Reliability of the medication appropriateness index in Dutch residential home

Clementine C.M. Stuijt, Eric J.F. Franssen, Antoine C.G. Egberts, S. Hudson

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

To validate the reliability of the Medication Appropriateness Index in the appraisal of quality of prescribing by assessing the inter- and intra-group variation in Dutch residential home patients. Eight raters evaluated 81 medication records of 15 patients from a group of older patients living in a residential nursing home the Netherlands. These patients had been recruited for a medication review investigation throughout a period of 12 months over the period April 2003 until April 2004. Patient information was acquired by connecting the medical record with the complete prescription record and pharmaceutical record. Each patient was assessed twice by two independent reviewers on the basis of a patient profile in combination with the extracted medical record and using a structured procedure. A summed MAI score, percent agreement, kappa, positive and negative agreement as well as intra-class correlation coefficient were calculated for each criterion. Medication appropriateness was assessed with the Medication Appropriateness Index (MAI) by an independent panel of Dutch hospital and community pharmacists. The overall percentage agreement was 83%. For each of the 10 different medication appropriateness questions it ranged from 79 to 100% for appropriate and from 47 to 60% for inappropriate ratings. The overall chance adjusted inter-rater agreement reached a moderate kappa score of 0.47. The overall intra-group agreement was very good with an overall percentage of 98 and a kappa score of at least 0.84 (all schemes). In a Dutch institutionalised setting with representative raters, the unmodified MAI can be used as an instrument to quantify changes in appropriateness of prescribing.
Original languageEnglish
Pages (from-to)380-386
Number of pages6
JournalPharmacy World and Science
Volume31
Issue number3
DOIs
Publication statusPublished - 12 Mar 2009

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Prescription Drugs
Nursing
Medical Records
Potentially Inappropriate Medication List
Nursing Homes
Pharmacists
Netherlands

Keywords

  • long term care
  • medication appropriateness index
  • netherlands
  • older people
  • validation

Cite this

Stuijt, C. C. M., Franssen, E. J. F., Egberts, A. C. G., & Hudson, S. (2009). Reliability of the medication appropriateness index in Dutch residential home. Pharmacy World and Science, 31(3), 380-386. https://doi.org/10.1007/s11096-009-9283-2
Stuijt, Clementine C.M. ; Franssen, Eric J.F. ; Egberts, Antoine C.G. ; Hudson, S. / Reliability of the medication appropriateness index in Dutch residential home. In: Pharmacy World and Science. 2009 ; Vol. 31, No. 3. pp. 380-386.
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Reliability of the medication appropriateness index in Dutch residential home. / Stuijt, Clementine C.M.; Franssen, Eric J.F.; Egberts, Antoine C.G.; Hudson, S.

In: Pharmacy World and Science, Vol. 31, No. 3, 12.03.2009, p. 380-386.

Research output: Contribution to journalArticle

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