How well does patient self-report predict asthma medication possession? Implications for medication reconciliation and adherence assessment

J Asthma. 2010 Oct;47(8):878-82. doi: 10.3109/02770903.2010.491143.


Background: Self-report is the most commonly used method for collecting information regarding asthma medication possession and adherence in clinical practice.

Objective: To determine the agreement between self-report and pharmacy claims data for asthma medication possession.

Methods: This is a retrospective study that examined pharmacy claims data 12 months before and after participants completed a structured asthma survey. This study was performed in a sample of health care workers and dependents >17 years old in a large, self-insured Midwestern United States health care center. The main outcome measure was agreement (kappa calculation) between self-report and pharmacy claims data of asthma medication possession.

Results: Self-report of asthma medication use agreed moderately with pharmacy claims data for short-acting albuterol (κ=0.47 ± 0.03), salmeterol (κ=0.79 ± 0.04), and montelukast (κ=0.69 ± 0.03) but only slightly for inhaled corticosteroids (κ=0.18 ± 0.03) and prednisone (κ=0.10 ± 0.03) (n=1050 respondents). Both under self-reporting and over self-reporting were common with inhaled corticosteroids (14.4% and 23.1%, respectively) and varied significantly by specific drug type.

Conclusions: Self-report moderately agrees with asthma medication possession for most adult asthma patients, though the agreement differs considerably between and within asthma medication classes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anti-Asthmatic Agents / therapeutic use*
  • Asthma / diagnosis*
  • Asthma / drug therapy*
  • Asthma / psychology
  • Female
  • Health Personnel
  • Humans
  • Insurance Claim Review
  • Male
  • Medication Adherence*
  • Middle Aged
  • Midwestern United States
  • Predictive Value of Tests
  • Retrospective Studies
  • Sensitivity and Specificity
  • Surveys and Questionnaires


  • Anti-Asthmatic Agents