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Generalisability of pharmacoepidemiological studies using restricted prescription data
C Brown1, T I Barron2, K Bennett2
1National Cancer Registry Ireland, Building 6800, Cork Airport Business Park, Kinsale Rd, Cork City, Cork, Ireland. c.brown@ncri.ie.
Insights
Medical card status in women with ovarian cancer varies by age and socioeconomic factors. These predictors are crucial for interpreting pharmacoepidemiology research using Irish dispensing data.
Area of Science:
- Epidemiology
- Health Services Research
- Oncology
Background:
- Population-based pharmacoepidemiology research relies on linking medication and disease data.
- Irish dispensing data is limited to the means-tested government-medical cards scheme, potentially affecting generalizability.
- Previous research identified gender as a predictor of medical card status.
Purpose of the Study:
- To compare women with and without medical cards at the time of ovarian cancer diagnosis.
- To investigate factors associated with medical card status in ovarian cancer patients.
- To assess the impact of medical card status on pharmacoepidemiological analyses.
Main Methods:
- Ovarian cancers diagnosed between 2001-2010 were identified from the National Cancer Registry Ireland.
- Logistic regression was used to evaluate associations between demographic and socioeconomic factors (age, region, deprivation, smoking, employment, marital status) and medical card status at diagnosis.
- Cumulative incidence of new medical card receipt post-diagnosis was assessed.
Main Results:
- Of 3396 women diagnosed with ovarian cancer, 1778 (52%) had a medical card at diagnosis.
- Medical card prevalence at diagnosis was 33% for women under 70 and 87% for women 70 and older.
- For women under 70, all evaluated factors were significantly associated with medical card status at diagnosis.
- 52% of women without a medical card at diagnosis obtained one post-diagnosis.
Conclusions:
- Medical card coverage among ovarian cancer patients mirrors the general population.
- Several factors predict medical card status, particularly in women under 70.
- External validity of pharmacoepidemiological studies using Irish dispensing data requires careful consideration due to these predictive factors.
Background:
Linking medication databases to disease registries enables population-based pharmacoepidemiology research. In Ireland, country-wide dispensing data is available only from the means-tested government-medical cards scheme. This restriction may impact generalisability of analyses based on these data.
Aim:
Gender was previously identified as predictor of card status so we aimed to compare women with and without medical cards at the time of ovarian cancer diagnosis.
Methods:
Ovarian cancers diagnosed 2001-2010 were identified from the National Cancer Registry Ireland. Age, region, deprivation, smoking, employment and marital status were evaluated using logistic regression for associations with card status. Cumulative incidence of de novo card receipt post-diagnosis was assessed.
Results:
1778 (52 %) of 3396 women with incident ovarian cancer had a card at diagnosis (<70:33 %; 70+:87 %). Within those <70, all variables were significantly associated with card status at diagnosis. 52 % of those without a card at diagnosis received one post-diagnosis.
Conclusions:
Although medical card coverage within ovarian cancer patients is similar to the general population, various factors predict card status. Particularly within those under 70, external validity needs to be considered when interpreting pharamcoepidemiological analyses using these data.
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