Original Article
Research on sinicization and application of Medication Appropriateness Index
Cai Jun, Li Huixin, Shu Qing, Nie Li, Han Dan, Zhang Jinping
Published 2021-03-28
Cite as ADRJ, 2021, 23(3): 128-133. DOI: 10.3760/cma.j.cn114015-20201202-01149
Abstract
ObjectiveTo establish the Chinese version of Medication Appropriateness Index (MAI) and evaluate the appropriateness of medication in elderly inpatients on trial.
MethodsAccording to Brislin′s translation model for cross-cultural research, the MAI was translated into Chinese through 4 steps: translation, back translation, cultural adaptation, and pre-survey. Using convenient sampling method, 300 elderly inpatients in the Department of Geriatrics, Nanjing Drum Tower Hospital from July to December 2019 were selected as the research subjects, and the Chinese version of MAI was used to evaluate the appropriateness of medication. Reliability of the Chinese version of MAI was evaluated using Cronbach′s α coefficient and intraclass correlation coefficient (ICC); the content validity and structural validity of the Chinese version of MAI were evaluated using 4-level scoring method and exploratory factor analysis, respectively. The appropriateness of medication in 300 elderly inpatients was evaluated by analyzing the MAI scores and the distribution of irrational items.
ResultsThe Chinese version of MAI contained 10 items. The evaluation results of 300 elderly inpatients were statistically analyzed. The Cronbach′s α coefficient of the scale was 0.892 and the ICC of the scale was 0.876 when 20 patients were selected for re-testing 14 days later. The item-level content validity index (I-CVI) of the Chinese version of MAI was 0.86 to 1.00 and the scale-level content validity index/average (S-CVI/Ave) was 0.96. A total of 4 common factors were extracted by exploratory factor analysis, the cumulative variance contribution rate was 58.132%, and the factor loading of 8 items was more than 0.4. The evaluation results of appropriateness of medication showed that the average MAI score in 300 patients was 2.6, of which 198 patients did not score 0; inappropriate medication counted 66.00% and the average MAI score of each drug was 0.2. The top 3 items with more inappropriate medication were drug-disease/abnormal condition interaction (88 cases, 29.3%), duplication (69 cases, 23.0%), and incorrect dosage (67 cases, 22.3%).
ConclusionsThe Chinese version of MAI had good reliability and validity. The items with more inappropriate medication in elderly inpatients in the Department of Geriatrics, Nanjing Drum Tower Hospital were mainly drug-disease/abnormal condition interaction, duplication, and incorrect dose.
Key words:
Aged; Drug utilization review; Translating; Medication appropriateness index
Contributor Information
Cai Jun
Department of Pharmacy, Nanjing Drum Tower Hospital Affiliated to Medical College of Nanjing University, Nanjing Medical Center for Clinical Pharmacy, Nanjing 210008, China
Li Huixin
Department of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing 210009, China
Shu Qing
Department of Pharmacy, Nanjing Drum Tower Hospital Affiliated to Medical College of Nanjing University, Nanjing Medical Center for Clinical Pharmacy, Nanjing 210008, China
Nie Li
Department of Pharmacy, Nanjing Drum Tower Hospital Affiliated to Medical College of Nanjing University, Nanjing Medical Center for Clinical Pharmacy, Nanjing 210008, China
Han Dan
Department of Pharmacy, Nanjing Drum Tower Hospital Affiliated to Medical College of Nanjing University, Nanjing Medical Center for Clinical Pharmacy, Nanjing 210008, China
Zhang Jinping
Department of Pharmacy, Nanjing Drum Tower Hospital Affiliated to Medical College of Nanjing University, Nanjing Medical Center for Clinical Pharmacy, Nanjing 210008, China
