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Evaluation of the antipsychotic medication review process at four long-term facilities in Alberta

Authors Birney A, Charland P, Cole M, Aslam Arain M

Received 29 June 2016

Accepted for publication 31 August 2016

Published 4 October 2016 Volume 2016:9 Pages 499—509

DOI https://doi.org/10.2147/JMDH.S116008

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 3

Editor who approved publication: Dr Scott Fraser

Arden Birney,1 Paola Charland,1 Mollie Cole,2 Mubashir Aslam Arain1

1Workforce Research & Evaluation, 2Seniors Health Strategic Clinical Network, Alberta Health Services, Calgary, AB, Canada


Purpose: The goal of this evaluation was to understand how four long-term care (LTC) ­facilities in Alberta have implemented medication reviews for the Appropriate Use of Antipsychotics (AUA) initiative. We aimed to determine how interprofessional (IP) collaboration was incorporated in the antipsychotic medication reviews and how the reviews had been sustained.
Methods: Four LTC facilities in Alberta participated in this evaluation. We conducted semistructured interviews with 18 facility staff and observed one antipsychotic medication review at each facility. We analyzed data according to the following key components that we identified as relevant to the antipsychotic medication reviews: the structure of the reviews, IP interactions between the staff members, and strategies for sustaining the reviews.
Results: The duration of antipsychotic medication reviews ranged from 1 to 1.5 hours. The number of professions in attendance ranged from 3 to 9; a pharmacist led the review at two sites, while a registered nurse led the review at one site and a nurse practitioner at the remaining site. The number of residents discussed during the review ranged from 6 to 20. The process at some facilities was highly IP, demonstrating each of the six IP competencies. Other facilities conducted the review in a less IP manner due to challenges of physician involvement and staff workload, particularly of health care aides. Facilities that had a nurse practitioner on site were more efficient with the process of implementing recommendations resulting from the medication reviews.
Conclusion: The LTC facilities were successful in implementing the medication review process and the process seemed to be sustainable. A few challenges were observed in the implementation process at two facilities. IP practice moved forward the goals of the AUA initiative to reduce the inappropriate use of antipsychotics.

Keywords: interprofessional, antipsychotic, senior, medication review, evaluation

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