TY  - JOUR
AU  - Sullivan, Patrick Sean
AU  - Mera-Giler, Robertino M
AU  - Bush, Staci
AU  - Shvachko, Valentina
AU  - Sarkodie, Eleanor
AU  - O'Farrell, Daniel
AU  - Dubose, Stephanie
AU  - Magnuson, David
PY  - 2024
DA  - 2024/11/4
TI  - Claims-Based Algorithm to Identify Pre-Exposure Prophylaxis Indications for Tenofovir Disoproxil Fumarate and Emtricitabine Prescriptions (2012-2014): Validation Study
JO  - JMIR Form Res
SP  - e55614
VL  - 8
KW  - pre-exposure prophylaxis
KW  - PrEP
KW  - classification
KW  - electronic medical record
KW  - EMR
KW  - algorithm
KW  - electronic health record
KW  - EHR
KW  - drug
KW  - pharmacology
KW  - pharmacotherapy
KW  - pharmaceutical
KW  - medication
KW  - monotherapy
KW  - HIV
KW  - prevention
AB  - 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. 
SN  - 2561-326X
UR  - https://formative.jmir.org/2024/1/e55614
UR  - https://doi.org/10.2196/55614
UR  - http://www.ncbi.nlm.nih.gov/pubmed/39141024
DO  - 10.2196/55614
ID  - info:doi/10.2196/55614
ER  -