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