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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. 

Printable form
Drug reviewed

Answer the following questions - comments are optional

  1. Is there an indication for the drug?
  2. Is the medication effective for the condition?

  3. Is the dosage correct?

  4. Are the directions correct?

  5. Are the directions practical or capable of being put into practice?

  6. Are there clinically significant drug-drug interactions?

  7. Are there clinically significant drug-disease/condition interactions?

  8. Is there unnecessary duplication with other drug(s)?

  9. Is the duration of therapy acceptable?

  10. Is this drug the least expensive alternative compared to others of
    equal utility?


  1. 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. 1994;47:891–896.
  2. 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.

  3. 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.

Medication Appropriateness Index Calculator