Document Detail


Validity of medication-based co-morbidity indices in the Australian elderly population.
MedLine Citation:
PMID:  19413854     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Agnes Vitry; Soo Ann Wong; Elizabeth E Roughead; Emmae Ramsay; John Barratt
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Validation Studies    
Journal Detail:
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:
Created Date:  2009-05-05     Completed Date:  2009-05-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9611095     Medline TA:  Aust N Z J Public Health     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  126-30     Citation Subset:  IM    
Affiliation:
Sansom Institute, University of South Australia, Adelaide, Australia. Agnes.Vitry@unisa.edu.au
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MeSH Terms
Descriptor/Qualifier:
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:
AG08523-02/AG/NIA NIH HHS
Chemical
Reg. No./Substance:
0/Prescription Drugs

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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