Fewer residents using antipsychotic medications in Ontario long-term care homes, new data shows 

National CIHI website also shows fewer residents with pain or restraints

(TORONTO, December 16, 2015) – Ontario’s long-term care homes are committed to reducing the use of antipsychotic medications for their residents, and today’s release of new data by the Canadian Institute for Health Information (CIHI) shows that 8% fewer residents are taking antipsychotics than just four years ago – with a drop of more than 3% in the last year alone.   

“This new data is evidence of the significant effort of long-term care homes to improve medication use in this vulnerable population,” says Dr. Carlos Rojas-Fernandez, a geriatric pharmacologist at the University of Waterloo and expert advisor to the Ontario Long Term Care Association on antipsychotic use. 

In seniors, antipsychotics are most commonly used to manage the challenging behaviours that can accompany dementia. Antipsychotics have an important role in severe cases of aggression, paranoia, and delusions as they reduce the resident’s stress, allow staff to approach them safely and provide care, and protect other residents from potential violence.  However, they are sometimes prescribed for other symptoms, or at too high a dose. 

“The goal is not to eliminate antipsychotics, but to ensure they are being used for the right symptoms, at the right dose, and only for as long as needed,” says Dr. Rojas-Fernandes, adding that the majority of people with dementia suffer from aggression or psychosis at some point during the progression of their disease, and may need an antipsychotic for a limited time.

Long-term care staff, physicians, and pharmacists have made it a priority in recent years to improve the appropriate prescribing of antipsychotics through strategies such as medication reviews and behaviour management supports. These efforts are being enhanced through project collaborations with the Canadian Foundation for Healthcare Improvement and the Ontario Medical Association/Ontario Ministry of Health and Long-Term Care. 

Other news in CIHI’s release of new long-term care data

Today’s data results on CIHI’s Your Health System In Depth website show a number of other positive trends in Ontario long-term care homes. Highlights of the findings from Ontario over the last four years (2010-11 and 2014-2015) include: 
nearly 8% (7.7%) decline in the number of residents on a potentially inappropriate antipsychotic from, 35% to 27.3%;
nearly 9% (8.7%) decline in the number of residents in restraints (such as lap belts and bed rails), from 16.1% to 7.4%;
5% decline in the number of residents experiencing pain in long-term care, from 11.9% to 6.9%; and 
stable results in pressure ulcers (3.1%), falls (14.8%), and worsening depression (25.7%).

“Staff in long-term care homes care about their residents and want to ensure they’re providing the best possible care,” says Candace Chartier, CEO of the Ontario Long Term Care Association. “This information helps homes to identify where things are going well and where to focus their efforts for improvements. Even a stable result can be a promising sign, because we’re looking after residents with much higher health care needs than even five years ago.” People are staying at home for longer, she explains, and by the time they come to long-term care, they are at a more advanced stage of their health conditions and/or dementia. 

The Association has made recommendations to government to help support homes as they strengthen quality of care. Specifically, the Association is asking for:
   •  a behavioural support team in every long-term care home in the province to help manage the challenging behaviours that can accompany dementia
   •  annual funding increases that improve resident care, comfort and safety by adequately covering  rising operational and staffing costs
   •  better funding and other supports for the construction of new homes with more privacy and generous common spaces, which are particularly important for people with dementia  

For more information, contact:
Judy Irwin
Senior Manager, Communications
Ontario Long Term Care Association
jirwin@oltca.com or 647-967-8995