Background: Positive associations between medication adherence and beneficial outcomes primarily come from studying filling/consumption behaviors after therapy initiation. Few studies have focused on what happens before initiation, the point from prescribing to dispensing of an initial prescription. 
Objective: to provide guidance and encourage high-quality research on the relationship between beneficial outcomes and initial medication adherence (IMA), the rate initially prescribed medication is dispensed.

Using “Initial Medication Adherence” IMA rigorously & include providing convincing evidence that initial prescribing and dispensing events are identified, supplemental parameters incorporating perspective and substitution biases are addressed, and contextual parameters are included.

Medications are the most common treatment regimen used in ambulatory health care. Yet, adhering to prescribed medications is a major issue affecting health care because nonadherence has been associated with worsening clinical symptoms and disease progression. Furthermore, medication nonadherence has been linked to increased health care visits, services, and costs. Studies linking nonadherence to these unfavorable outcomes have used various operational definitions for adherence—each with its own nomenclature (e.g., persistence), several representing similar if not exact components of medication adherence, which we call initial medication adherence (IMA). 

For example: the IMA process begins with a prescriber and patient interaction in an emergency room/ department, hospital, or other clinic setting (step 1) that results in a prescribing event (step 2)—the first of the two key events needed for an IMA measurement. When a prescribing event occurs, data collected from the perspective of either a prescriber or a patient will capture it, whereas data collected from the perspective of a pharmacist will not. To qualify as IMA, however, the prescribing event must relate to a patient’s first prescription within a therapeutic class (step 4).

Otherwise, the dispensing event becomes part of a PIMA metric (step 5).

Data from either the patient or the prescriber should be able to determine whether the prescribing event is an initial event. The pharmacist becomes aware of prescribing events only when these events are communicated to the pharmacist for filling (step 6).

Therefore, the pharmacist does not know how many prescribing events have occurred, only how many have been communicated. However, once the pharmacist receives the prescription (step 7) and fills it (step 8), the pharmacist must dispense the prescription to the patient (step 9). The dispensing event is the second key event needed for measuring IMA (step 10).

With dispensing the medication to the patient, both the pharmacist and the patient know that the IMA is achieved, but the prescriber does not. If a pharmacist does not dispense a filled prescription, the prescription becomes abandoned to the pharmacist and is restocked (step 11).

If an abandoned prescription is not transferred to another pharmacist (step 12) and subsequently dispensed, the patient will be initially nonadherent (step 13). Either the pharmacist or the prescriber may transfer the prescription from one pharmacy to another, but neither may know that the prescription has been dispensed. 


— How can pharmacists use the IMA process in communications with physicians? — Explain how pharmacists can educate patients about better adherence with their initial prescriptions—What are the main reasons for medication non-adherence? 

Background: Positive associations between medication adherence and beneficial outcomes primarily come from studying filling/consumption behaviors after therapy initiation.&nbsp;Few studies have focused on what happens before initiation, the point from prescribing to dispensing of an initial prescription.&nbsp; Objective:&nbsp;to provide guidance and encourage high-quality research on the relationship between beneficial outcomes and initial medication adherence (IMA), the rate initially prescribed medication is dispensed.
Using &ldquo;Initial Medication Adherence&rdquo; IMA rigorously &amp; include providing convincing evidence that initial prescribing and dispensing events are identified, supplemental parameters incorporating perspective and substitution biases are addressed, and contextual parameters are included.
Medications are the most common treatment regimen used in ambulatory health care. Yet, adhering to prescribed medications is a major issue affecting health care because nonadherence has been associated with worsening clinical symptoms and disease progression. Furthermore, medication nonadherence has been linked to increased health care visits, services, and costs. Studies linking nonadherence to these unfavorable outcomes have used various operational definitions for adherence&mdash;each with its own nomenclature (e.g., persistence), several representing similar if not exact components of medication adherence, which we call initial medication adherence (IMA).&nbsp;
For example: the IMA process begins with a prescriber and patient interaction in an emergency room/ department, hospital, or other clinic setting (step 1) that results in a prescribing event (step 2)&mdash;the first of the two key events needed for an IMA measurement. When a prescribing event occurs, data collected from the perspective of either a prescriber or a patient will capture it, whereas data collected from the perspective of a pharmacist will not. To qualify as IMA, however, the prescribing event must relate to a patient&rsquo;s first prescription within a therapeutic class (step 4).
Otherwise, the dispensing event becomes part of a PIMA metric (step 5).
Data from either the patient or the prescriber should be able to determine whether the prescribing event is an initial event. The pharmacist becomes aware of prescribing events only when these events are communicated to the pharmacist for filling (step 6).
Therefore, the pharmacist does not know how many prescribing events have occurred, only how many have been communicated. However, once the pharmacist receives the prescription (step 7) and fills it (step 8), the pharmacist must dispense the prescription to the patient (step 9). The dispensing event is the second key event needed for measuring IMA (step 10).
With dispensing the medication to the patient, both the pharmacist and the patient know that the IMA is achieved, but the prescriber does not. If a pharmacist does not dispense a filled prescription, the prescription becomes abandoned to the pharmacist and is restocked (step 11).
If an abandoned prescription is not transferred to another pharmacist (step 12) and subsequently dispensed, the patient will be initially nonadherent (step 13). Either the pharmacist or the prescriber may transfer the prescription from one pharmacy to another, but neither may know that the prescription has been dispensed.&nbsp;
 &mdash; How can pharmacists use the IMA process in communications with physicians?&nbsp;&mdash; Explain how pharmacists can educate patients about better adherence with their initial prescriptions&mdash;What are the main reasons for medication non-adherence?&nbsp;

