Potentially Inappropriate Use of Antipsychotics in Long-Term Care

Identifying Attributes

Care Settings
Residential Aged Care
Country
Canada
Publishing Organisation
Canadian Institute for Health Information (CIHI): Long-Term Care Indicators
Type of Quality Indicator
Process
IOM Quality Dimension
Safety
Domain
Medication-Related

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
  1. Residents who are end-stage disease (<6 months to live) or receiving hospice care
  2. Residents who have a diagnosis of schizophrenia or Huntington's chorea or
  3. Experienced hallucinations or delusions in 7 days prior to assessment.
Use of Risk Adjustment
Yes
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
Standardised clinical data
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
90 days
Frequency of Data Collection in Days
90
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.

Reporting Frequency
Quarterly
Reporting Frequency in Days
91
Indicator Has Recommended Targets
No

Source and Reference Attributes

Link to Measurement Tools
Quality Indicator Confirmed to be Part of a Program Used to Monitor Quality and Safety of Care Among Older People at a Population-Level between 2012-2022
Yes
Assessed by the Australian Consortium for Aged Care Collaborators as Generally Containing Good Properties (Importance and Scientific Acceptability)
Yes
Australian Consortium for Aged Care Endorsed
No
Identified by PHARMA-Care Project
No
Upload Date
12 March 2025