| Validity of medication-based co-morbidity indices in the Australian elderly population. | |
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MedLine Citation:
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PMID: 19413854 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: To determine the validity of two medication-based co-morbidity indices, the Medicines Disease Burden Index (MDBI) and Rx-Risk-V in the Australian elderly population. METHODS: In Phase I, the sensitivity and specificity of both indices were determined in 767 respondents from wave 6 of the Australian Longitudinal Study of Ageing (ALSA). Medication-defined index disease categories were compared to self-reported medical conditions. Correlation with self-rated health was examined and Cox proportional hazards models were used to assess the predictive validity for mortality. Phase II verified the predictive ability of Rx-Risk-V in a sample of 213,191 veterans from Australian Department of Veterans' Affairs (DVA) database. RESULTS: MDBI and Rx-Risk-V scores could be calculated for 28% and 73% of the ALSA sample respectively. Both indices had high specificities and low to moderate sensitivities compared to self-reported medical conditions. Total weighted scores were significantly related to self-rated health (p<0.001). Both indices were predictive of mortality (Hazard Ratio (HR) =3.690 (95% CI 2.264-6.015) for MDBI and HR 1.079 (95% CI 1.045-1.114) for Rx-Risk-V. The predictive validity for mortality of Rx-Risk-V was confirmed using DVA data (HR= 1.090, 95% CI 1.088-1.092). CONCLUSIONS: Medication-based co-morbidity indices Rx-Risk-V and MDBI are valid measures of co-morbidity. However, Rx-Risk-V detects more comorbidity in the Australian elderly population and is likely to be a more suitable index to use in administrative datasets, particularly where studies include large numbers of outpatients. |
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Authors:
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Agnes Vitry; Soo Ann Wong; Elizabeth E Roughead; Emmae Ramsay; John Barratt |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Validation Studies |
Journal Detail:
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Title: Australian and New Zealand journal of public health Volume: 33 ISSN: 1326-0200 ISO Abbreviation: Aust N Z J Public Health Publication Date: 2009 Apr |
Date Detail:
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Created Date: 2009-05-05 Completed Date: 2009-05-26 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9611095 Medline TA: Aust N Z J Public Health Country: Australia |
Other Details:
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Languages: eng Pagination: 126-30 Citation Subset: IM |
Affiliation:
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Sansom Institute, University of South Australia, Adelaide, Australia. Agnes.Vitry@unisa.edu.au |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Australia / epidemiology Comorbidity* Drug Utilization Health Status Indicators* Humans Longitudinal Studies Mortality Prescription Drugs / therapeutic use* Proportional Hazards Models Questionnaires / standards* Sensitivity and Specificity Veterans |
| Grant Support | |
ID/Acronym/Agency:
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AG08523-02/AG/NIA NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Prescription Drugs |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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