OPUS-AP: Best Practices for Appropriate Use of Antipsychotics 

Award Date: 2018

Project Lead(s): Benoît Cossette, Professeur and Olivier Beauchet, Director The Centre of Excellence on Longevity

Project Title: OPUS-AP - ApprOPriate USe of AntiPsychotics in older residents living in long-term care centres: A Quebec program for best practices

What is the issue? 

Up to half of the long-term care residents in Quebec take antipsychotic medications. This is one of the highest utilization rates of antipsychotic medications in CanadaDeprescribing is the practice of stopping or reducing medications. There have been ongoing deprescribing efforts, but the use is still high, especially among individuals with major neurocognitive disorders 

What did we do?  

We implemented a new program called Optimizing Practices, Use, Care and Services Antipsychotics (OPUS-AP) in public long-term care centres in Quebec. The program is based on evidence-based practice and was implemented in two phases. In phase one, we stopped antipsychotic medications or decreased doses in 220 of 334 residents who had been admitted for at least nine months. In phase two, we expanded the program to 10,601 residents in 129 long-term care homes  

What did we find?  

Almost 80 percent of residents had a diagnosis of major neurocognitive disorderand a little over half had a prescription for an antipsychotic medication. The OPUS-AP program identified residents for whom deprescribing could be attempted: half could discontinue antipsychotics, and one-third could take reduced dosesResidents who stopped taking or reduced their medications showed decreased agitation. Caregivers and clinicians reported that these residents experienced an improved quality of life.