Medication Appropriateness Index (MAI)
Background - using this tool
This tool requires the user to answer 10 questions regarding a particular
medication in order to determine its appropriateness for a patient. The
score is automatically calculated after submitting the responses.
The indication and effectiveness of a particular drug are given the most weight.
All 'yes' responses have a score of zero, while 'no' responses have values
ranging from 1 to 3 depending on its importance in assessing the appropriateness
of a particular drug. The maximum score is 18 which translates into
maximum inappropriateness. If a patient is on multiple drugs, this test
can be repeated for each drug in order to determine a total MAI score (simply
add the results for each drug reviewed). 1,2,3
A modified version has also been studied: Somers A,
Mallet L, van der Cammen T, Robays H, Petrovic M. Applicability of an adapted
medication appropriateness index for detection of drug-related problems in
geriatric inpatients. Am J Geriatr Pharmacother. 2012 Apr;10(2):101-9. doi:
10.1016/j.amjopharm.2012.01.003. Epub 2012 Feb 1.
Answer the following questions - comments are optional
- Is there an indication for the drug?
- Is the medication effective for the condition?
- Is the dosage correct?
- Are the directions correct?
- Are the directions practical or capable of being put into practice?
- Are there clinically significant drug-drug interactions?
- Are there clinically significant drug-disease/condition
- Is there unnecessary duplication with other drug(s)?
- Is the duration of therapy acceptable?
- Is this drug the least expensive alternative compared to others of
- Samsa GP, Hanlon JT, Schmader KE, Weinberger M, Clipp EC, Uttech KM,
Lewis IK, Landsman PB, Cohen HJ. A summated score for the medication
appropriateness index: development and assessment of clinimetric
properties including content validity. J Clin Epidemiol.
- Hanlon J, Schmader K, Samsa G, Weinberger M, Uttech KM, Lewis IK,
Cohen HJ, Feussner JR. A method for assessing drug therapy
appropriateness. J Clin Epidemiol. 1992;45:1045-1051.
- West, LM., Cordina, M. & Cunningham, S. Clinical pharmacist
evaluation of medication inappropriateness in the emergency department
of a teaching hospital in Malta. Pharmacy Practice 2012;10 (14) 181-187.