OBJECTIVES

: To analyze concordance and associated factors between self-declared chronic conditions and drug consumption, and individual medical records of diseases and pharmacy claims.

METHODS

: Cross-sectional study in an integrated health organization (IHO) in Baix Empordà (Catalonia). Proportional stratified sample of residents older than 14 years old (N=90,523) according to sex, age group and burden of disease, using 3M Clinical Risk Groups (CRG) grouper (N = 1,012). Individuals were asked if they had a chronic condition, from a list of chronic conditions. The same scheme was repeated for drug consumption. We analysed concordance and associated factors with medical records of diseases and pharmacy claims registered in IHO databases. Data collection: Telephone survey. Statistical analysis included frequencies, Kappa concordance index and logistic regression with a confidence level of 95%.

RESULTS

: The higher level of concordance was for Diabetes Mellitus (k=0.837); Fibromyalgia (k=0.754); thyroid diseases (k=0.738) and malignant neoplasms (k=0.703). 13 diseases presented a kappa below 0,4 including COPD, migraines, hyperlipidaemias or chronic back pain. A significant share of individuals (49,2% persons) disagree in chronic condition (k=0.071, p<0,011). Disagreement was associated with age and burden of disease (bivariate analysis) but both were no statistical significant when adjusted in logistic regression.

Similar findings appeared for drug consumption. The best concordance was for antidiabetic, antihypertensive and anticholesterol drugs (kappa about 0,8 for all three groups). Disagreement about drug consumption was associated with high burden of disease (OR=19,06) and age (OR=3,02) in a logistic regression.

CONCLUSIONS

: There are differences between self-reported chronic conditions and drug consumption, and registered chronic conditions and pharmacy claims. Improving the transmission of clinical knowledge from healthcare system actors to patients can have a positive impact on the engagement of patients and their use of medications.