Evidence map›Paper›PMID 16200422›Full record

ArticleEuropean journal of clinical pharmacology2005

Reliability of a modified medication appropriateness index in primary care.

Lisbeth Bregnhøj, Steffen Thirstrup, Mogens Brandt Kristensen, Jesper Sonne

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Article in European journal of clinical pharmacology, 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Identification of an updated set of prescribing--safety indicators for GPs.The British journal of general practice : the journal of the Royal College of General Practitioners · 2014
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  13. Development of prescribing-safety indicators for GPs using the RAND Appropriateness Method.The British journal of general practice : the journal of the Royal College of General Practitioners · 2011
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  14. Development and validation of a new Prescription Quality Index.British journal of clinical pharmacology · 2010
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Lisbeth BregnhøjClinical Pharmacology Unit, Gentofte University Hospital, Post 4022, Niels Andersensvej 65, 2900, Hellerup, Denmark. libregn@tiscali.dk
Steffen Thirstrup
Mogens Brandt Kristensen
Jesper Sonne

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo evaluate the inter-group and intra-group reliability of a modified Medication Appropriateness Index (MAI) for use in primary care.

methodsElderly (>65 years) polypharmacy (> or =5 drugs) patients in Copenhagen County participated in the study. Information concerning their medical history and information regarding each drug taken by them was provided by their own general practitioners. A MAI was scored by two groups of evaluators for every drug. To evaluate inter-group agreement, 211 drugs taken by 30 patients were rated according to the ten criteria making up the MAI. Both evaluator groups provided summaries of comments on the medication of each patient. Intra-group agreement was determined from MAI ratings performed twice at two different times on 86 drugs taken by ten patients. Agreement and chance-adjusted agreement were determined, the latter through kappa statistics. The proportion of positive (ppos) and negative (pneg) agreement was also determined.

resultsThe overall chance-adjusted inter-group agreement (kappa) was moderate. The agreement was good on the criteria practical directions and drug-disease interaction, moderate on the criteria dosage and duration, fair on the criteria indication, effectiveness, duplication and expense, and poor on the criterion drug-drug interaction. The overall chance-adjusted intra-group agreement was good for all criteria and very good for the criteria indication and practical directions.

conclusionThe MAI is used to quantify appropriate and inappropriate prescribing and changes in prescribing quality in intervention studies. However, caution should be used when comparing results across different settings and evaluators. Our study suggests that the index should only be used in intervention studies if the same group rates the appropriateness pre- and post-intervention.

Indexed as

AgedAged, 80 and overDenmarkDrug PrescriptionsDrug TherapyDrug Utilization ReviewHumansObserver VariationPractice Patterns, Physicians'Primary Health CareReproducibility of Results

Identifiers

PMID16200422

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.