In March of 2009, Todd S. Eury, launched the Pharmacy Podcast Show. Over the years, the Pharmacy Podcast has accumulated over 75,000+ listeners and subscribers and is the most popular and downloaded podcast about the Pharmacy Industry.

The Pharmacy Podcast Show transformed into the Pharmacy Podcast Network (PPN) in 2014 and will continue to collect the thought leading interviews with some of the most brilliant minds in Pharmacy with over 30 co-hosts. The PPN is a Digital Health Publication and Content Developing partner to the Pharmaceutical industry focusing on Specialty medications, pharmacy business supportive technologies, and industry trends.

The PPN is the world's largest network of podcasts dedicated to the pharmacy professional and industry insiders leading with our hosts interviewing dynamic people in the pharmacy industry making a difference for our profession, customers, and patients.

The definition of “Innovation” is: A new method, idea, product, or process. Processing, implementing, operating, or designing beyond the status-quo. Pharmacists are the HUB of Healthcare & the PPN is the Pharmacist's biggest fan. 

In March of 2009, Todd S. Eury, launched the Pharmacy Podcast Show. Over the years, the Pharmacy Podcast has accumulated over 75,000+ listeners and subscribers and is the most popular and downloaded podcast about the Pharmacy Industry.
The Pharmacy Podcast Show transformed into the Pharmacy Podcast Network (PPN) in 2014 and will continue to collect the thought leading interviews with some of the most brilliant minds in Pharmacy with over 30 co-hosts. The PPN is a Digital Health Publication and Content Developing partner to the Pharmaceutical industry focusing on Specialty medications, pharmacy business supportive technologies, and industry trends.
The PPN is the world's largest network of podcasts dedicated to the pharmacy professional and industry insiders leading with our hosts interviewing dynamic people in the pharmacy industry making a difference for our profession, customers, and patients.
The definition of &ldquo;Innovation&rdquo; is: A new method, idea, product, or process. Processing, implementing, operating, or designing beyond the status-quo. Pharmacists are the HUB of Healthcare &amp; the PPN is the Pharmacist's biggest fan.&nbsp;

Pharmacy Podcast Network

The Pharmacy Podcast Network is ranked as the number one podcast in healthcare dedicated to the Business of Pharmacy and TOP 25 Podcasts in U.S. Business News. The most influential voices in the pharmacy industry are published on the Pharmacy Podcast Network (PPN). The PPN is the leading audio authority of the pharmaceutical & pharmacy industry with more than 30 hosts, 1,200+ episodes, supporting more than 25+ pharmacy industry associations, with more than 80,000 listeners world wide. 

The PPN is an Audio Branding & Public Relations Communications company dedicated to the Pharmaceutical industry focusing on Community, Long-term care, Health System, Specialty, pharmacy business supportive technologies, and industry trends. 

Pharmacy Podcast™ is a registered trademark

The Pharmacy Podcast Network is ranked as the number one podcast in healthcare dedicated to the Business of Pharmacy and TOP 25 Podcasts in U.S. Business News. The most influential voices in the pharmacy industry are published on the Pharmacy Podcast Network (PPN). The PPN is the leading audio authority of the pharmaceutical &amp; pharmacy industry with more than 30 hosts, 1,200+ episodes, supporting more than 25+ pharmacy industry associations, with more than 80,000 listeners world wide.&nbsp;
The PPN is an Audio Branding &amp; Public Relations Communications company dedicated to the Pharmaceutical industry focusing on Community, Long-term care, Health System, Specialty, pharmacy business supportive technologies, and industry trends.&nbsp;
Pharmacy Podcast&trade; is a registered trademark

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