APPENDIX I.

Medication Appropriateness Index ^*

1. Is there an indication for the drug?	A_______	B_______	C_________
	Indicated		Not Indicated
Indication is defined as the sign, symptom, disease, or condition for which the medication is prescribed.
2. Is the medication effective for the drug?	A_______	B_______	C_________
	Effective		Not Effective
Effective is defined as producing a beneficial result. The question assesses whether the drug prescribed is capable of being effective for the indication in a population of patients.
3. Is the dosage correct?	A_______	B_______	C_________
	Correct		Not Correct
Dosage is defined as the total amount of medication taken per 24-hour period for regularly scheduled medications.
4. Are the directions correct?	A_______	B_______	C_________
	Correct		Not Correct
Directions are defined as the instructions in the use of a medication by a patient. The question assesses the route of administration, relationship to food and liquid, the schedule, and time of the day.
5. Are the directions practical?	A_______	B_______	C_________
	Practical		Impractical
Practical is defined as capable of being used or being put into practice. This question assesses whether the directions for use are practical for the patient to take and takes into consideration the potential for patient adherence without sacrificing efficacy, as well as formulary status.
6. Are there clinically significant  drug-drug interactions?	A_______	B_______	C_________
	Insignificant		Significant
A drug-drug interaction is defined as the effect that the administration of one medication has on another drug. Clinical significance connotes a harmful interaction.
7. Are there clinically significant  drug-disease/condition interactions?	A_______	B_______	C_________
	Insignificant		Significant
Drug-disease interaction is defined as the effect that the drug has on a pre-existing disease or condition. Clinical significance connotes a harmful interaction. This question assesses whether the drug in question may be worsening the patient’s disease or condition.
8. Is there unnecessary duplication with  other drugs (s)?	A_______	B_______	C_________
	Necessary		Unnecessary
Unnecessary duplication is defined as nonbeneficial or risky copying of drug(s). Unnecessary duplication exists when two drugs from the same chemical or pharmacological class are prescribed simultaneously.
9. Is the duration of therapy acceptable?	A_______	B_______	C_________
	Acceptable		Not Acceptable
Duration is defined as the length of therapy. This question assesses whether the length of time that the patient has received the drug is acceptable.
10. Is this drug the least expensive  alternative compared to others of  equal utility?	A_______	B_______	C_________
	Least		Most
	Expensive		Expensive
This question assesses how the cost of the drug compares to other agents of equal efficacy and safety.

^*Complete instructions are available upon request from Dr. Hanlon