The Medication Appropriateness Index (MAI) measures the appropriateness of prescribing for elderly patients, using 10 criteria for each medication prescribed.

​

The MAI has been used in observational and interventional studies.

Its feasibility, content validity, predictive validity, and reliability have been demonstrated in ambulatory settings, and use in clinical settings has been recommended.

 

Its limitations are that reliability was lower when assessed by researchers different from the authors and that the original instrument does not address some areas (drug allergy, adverse drug reactions, compliance).

 

In the original MAI, for each criterion, the evaluator rates whether the medication is appropriate, marginally appropriate, or inappropriate. Support is provided through explicit definitions and instructions.

Each criterion is assigned a score of 1-3, with a possible maximum total score of 18.

​

The scoring system has been extensively studied and found to be useful by researchers in observational and interventional studies, but of arbitrary use in clinical settings. Several modifications and interpretation rules have been suggested.

 

The modified version published in this toolkit dispenses altogether with the scoring system and is designed to simply apply the original criteria to each medication in the Medication Review process.

​