%0 Journal Article
%@ 2561-326X
%I JMIR Publications
%V 8
%N 
%P e55614
%T Claims-Based Algorithm to Identify Pre-Exposure Prophylaxis Indications for Tenofovir Disoproxil Fumarate and Emtricitabine Prescriptions (2012-2014): Validation Study
%A Sullivan,Patrick Sean
%A Mera-Giler,Robertino M
%A Bush,Staci
%A Shvachko,Valentina
%A Sarkodie,Eleanor
%A O'Farrell,Daniel
%A Dubose,Stephanie
%A Magnuson,David
%+ Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, CNR 2005, Atlanta, GA, 30322, United States, 1 40421016039, pssulli@emory.edu
%K pre-exposure prophylaxis
%K PrEP
%K classification
%K electronic medical record
%K EMR
%K algorithm
%K electronic health record
%K EHR
%K drug
%K pharmacology
%K pharmacotherapy
%K pharmaceutical
%K medication
%K monotherapy
%K HIV
%K prevention
%D 2024
%7 4.11.2024
%9 Original Paper
%J JMIR Form Res
%G English
%X 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. 
%M 39141024
%R 10.2196/55614
%U https://formative.jmir.org/2024/1/e55614
%U https://doi.org/10.2196/55614
%U http://www.ncbi.nlm.nih.gov/pubmed/39141024