64–1.54) | 0.77 (0.56–1.07) |
Poor Delayed Recall | 1.25 (1.00–1.57) | 1.11 (0.93–1.34) | 0.76 (0.48–1.22) | 1.06 (0.75–1.48) | 0.89(0.64–1.25) | 0.85 (0.68–1.07) | 1.13 (0.82–1.56) | 0.93 (0.67–1.30) | 1.04 (0.80–1.32) |
Depression (Yes) | 2.34 (1.85–2.95)* | 1.34 (1.09–1.67)* | 1.30 (0.89–1.91) | 1.36 (1.01–1.82)* | 1.26(0.94–1.70) | 1.00 (0.73–1.38) | 1.71 (1.15–2.55)* | 1.67 (1.10–2.50)* | 1.47 (1.04–1.34)* |
Polypharmacy | 1.60 (1.31–1.95)* | 2.17 (1.84–2.55)* | 1.82 (1.29–2.58)* | 0.79 (0.60–1.04) | 1.11 (0.84–1.47) | 1.88 (1.50–2.30)* | 3.64 (2.67–4.93)* | 3.28 (2.40–4.49)* | 1.56 (1.23–1.97)* |
Osteoporosis | Psychosis only | Incontinence | Pain | Pain (meds) | |||||
Age | 1.01 (0.98–1.03) | 1.01 (0.98–0.05) | 1.02 (0.99–1.04) | 0.99 (0.97–1.01) | 1.00 (0.98–1.01) | ||||
Gender | |||||||||
Male | |||||||||
Female | 5.20 (3.33–8.09)* | 2.00 (1.34–2.97)* | 2.13 (1.59–2.85)* | 1.20 (0.97–1.50) | 1.43 (1.13–1.80)* | ||||
Marital Status | |||||||||
Married | |||||||||
Never Married | 0.76 (0.39–1.45) | 1.10 (0.60–2.02) | 1.04 (0.65–1.67) | 1.19 (0.84–1.67) | 1.43 (1.00–2.00) | ||||
Separated/Divorced | 0.77 (0.29–2.05) | 1.71 (0.76–3.85) | 1.37 (0.68–2.70) | 1.20 (0.69–2.08) | 1.19 (0.66–2.10) | ||||
Widowed | 1.07 (0.73–1.56) | 0.85 (0.55–1.32) | 1.25 (0.91–1.71) | 0.94 (0.73–1.22) | 0.88 (0.67–1.16) | ||||
Education | |||||||||
Primary/None | |||||||||
Secondary | 1.15 (0.79–1.67) | 0.68 (0.44–1.05) | 1.10 (0.82–1.49) | 0.80 (0.63–1.02) | 0.83 (0.64–1.00) | ||||
Third/Higher Level | 1.23 (0.76–1.97) | 0.89 (0.59–1.59) | 1.07 (0.73–1.57) | 1.00 (0.75–1.32) | 0.78 (0.57–1.00) | ||||
Poor Delayed Recall | 1.32 (0.92–1.89) | 1.40 (0.96–2.06) | 1.24 (0.93–1.65) | 0.98 (0.78–1.23) | 1.17 (0.92–1.40) | ||||
Depression (Yes) | 1.36 (0.87–2.14) | 2.00 (1.27–3.14)* | 2.40 (1.70–3.40)* | 1.59 (1.16–2.16)* | 1.30 (0.93–1.80) | ||||
Polypharmacy | 1.57 (1.14–2.20)* | 1.27 (0.89–1.01) | 1.92 (1.48–2.50)* | 1.27 (1.03–1.56)* | 1.49 (1.19–1.80)* |