Self-reported medication use validated through record linkage to national prescribing data.

Area of Science:

• Epidemiology
• Pharmacovigilance
• Health Services Research

Background:

• Accurate quantification of medication use in epidemiologic studies is crucial for public health.
• Psychiatric medications are suspected to be systematically under-reported in self-report studies.
• Modern record linkage offers a gold standard for validating self-reported medication use.

Purpose of the Study:

• To investigate the validity of self-reported medication use across multiple drug classes.
• To compare the accuracy of self-reported psychiatric medication use with other common medications.
• To identify predictors of accurate medication self-report.

Main Methods:

• Utilized a large population-based cohort (Generation Scotland, N=10,244).
• Matched self-reported regular medication usage against Scottish NHS prescriptions data.
• Employed 3- and 6-month fixed time windows and multivariable logistic regression to analyze predictors.

Main Results:

• High agreement between self-report and prescriptions for antidepressants (κ=0.85) and antihypertensives (κ=0.90).
• Moderate-to-poor agreement for mood stabilizers (κ=0.42).
• Relevant past medical history was the strongest predictor of self-report sensitivity; general intelligence was not predictive.

Conclusions:

• Self-report validity for medication use is variable across different drug classes.
• No straightforward association exists between psychiatric medication use and under-reporting.
• Accurate self-reporting is associated with a history of the indicated illness, regardless of medication type.