Potentially Inappropriate Use of Antipsychotics in Long-Term Care
Identifying Attributes
Care Settings
Country
Publishing Organisation
Type of Quality Indicator
IOM Quality Dimension
Domain
Defining Attributes
Definition
Percentage of residents on antipsychotics without a diagnosis of psychosis.
Numerator
Residents who received antipsychotic medication on one or more days in the seven days prior to their target assessment.
Denominator
All residents.
Exclusions
- Residents who are end-stage disease (<6 months to live) or receiving hospice care
- Residents who have a diagnosis of schizophrenia or Huntington's chorea or
- Experienced hallucinations or delusions in 7 days prior to assessment.
Use of Risk Adjustment
Risk Adjustments
Direct Standardisation, Indirect Standardisation. Standard Population: 3,000 facilities in 6 U.S. states and 92 residential care facilities and continuing care hospitals in Ontario and Nova Scotia. Individual Covariates: Motor agitation; moderate/impaired decision-making problem; long-term memory problem; Cognitive Performance Scale; combination Alzheimer's disease/other dementia; age younger than 65.
Stratifications
Facility-Level Stratification: Case Mix Index.
Data Attributes
Type of Data Collection
Data Collection Methods
Data availability 2017-21. Resident Assessment Instrument–Minimum Data Set 2.0 (RAI-MDS 2.0) and submitted to the Continuing Care Reporting System (CCRS), or using the interRAI Long-Term Care Facilities (interRAI LTCF) assessment and submitted to the Integrated interRAI Reporting System (IRRS).
Frequency of Data Collection
Frequency of Data Collection in Days
Reporting Methods
Publicly reported at national and provincial/territory level as part of national Continuing Care Reporting System (CCRS), quarterly. Also includes reporting at region, LTCF, corporation, and sector level (not public). The CCRS quality indicators use 4 rolling quarters of data for calculations in order to have a sufficient number of assessments for risk adjustment. Since residents are assessed on a quarterly basis, each resident can contribute to the indicator up to 4 times.