{"id":4589,"date":"2020-06-22T18:16:44","date_gmt":"2020-06-22T22:16:44","guid":{"rendered":"https:\/\/ccna-ccnv.ca\/ccna_publication\/optimizing-prescribing-of-antipsychotics-in-long-term-care-opal-a-stepped-wedge-trial-to-reduce-inappropriate-antipsychotic-prescribing-in-long-term-care-2\/"},"modified":"2024-12-03T14:57:06","modified_gmt":"2024-12-03T19:57:06","slug":"optimizing-prescribing-of-antipsychotics-in-long-term-care-opal-a-stepped-wedge-trial-to-reduce-inappropriate-antipsychotic-prescribing-in-long-term-care-2","status":"publish","type":"ccna_publication","link":"https:\/\/ccna-ccnv.ca\/fr\/ccna_publication\/optimizing-prescribing-of-antipsychotics-in-long-term-care-opal-a-stepped-wedge-trial-to-reduce-inappropriate-antipsychotic-prescribing-in-long-term-care-2\/","title":{"rendered":"Optimizing Prescribing of Antipsychotics in Long-Term Care (OPAL): A Stepped Wedge Trial to Reduce Inappropriate Antipsychotic Prescribing in Long-Term Care"},"content":{"rendered":"<h2 class=\"title\">Abstract<\/h2>\n<div id=\"en-abstract\" class=\"abstract-content selected\">\n<p><strong class=\"sub-title\">Background:\u00a0<\/strong>Inappropriate antipsychotic prescribing is a key quality indicator by which clinical outcomes might be monitored and improved in long-term care (LTC), but limited evidence exists on the most effective strategies for reducing inappropriate antipsychotic use.<\/p>\n<p><strong class=\"sub-title\">Objectives:\u00a0<\/strong>The objective of the study was to evaluate a multicomponent approach to reduce inappropriate prescribing of antipsychotics in LTC.<\/p>\n<p><strong class=\"sub-title\">Design:\u00a0<\/strong>A prospective, stepped-wedge study design was used to evaluate the effect of the intervention.<\/p>\n<p><strong class=\"sub-title\">Settings and participants:\u00a0<\/strong>Interdisciplinary staff at 10 Canadian LTC facilities.<\/p>\n<p><strong class=\"sub-title\">Methods:\u00a0<\/strong>The intervention consisted of an educational in-service, provision of evidence-based tools to assess and monitor neuropsychiatric symptoms (NPS) in dementia, and monthly interprofessional team meetings. The primary outcome was the proportion of residents receiving an antipsychotic without a diagnosis of psychosis using a standardized antipsychotic quality indicator.<\/p>\n<p><strong class=\"sub-title\">Results:\u00a0<\/strong>The weighted mean change in inappropriate antipsychotic prescribing rate from baseline to 12-month follow-up was -4.6% [standard deviation (SD) = 2.8%, P &lt; .0001], representing a 16.1% (SD = 17.0) relative reduction. After adjusting for site, the odds ratio for the inappropriate antipsychotic prescribing quality indicator at 12 months compared to baseline was 0.73 (95% confidence interval = 0.48-0.94; chi-square = 6.59; P = .01). There were no significant changes in related quality indicators, including falls, restraint use, or behavioral symptoms.<\/p>\n<p><strong class=\"sub-title\">Conclusions and implications:\u00a0<\/strong>This multicomponent intervention was effective in reducing inappropriate antipsychotic prescribing in LTC without adversely affecting other domains related to quality of care, and offers a practical means by which to improve the care of older adults with dementia in LTC.<\/p>\n<\/div>\n","protected":false},"author":19,"featured_media":0,"template":"","meta":{"_acf_changed":false},"studies-relation":[],"class_list":["post-4589","ccna_publication","type-ccna_publication","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.2 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Optimizing Prescribing of Antipsychotics in Long-Term Care (OPAL): A Stepped Wedge Trial to Reduce Inappropriate Antipsychotic Prescribing in Long-Term Care - CCNA - CCNV<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/ccna-ccnv.ca\/fr\/ccna_publication\/optimizing-prescribing-of-antipsychotics-in-long-term-care-opal-a-stepped-wedge-trial-to-reduce-inappropriate-antipsychotic-prescribing-in-long-term-care-2\/\" \/>\n<meta property=\"og:locale\" content=\"fr_CA\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Optimizing Prescribing of Antipsychotics in Long-Term Care (OPAL): A Stepped Wedge Trial to Reduce Inappropriate Antipsychotic Prescribing in Long-Term Care - CCNA - CCNV\" \/>\n<meta property=\"og:description\" content=\"Abstract Background:\u00a0Inappropriate antipsychotic prescribing is a key quality indicator by ...\" \/>\n<meta property=\"og:url\" content=\"https:\/\/ccna-ccnv.ca\/fr\/ccna_publication\/optimizing-prescribing-of-antipsychotics-in-long-term-care-opal-a-stepped-wedge-trial-to-reduce-inappropriate-antipsychotic-prescribing-in-long-term-care-2\/\" \/>\n<meta property=\"og:site_name\" content=\"CCNA - 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