Development and validation of the medication-based disease burden index

Area of Science:

• Pharmacology and Health Services Research
• Development and validation of novel health metrics
• Quantification of chronic disease burden

Background:

• Medication lists serve as a valuable data source for assessing comorbidities and disease burden.
• Existing methods for disease burden assessment can be resource-intensive.
• A need exists for convenient and cost-effective tools to measure disease burden.

Purpose of the Study:

• To develop and validate the Medication-Based Disease Burden Index (MDBI).
• To establish the MDBI as a reliable and valid measure of disease burden.
• To assess the MDBI's utility in predicting patient outcomes.

Main Methods:

• A medication list for 20 chronic conditions was finalized by expert consensus.
• The MDBI was pilot tested on patients at risk of medication misadventure.
• Criterion validity was assessed against Charlson's index and Chronic Disease Score (CDS), alongside reliability and predictive validity analyses.

Main Results:

• The MDBI was developed, incorporating medications for 20 chronic conditions with disability weightings.
• MDBI scores correlated significantly with Charlson's index (r=0.31) and CDS (r=0.53).
• The MDBI demonstrated high sensitivity, specificity, and predictive validity for death and readmissions (OR=4.7), with excellent inter-rater (ICC=0.99) and test-retest (ICC=0.98) reliability.

Conclusions:

• The Medication-Based Disease Burden Index (MDBI) is a novel tool for quantifying disease burden.
• Initial validation suggests MDBI is a reliable and valid measure.
• MDBI offers a low-cost, convenient method for assessing disease burden and predicting health outcomes.