Optimizing Practices, Use, Care and Services–Antipsychotics (OPUS-AP) in Long-term Care Centers in Québec, Canada: A Strategy for Best Practices

Cossette, Benoȋt; Bruneau, Marie‐Andrée; Couturier, Yves; Gilbert, Suzanne; Boyer, Diane B.; Ricard, Jacques; McDonald, Tanya; Labarre, Karine; Déry, Véronique; Arcand, Marcel; Rodrigue, Claudie; Rhéaume, Andrée-Anne; Moreault, Sylvie; Allard, Catherine; Pépin, Maude-Émilie; Beauchet, Olivier; investigators, Opus-Ap

doi:10.1016/j.jamda.2019.08.027

Cited by 24 publications

(19 citation statements)

References 21 publications

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“…There was low-quality evidence that, in general, discontinuation might make little or no difference to overall neuropsychiatric symptoms, adverse events, quality of life or cognitive function. 226 …”

Section: Interventions and Care In Dementiamentioning

confidence: 99%

Dementia prevention, intervention, and care: 2020 report of the Lancet Commission

et al. 2020

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Prof J Cohen-Mansfield), and Minerva Center for Interdisciplinary Study of End of Life (Prof J Cohen-Mansfield),should consider dementia in older people without known dementia who have frequent admissions or who develop delirium. Delirium is common in people with dementia and contributes to cognitive decline. In hospital, care including appropriate sensory stimulation, ensuring fluid intake, and avoiding infections might reduce delirium incidence.Acting now on dementia prevention, intervention, and care will vastly improve living and dying for individuals with dementia and their families, and thus society.

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Section: Interventions and Care In Dementiamentioning

confidence: 99%

Dementia prevention, intervention, and care: 2020 report of the Lancet Commission

et al. 2020

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“…Many interventions are under way to reduce polypharmacy and PIM use, such as those by the Canadian Deprescribing Network 37 and OPUS-AP for antipsychotics use in Quebec. 38 In fact, polypharmacy and PIM use followed a downward trend over the last years. 5 Finally, visits to the emergency department (ED) are recognized as a factor associated with PIM use.…”

Section: Discussionmentioning

confidence: 99%

A New Care Model Reduces Polypharmacy and Potentially Inappropriate Medications in Long-Term Care

Garland

Guénette

Kröger

et al. 2021

Journal of the American Medical Directors Association

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“…Facilitators discussed by our participants include checkpoints and having another time to carry out an intervention, sharing best practices across the LTC sector, technology, value propositions, and existing avenues to implement changes in LTC homes. In particular, when discussing existing avenues to change in LTC homes, a participant noted “being used to change” as a facilitator to evidence uptake and pointed to previous work done on antipsychotic use reduction in LTC that may pave the way for implementing the Fracture Risk CAP [ 41 ]. On the other hand, studies on implementation of evidence-based tools and guidelines have noted change fatigue as a barrier to knowledge translation [ 42 , 43 ].…”

Section: Discussionmentioning

confidence: 99%

Strategies for the implementation of an electronic fracture risk assessment tool in long term care: a qualitative study

et al. 2021

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Background Older adults in long-term care (LTC) homes experience high rates of fractures, which are detrimental to their quality of life. The purpose of this study is to identify and make recommendations on strategies to implementing an evidence-based Fracture Risk Clinical Assessment Protocol (CAP) in LTC. Methods Following the Behaviour Change Wheel framework, we conducted six focus group interviews with a total of 32 LTC stakeholders (e.g. LTC physicians) to identify barriers and facilitators, suggest implementation strategies, and discuss whether the identified strategies were affordable, practicable, effective, acceptable, safe, and if they promote equity (APEASE). The interviews were transcribed verbatim and analyzed using thematic content analysis. Results Themes of implementation strategies that met the APEASE criteria were minimizing any increase in workload, training on CAP usage, education for residents and families, and persuasion through stories. Other strategy themes identified were culture change, resident-centred care, physical restructuring, software features, modeling in training, education for staff, social rewards, material rewards, public benchmarking, and regulations. Conclusions To implement the Fracture Risk CAP in LTC, we recommend using implementation strategies centred around minimizing any increase in workload, training on CAP usage, providing education for residents and families, and persuading through stories. Through improving implementation of the fracture risk CAP, results from this work will improve identification and management of LTC residents at high fracture risk and could inform the implementation of guidelines for other conditions in LTC homes.

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Optimizing Practices, Use, Care and Services–Antipsychotics (OPUS-AP) in Long-term Care Centers in Québec, Canada: A Strategy for Best Practices

Cited by 24 publications

References 21 publications

Dementia prevention, intervention, and care: 2020 report of the Lancet Commission

Dementia prevention, intervention, and care: 2020 report of the Lancet Commission

A New Care Model Reduces Polypharmacy and Potentially Inappropriate Medications in Long-Term Care

Strategies for the implementation of an electronic fracture risk assessment tool in long term care: a qualitative study

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