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Medication-based measures of morbidity may be valuable resources in the primary-care setting where access to medical data can be limited. We compare the agreement between patient self-reported and medication-based morbidity; and examine potential patient-level predictors of discordance between these two measures of morbidity in an older (\u2265 50\u2009years) community-based population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective cohort study was performed using national pharmacy claims data linked to The Irish LongituDinal study on Ageing (TILDA). Morbidity was measured by patient self-report (TILDA) and two medication-based measures, the Rx-Risk (&lt;\u200965\u2009years) and Rx-Risk-V (\u226565\u2009years), which classify drug claims into chronic disease classes. The kappa statistic measured agreement between self-reported and medication-based morbidity at the individual patient-level. Multivariate logistic regression was used to examine patient-level characteristics associated with discordance between measures of morbidity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Two thousand nine hundred twenty-five patients were included (&lt;\u200965\u2009years:<jats:italic>N<\/jats:italic>\u2009=\u20091095, 37.44%; and\u2009\u2265\u200965\u2009years:<jats:italic>N<\/jats:italic>\u2009=\u20091830 62.56%). Hypertension and high cholesterol were the most prevalent self-reported morbidities in both age cohorts. Agreement was good or very good (\u03ba\u2009=\u20090.61\u20130.81) for diabetes, osteoporosis and glaucoma; and moderate for high cholesterol, asthma, Parkinson\u2019s and angina (\u03ba\u2009=\u20090.44\u20130.56). All other conditions had fair or poor agreement. Age, gender, marital status, education, poor-delayed recall, depression and polypharmacy were significantly associated with discordance between morbidity measures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Most conditions achieved only moderate or fair agreement between self-reported and medication-based morbidity. In order to improve the accuracy in prevalence estimates of multimorbidity, multiple measures of multimorbidity may be necessary. Future research should update the current Rx-Risk algorithms in-line with current treatment guidelines, and re-assess the feasibility of using these indices alone, or in combination with other methods, to yield more accurate estimates of multimorbidity.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s12877-020-01684-8","type":"journal-article","created":{"date-parts":[[2020,8,10]],"date-time":"2020-08-10T17:03:48Z","timestamp":1597079028000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Agreement between self-reported morbidity and pharmacy claims data for prescribed medications in an older community based population"],"prefix":"10.1186","volume":"20","author":[{"given":"Clionadh","family":"Mannion","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Hughes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank","family":"Moriarty","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathleen","family":"Bennett","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caitriona","family":"Cahir","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,8,10]]},"reference":[{"key":"1684_CR1","doi-asserted-by":"crossref","first-page":"h176","DOI":"10.1136\/bmj.h176","volume":"350","author":"E Wallace","year":"2015","unstructured":"Wallace E, Salisbury C, Guthrie B, Lewis C, Fahey T, Smith SM. 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