Recall Accuracy for Prescription Medications: Self-report Compared with Database Information

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Abstract
A methodological study was performed in 1992 to evaluate the accuracy of self-reported use of nonsteroidal antiinflammatory drugs (NSAIDs) and noncontraceptive estrogens that had been dispensed during the previous 12 years. A sample of 560 individuals dispensed NSAIDs or estrogens, and 140 individuals without NSAID/estrogen dispensations were selected from the Group Health Cooperative pharmacy database. Demographic, behavioral, and drug information was ascertained by telephone interview for 356 persons with and 98 persons without NSAID/estrogen dispensations. Of those with only a single NSAID dispensation, 41% (95% confidence interval (Cl) 32–50%) were able to recall any NSAJD use compared with 85%(95% Cl 76–94%) for those with multiple NSAID dispensations. Thirty percent (95% Cl 24–36%) recalled the NSAID name, and 15% (95% Cl 10 –20%) recalled both the name and dose. For estrogens, 78% (95%Cl 70–86%) recalled the name, but only 26% (95%Cl 17–34%) recalled the name and dose. Age, but not sex, appeared to influence recall accuracy: Persons 50–65 years of age recalled the NSAID name more accurately than those aged 66–80 (odds ratio (OR) = 1.8, 95% confidence interval (CO 1.0–3.4). A similar advantage was noted for 50- to 65-year-old women in recalling the estrogen name (OR = 1.5, 95% Cl 0.6–3.9). Drug name was recalled more frequently for exposures stopped 2–3 years prior to interview than for those stopped 7–11 years prior (OR =3.0, 95%Cl 1.6–5.7, and OR = 2.4, 95%Cl 0.9–6.7, for NSAIDs and estrogens, respectively). Specificity was consistently high, ranging from 92%to 100%. This study suggests significant underascertainment of self-reported prescription drug exposure but little evidence that exposures are overreported. Am J Epidemiol 1995;142:1103–12.

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