Medication appropriateness/safety indicators

There are many measures that have been used as a measure of medication safety including the Medication Appropriateness Index (MAI),⁸² recently developed into Person-Centred Medication Appropriateness Index (PC-MAI), and medication safety indicators.  These focus on assessment of the suitability of a medication for an individual considering drug interactions, drug-disease interactions and contraindications. Core indicators identified in a systemic review support these and include whether medication reviews have been conducted.⁸³

Since 2018, Scotland has used a suite of 17 quality and safety indicators to monitor the appropriateness of polypharmacy. For this updated guidance, these have been peer reviewed with evidence and there are now 27 national indicators. These have been developed to include a sub analysis for care home residents. The full suite is found in Polypharmacy National Therapeutic Indicators. These could be used alongside the cumulative toxicity table when multiple medications are prescribed.