Claims-Based Algorithm to Identify Pre-Exposure Prophylaxis Indications for Tenofovir Disoproxil Fumarate and Emtricitabine Prescriptions (2012-2014): Validation Study.

Autor:	Sullivan PS; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States., Mera-Giler RM; Universidad Espiritu Santo, Guayaquil, Ecuador., Bush S; Brooklyn, NY, United States., Shvachko V; Gilead Sciences, Foster City, CA, United States., Sarkodie E; Whitman Walker Institute, Washington, DC, United States., O'Farrell D; Brooklyn, NY, United States., Dubose S; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States., Magnuson D; Brooklyn, NY, United States.
Jazyk:	angličtina
Zdroj:	JMIR formative research [JMIR Form Res] 2024 Nov 04; Vol. 8, pp. e55614. Date of Electronic Publication: 2024 Nov 04.
DOI:	10.2196/55614
Abstrakt:	Background: To monitor the use of tenofovir disoproxil fumarate and emtricitabine (TDF/FTC) and related medicines for pre-exposure prophylaxis (PrEP) as HIV prevention using commercial pharmacy data, it is necessary to determine whether TDF/FTC prescriptions are used for PrEP or for some other clinical indication. Objective: This study aimed to validate an algorithm to distinguish the use of TDF/FTC for HIV prevention or infectious disease treatment. Methods: An algorithm was developed to identify whether TDF/FTC prescriptions were for PrEP or for other indications from large-scale administrative databases. The algorithm identifies TDF/FTC prescriptions and then excludes patients with International Classification of Diseases (ICD)-9 diagnostic codes, medications, or procedures that suggest indications other than for PrEP (eg, documentation of HIV infection, chronic hepatitis B, or use of TDF/FTC for postexposure prophylaxis). For evaluation, we collected data by clinician assessment of medical records for patients with TDF/FTC prescriptions and compared the assessed indication identified by the clinician review with the assessed indication identified by the algorithm. The algorithm was then applied and evaluated in a large, urban, community-based sexual health clinic. Results: The PrEP algorithm demonstrated high sensitivity and moderate specificity (99.6% and 49.6%) in the electronic medical record database and high sensitivity and specificity (99% and 87%) in data from the urban community health clinic. Conclusions: The PrEP algorithm classified the indication for PrEP in most patients treated with TDF/FTC with sufficient accuracy to be useful for surveillance purposes. The methods described can serve as a basis for developing a robust and evolving case definition for antiretroviral prescriptions for HIV prevention purposes. (©Patrick Sean Sullivan, Robertino M Mera-Giler, Staci Bush, Valentina Shvachko, Eleanor Sarkodie, Daniel O'Farrell, Stephanie Dubose, David Magnuson. Originally published in JMIR Formative Research (https://formative.jmir.org), 04.11.2024.)
Databáze:	MEDLINE
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