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Antipsychotics are often prescribed to seniors in order to manage behavioural and psychological symptoms of dementia. Yet, in most cases, non-pharmaceutical approaches are a more appropriate and effective first line of treatment. Antipsychotics can cause serious side effects or complications and should be used under strict directives and over limited periods of time.

The inappropriate use of antipsychotics happens in long term care facilities across Canada. The province of Quebec has the highest rate of antipsychotic prescriptions among people aged 65 and older, with 40-to-60% of residents prescribed antipsychotics within certain long term care facilities.

In 2017, government authorities and CEOs of all of Quebec’s health and social service institutions that provide some level of long-term care agreed to launch an integrated collaborative. The collaborative, Optimizing Practices, Use, Care and Services – Antipsychotics (OPUS-AP), operates in close partnership between CFHI, the Ministry of Health and Social Services in Quebec, l’Institut national d’excellene en santé et en services sociaux (INESSS) and Quebec’s leading experts from the four research networks, and is based on CFHI’s Appropriate Use of Antipsychotics (AUA) initiative. The aim of OPUS-AP is to improve the quality and experience of care in long-term care centres (CHSLDs) for people with dementia, their loved ones, and staff.


The collaborative has two phases:

  • Phase I [April 2017 to October 2018]: 24 long term care centres (one unit per establishment)
  • Phase II [January 2019 to April 2020]: 134 long term care centres (325 units within establishments)

Phase I

Phase I of the OPUS-AP collaborative has now ended. It resulted in 85.9% of residents having their antipsychotics discontinued or dose reduced among those for which deprescription was attempted. Among participating organizations, the collaborative also had a positive impact on patient experience, population health, and healthcare provider work life, and reduced costs. To learn more about the OPUS-AP phase I experience, view a testimonial from one of our participating unit chief and project managers [available in French only]. To read more of our phase I results view our poster below.

Phase II

OPUS-AP phase II is underway. See our two videos showcasing one of our train-the-trainer sessions and a phase II launch workshop from March 2019 at Sainte-Justine Hospital in Montréal.

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