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Resources for the Comprehensive Geriatric Assessment based
Proactive and Personalised Primary Care of the Elderly


Medication Appropriateness Index


Purpose : Measures of the appropriateness of prescribing for elderly patients, using 10 criteria for each medication prescribed.

Admin time :  Highly operator dependent, and increases progressively for each additional medication.

User Friendly :  Straightforward but painstaking.

Administered by : GP, Physician, Community pharmacist


Content : Questions pertaining to the following aspects of prescribing for the individual: indication, effectiveness, dose, correct directions, practical directions, drug-drug / drug-disease interactions, duplication, duration of therapy, cost comparison with alternatives.


Orginal Author : Hanlon JT et al. 1992

​​Copyright : Public domain

Modified by : Grazioli A, 2021

Copyright : Public domain

MAI (modified)

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.

This Tool is used in the Medication Review

Back To : Medication Review

medication tablets capsules
medical assessment blood pressure measurement medication pills

The Medication Review is one of 5 sub-domains of the

 Medical Assessment

Back To : Medical Assessment

The Medical Assessment is one of 8 domains of the

 Comprehensive Geriatric Assessment (CGA)

Back To : Comprehensive Geriatric Assessment

This Tool is also used in Proactive Care 

 of the Elderly

Back To : Proactive Care

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