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Measuring Exposure to Opioids Using Self-Reported Medication Use Data Versus General Practitioner Prescription

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Self-reported opioid use in UK Biobank shows moderate agreement with prescription records, especially for analgesic opioids. This suggests self-report can identify regular analgesic opioid users but is less reliable for non-analgesic types.

Keywords:
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Area of Science:

  • Pharmacovigilance
  • Epidemiology
  • Data Science

Background:

  • Global opioid use is rising, necessitating accurate long-term health impact studies.
  • Prospective cohorts often use self-reported data, which can be biased compared to objective measures.
  • The UK Biobank (UKBB) offers a large dataset with linked general practitioner (GP) records for validation.

Purpose of the Study:

  • To evaluate the agreement between self-reported regular opioid use and prescription-based opioid exposure indicators in the UKBB.
  • To assess the reliability of self-reported data against objective prescription records for opioid use.

Main Methods:

  • Analysis of 171,813 UKBB participants with linked GP prescription records.
  • Assessment of agreement between self-reported regular opioid use and prior opioid prescriptions using various look-back periods.
  • Logistic regression to identify factors associated with reporting omissions and commissions.

Main Results:

  • Moderate to substantial agreement (Cohen's Kappa = 0.66 for ≥3 prescriptions in 365 days) was found between self-reported use and prescription records.
  • Agreement was higher for analgesic opioids (Kappa = 0.43-0.63) than non-analgesic opioids (Kappa = 0.25-0.34).
  • Factors like time since last record, chronic pain, and marital status influenced reporting accuracy.

Conclusions:

  • Self-reported regular opioid use in UKBB is a potentially valid indicator for identifying individuals with recent analgesic opioid prescriptions.
  • Self-report may capture opioid use from non-linked sources, but its utility is limited for non-analgesic opioids.
  • Further research is needed to refine self-report measures for diverse opioid types.