On Call Innovation Conversation

Transforming Care for the Elderly: ensuring that seniors receive appropriate and person-centred care

Session 2: Engaging pharmacists and interdisciplinary care teams to improve prescribing of antipsychotics and to curtail polypharmacy

Held January 11, 2017



Did you know?

  • Evidence shows that 5‒15% of seniors in long term care (LTC) facilities should be on antipsychotic medication, yet the national average is much higher. Currently, 27% of Canadian seniors in long term care are inappropriately using antipsychotics.
  • One in four residents in LTC in Canada receives antipsychotics without a diagnosis of psychosis.
  • The use of some medication, especially as people get older, can cause more harm than good. Antipsychotic use is associated with harmful side effects and is often not effective in treating behaviours in LTC residents.


Consider this …

The implications of polypharmacy and the “prescribing cascade” is a common situation in eldercare. Optimizing medication through targeted deprescribing is an important part of managing chronic conditions. A central part of optimizing medication in the elderly (or any population) is to create time and space for pharmacists and physicians to work within an interdisciplinary team to aid in the management of patient care through medication reviews and monitoring.

A new pharmacy practice model is being advanced in New Brunswick that aims to improve prescribing and care outcomes for seniors. Through this practice model, pharmacists perform thorough medication reviews and complete technical and ‘cognitive’ checks to assess the appropriateness of drug therapies prescribed, and collaborate with other care providers, including physicians and nurse practitioners, to implement any revisions to a medication care plan. Early results suggest the model works to reduce the number of medications prescribed and can improve care outcomes, relative to when care is not as directly managed by pharmacists.

Be part of the conversation!

This interactive On Call session will be presented by clinical experts in appropriate prescribing (including a representative from CFHI’s Pan-Canadian Antipsychotic Reduction Collaborative) and hosted by Kaye Phillips, Senior Director, CFHI, and Jennifer Major, CFHI

Join us to learn:

  • About the success of an innovative pharmacy practice model that aims to improve prescribing and care outcomes for elderly
  • Tips for engaging improving pharmacists and interdisciplinary teams in healthcare improvement initiatives
  • About the prescribing cascade and its implications for medication reviews 


Alistair Bursey is the Chair of the CPhA Board of Directors for the 2016-2017 term. He was elected Vice Chair in 2015 and is the New Brunswick Pharmacists’ Association (NBPA) representative on the Board. A member of the NPBA Board since 2009, Alistair served as Chair from 2011-2014. He has also served on various committees, including the Members Benefit Committee, and was the NBPA representative on the Operations Service Committee on Primary Care for the NB Department of Health. A graduate of Dalhousie University, Alistair is currently a pharmacist-owner in Fredericton.

Krista Millette Rocan PhotoKrista Millette-Rocan is a Certified Geriatric Pharmacist a Certified Diabetes Educator. Krista received her Bachelor of Pharmacy degree from Université Laval in 2007. She immediately started working as a clinical hospital pharmacist in Moncton, specializing in cardiology. She became the primary pharmacist at their heart failure clinic and was one of the first pharmacists in New Brunswick to be actively prescribing as part of a collaborative practice with the cardiologists. Krista moved to Fredericton in 2012 and has since worked at Jean Coutu Pharmacy, focusing on long term care. She actively partnered with York Care Centre throughout CFHI’s pan-Canadian Reducing Antipsychotic Medication Use in Long Term Care collaborative.

Paula Rochon PhotoDr. Paula Rochon is a geriatrician and the vice-president of research at Women’s College Hospital, which is fully affiliated with the University of Toronto. She is a senior scientist at Women's College Research Institute; a professor in the Department of Medicine and Institute of Health Policy, Management and Evaluation at the University of Toronto; and a senior scientist at the Institute for Clinical Evaluative Sciences. In July 2015 she was appointed as the inaugural Retired Teachers of Ontario Chair in Geriatric Medicine at the University of Toronto.



Kaye Phillips PhotoKaye Phillips, Senior Director, CFHI

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Jennifer Major, Senior Improvement Lead, CFHI