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Thus two dispensing events are required to calculate the measure.
Prescription dispensing events were drawn from a U.S. national claims database including over 80managed-caremanaged-care
The preceding are all classical CMA-type measures in that they do not account for the timing of the dispensing events.
It would also by definition be definable for all subjects, and not just those with one or more dispensing events during the observation window.
The CDM contains over 60 million drug dispensing events, 140 million patient diagnoses, and 360 million clinical observations (e.g., laboratory results, diagnose codes, medications).
For any given participant, let t1, t2, …, tk be the dates of the k ICS dispensing events that occurred during the observation window, and n1, n2, …, nk be the corresponding number of days of medication dispensed at each timepoint.
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In contrast to CMA1, CMA2 requires only one dispensing event to be calculated.
Measurement strategies that require a second dispensing event evidence even greater upward bias.
Comparative analysis found a relative upward bias in adherence estimates for those measures that require at least one dispensing event to be calculated.
The fact that the measurement windows for CMA1, CMA3, and CMA5 also all end with a dispensing event leads to a further upward bias, since they effectively require that one is actively using the medication throughout the measurement window (or at least at both the beginning and end of the window).
Using this information, we define CMA1 as the total days' supply of ICS dispensed between the first and last dispensing event, excluding medications dispensed at the final dispensing event, divided by the elapsed time between these events.
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