Reducing Antipsychotic Medication Use in Long Term Care

Across Canada, more than one in four seniors in long term care (LTC) is on antipsychotic medication without a diagnosis of psychosis. The rates vary greatly between LTC homes and jurisdictions, pointing to the potentially inappropriate use of these medications.

In 2014-2015, CFHI worked with 56 long term care homes that agreed to curb the inappropriate prescribing of antipsychotic medication to seniors.

Participants received seed funding and training to implement programs to reduce and eliminate antipsychotic use, along with coaching and mentoring, educational materials, tools, and forums for sharing with other sites. The goal was to lower the use of antipsychotics, and improve the quality of care and quality of life for residents.



Long term care homes see results of reducing antipsychotics

Three women smiling together

The best health evidence says 5-15% of seniors in long-term care facilities should be on antipsychotic medication. Yet recent studies show that as many as five times that many are on these drugs. What happens if they’re weaned off? A new CFHI initiative shows a significant improvement in care and huge potential savings from fewer falls and hospital visits. Media release »  Results »

Backgrounders:  Atlantic Canada  |   Ontario / Quebec  |   Western Canada

A group of women smilingReport shows big savings from better care

For many seniors in long term care, antipsychotic medication can be minimally effective at best. At worst, it can cause harmful side effects and contribute to falls and hospitalizations. LTC homes that participated in a CFHI collaborative, across seven provinces and one territory, were able to eliminate or significantly reduce the use of antipsychotics. If these efforts were scaled up, they could improve quality of life for tens of thousands of seniors in LTC, and save millions of dollars in prescriptions and ER and hospital costs.


long term care residents playing with a beach ball

The family view

Antipsychotic medications changed their loved ones – and not for the better. Two adult children share the stories of what happened to their parents in long term care, and how their care and comfort dramatically improved after the meds stopped.


How we started

The antipsychotics reduction collaborative had its roots in CFHI’s EXTRA: Executive Training Program. Two managers with the Winnipeg Regional Health Authority designed an initiative to help multi-disciplinary teams of healthcare providers better use data from the Resident Assessment Instrument/Minimum Data Set. The goal was to identify patients who may benefit from non-drug therapies to treat behavioural issues associated with dementia.

At one site, staff were trained to provide non-pharmacological approach to managing behaviours associated with dementia. As a result, 27% of a cohort of residents was taken off antipsychotic medication without any increase in behavioural symptoms. This innovation improved quality of life for patients, and translated to a potential cost saving of $400,000 in six months across the region.