Int J Pharm Pract 1999:7:129-37

Faculty of Pharmacy and Pharmaceutical Sciences, 3118 Dentistry/Pharmacy Building, University of Alberta, Edmonton, Alberta, Canada T6G 2N8
Carlyn I. Volume, BScPharm, MSc PhD candidate
Lisa M. Burback, pharmacy student and research assistant
Karen B. Farris, BS Pharm, PhD associate professor

Correspondence: Ms Volume cvolume@pharmacy.ualberta.ca

Original Papers

Reassessing the MAI: elderly people's opinions about medication appropriateness

CARLYN I. VOLUME, LISA M. BURBACK and KAREN B. FARRIS

Objectives - To identify the criteria that the elderly use to assess the appropriateness of their medications, rank the identified criteria in terms of importance, and compare elderly people's and clinicians' ratings of the importance of medication appropriateness index (MAI) criteria.
Methods - A qualitative method was used to understand why elders' rankings of appropriateness criteria may or may not differ from clinicians'. Five focus groups with 38 elderly people were completed and content analysed. The participants also completed a written ranking of 10 criteria, indicating them as being of high importance, moderate importance or low importance.
Key findings - Overall, the group discussion cited indication, effectiveness and drug-drug interactions as most important. The written ranking of the MAI criteria suggested drug-drug interactions and correct directions as being most important. Elderly people appeared to have difficulty ranking the criteria of indication and effectiveness, as there was some evidence that they took these criteria for granted. Differences among focus group participants appeared to be due to their varied medication use experience.
Conclusion - These findings suggest that drug-drug interactions may be ranked highly important and practicality ranked moderately important when elderly patients' opinions are sought about medication appropriateness. Further research should be conducted to assess whether the MAI is accountable to patient viewpoints.