Implementing antipsychotic reduction in long-term care: interdisciplinary and lived-experience insights into system-level barriers and facilitators.
Background and Objectives Despite the availability of evidence-based antipsychotic reduction strategies, implementation of these strategies in long-term care (LTC) often stalls. Understanding how change occurs in real-world practice requires perspectives from interdisciplinary team members. This stu...
| Publicado en: | Gerontologist Vol. 66; no. 7; pp. 1 - 15 |
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| Autores principales: | , , , , , , , |
| Formato: | Artículo |
| Publicado: |
Oxford University Press / USA
Jul2026
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=195281453&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 195281453 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00169013 GET jtl: Gerontologist issn: 00169013 maglogo: N pubinfo: dt: Jul2026 vid: 66 iid: 7 pid: 622 pub: Oxford University Press / USA artinfo: ui: 195281453 10.1093/geront/gnag126 ppf: 1 ppct: 14 formats: tig: atl: Implementing antipsychotic reduction in long-term care: interdisciplinary and lived-experience insights into system-level barriers and facilitators. aug: au: Wong, Karen Lok Yi Hung, Lillian Wong, Jason Adekoya, Adebusola Wong, Joey Oi Yee Young, Erika Acosta, Cromwell Vasarhelyi, Krisztina affil: Department of Social Work, Chinese University of Hong Kong, Hong Kong, China IDEA Lab, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada School of Public Health Sciences, Faculty of Health, University of Waterloo, Waterloo, Ontario, Canada Vancouver Community, Vancouver Coastal Health, Vancouver, British Columbia, Canada su: Canada Teams in the workplace Human services programs Qualitative research Patient safety Empirical research Interviewing Work environment Leadership Patient care Nursing care facilities Patient-centered care Sound recordings Communication Labor demand Health education Patients' attitudes Inappropriate prescribing (Medicine) Research funding Drug therapy Long-term health care Music therapy Antipsychotic agents Medication error prevention Judgment sampling Descriptive statistics Thematic analysis Research Research methodology Environmental exposure Health care teams Caregiver attitudes Dementia patients sug: subj: Teams in the workplace Human services programs Qualitative research Patient safety Empirical research Interviewing Work environment Leadership Patient care Nursing care facilities Patient-centered care Sound recordings Communication Labor demand Health education Patients' attitudes Canada Pharmaceutical and medicine manufacturing Nursing Care Facilities (Skilled Nursing Facilities) Community care facilities for the elderly Integrated Record Production/Distribution Record Production Sound recording merchant wholesalers Inappropriate prescribing (Medicine) Research funding Drug therapy Long-term health care Music therapy Antipsychotic agents Medication error prevention Judgment sampling Descriptive statistics Thematic analysis Research Research methodology Environmental exposure Health care teams Caregiver attitudes Dementia patients keyword: Alzheimer's antipsychotic agents Care home copyrightHolder:The Gerontological Society of America copyrightYear:2026 dementia https://dx.doi.org/10.1093/geront/gnag126 inLanguage:en internship and residency long-term care medical residencies medication review Nursing home patient-centered care pharmacology publisher:Oxford University Press Residential care sameAs:https://pubmed.ncbi.nlm.nih.gov/42286801/ workplace Alzheimer's antipsychotic agents Care home copyrightHolder:The Gerontological Society of America copyrightYear:2026 dementia https://dx.doi.org/10.1093/geront/gnag126 inLanguage:en internship and residency long-term care medical residencies medication review Nursing home patient-centered care pharmacology publisher:Oxford University Press Residential care sameAs:https://pubmed.ncbi.nlm.nih.gov/42286801/ workplace ab: Background and Objectives Despite the availability of evidence-based antipsychotic reduction strategies, implementation of these strategies in long-term care (LTC) often stalls. Understanding how change occurs in real-world practice requires perspectives from interdisciplinary team members. This study interviewed interdisciplinary team members, a family caregiver, and a person living with dementia in LTC in Vancouver, Canada, to explore how they operationalize antipsychotic reduction in LTC homes and examine their perceived barriers and facilitators to implementation. Research Design and Methods Semi-structured interviews were conducted with 20 participants: 18 interdisciplinary healthcare providers, one dementia advocate, and one family caregiver. Data were analyzed using reflexive thematic analysis. To preserve inductive insights, the Consolidated Framework for Implementation Research (CFIR) was applied post hoc to the emergent themes. We examined the extent to which the findings were aligned with the CFIR, thereby deepening the analysis. Results Identified strategies included person-centered care planning, non-pharmacological interventions, medication review with behavior monitoring, and education. Barriers were: (1) challenging work environments, (2) safety concerns and unconscious dismissive attitudes, and (3) communication gaps. Facilitators included: (1) supportive leadership and frontline champions, (2) team communication, and (3) persistence. Each factor aligns with different CFIR constructs and domains to varying degrees. Discussion and Implications The main contribution of this study is that, drawing on CFIR, it found barriers to antipsychotic reduction in LTC are not merely individual but also systemic. Sustained improvement depends on policies that enable and resource effective interdisciplinary teamwork. This includes adequate staffing, education, team communication, and culture change. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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