b'ANTIPSYCHOTICSKEY FACTORS FOR SUCCESS1. Interdisciplinary team-based approach: This included nurses, behavioural leads, pharmacists,clinicians and a central QI team to provide homes with support.2.Education of all frontline staff on the appropriate and inappropriate use of antipsychotics: Thisincreased the focus on finding non-pharmaceutical approaches to alleviate symptoms rather than starting with an antipsychotic as a first-line response to BPSD.3. Family and caregiver education and collaboration: Families were often concerned about relapsingbehaviours in their loved ones as a result of reduction of antipsychotic medication. They were provided with education on the benefits of deprescribing and non-pharmaceutical approaches, as well as reassurance that the resident was being carefully monitored during the drug tapering program. Clinical teams collaborated with families to ensure personalized care for each resident.4. Behavioural support expertise: To support their efforts in non-drug approaches to managing symptoms, all homes in the study had access to the support of a central, advanced practice nurse practitioner who specializes in behavioural and psychological symptoms of dementia anddementia care.5. Data analytics: The team developed a Decision Support Tool with the support of PointClickCare that supported both the core team and long-term care home teams in easily identifying and monitoring residents.Regular team meetings were a criticalis also important as behaviouralDR. VANKER: Anecdotally, weve component of the intervention.symptoms of dementia can changeheard many stories of residents who Once teams saw positive results, theover time as the disease progresses. are now on a lower dose or whose quality improvements continued. As aantipsychotic was discontinued, and result, all the 34 homes achieved andDR. VANKER: There was somewho are more engaged with staff and sustained a reduction in inappropriateapprehension among staff about theirtheir families and able to function antipsychotic prescriptions. capacity, but we encouraged teamsmore independently. Staff have toldto start with what they could do, andus theyre proud to have been Also important was the comprehensivewhen they saw the positive results forinvolved in this study and in making education the interdisciplinarytheir residents and heard from familiesa difference to the lives of their teams provided within the homesabout the improved engagement theyresidents. These stories are very on the importance of reducingwere seeing in their loved ones, itpowerful and heartening. antipsychotic use and using non- motivated the teams to push further pharmaceutical approaches to helpand to do more. Not overwhelmingDR. MORGAN: Our hope is that this alleviate symptoms of BPSD. Theour hard-working teams, but ratherprogram will become a template to teams provided education to frontlinebringing them along in steadydrive other deprescribing initiatives in staff and then to residents, familiespartnership, is a key success factorlong-term care across Canada. Its also and caregivers, using the excellentand part of our overall approach toa model for us to enhance our work resources on antipsychotics from thequality at Extendicare. in other areas such as falls prevention Centre for Effective Practice. and pressure injury prevention. LTCTDR. MORGAN: Our external DR. MORGAN: Our program ispartnerships are also vital to ourFull details of Extendicares quality very focused on individual care bysuccess. MediSystem is our nationalimprovement study are available ensuring that residents who arepharmacy partner, and their clinicalin the January 2025 issue of the on antipsychotics are reviewed onpharmacists are essential teamJournal of the American Medical a regular basis to determine themembers who are critical to ourDirectors Association, titled appropriateness of the treatment.accomplishments and progress. Sometimes dose reduction, ratherWe would not have attempted thisReducing the Inappropriate Use of than discontinuation of medication,initiative in a paper-based world.Antipsychotics in Long-Term Care: is the right thing for the resident. ItsWithout the implementation ofStrategies for Success. Authors: about whats best for each residentPointClickCare, the electronic medicalAhmed Vanker, MD; Lara de Waal, and providing our teams with the toolsrecord utilized in all our homes,MBA; Natasha Milijasevic, PhD; and to deliver personalized care. Regularwe would have lacked an essentialMatthew Morgan, MD.review of antipsychotic medicationtechnological tool to sustain success.14 LONG TERM CARE TODAY Spring/Summer 2025'