Integrated approach for optimal use of medication in long-term care centres in Quebec (OPUS-AP – PEPS)

Based on the Appropriate Use of Antipsychotics (AUA) approach, the Optimizing Practices, Use, Care and Services – Antipsychotics (OPUS-AP) collaborative is a partnership between Healthcare Excellence Canada, the Ministry of Health and Social Services of Quebec, the Institut national d’excellence en santé et en services sociaux (INESSS), and Quebec’s leading experts from the four integrated university health and social services networks. OPUS-AP aims to improve the quality and experience of care for residents living with a major neurocognitive disorder, as well as for their families, care partners and providers.  

The OPUS-AP collaborative has three phases:  

• Phase 1 (April 2017 to October 2018): 24 CHSLDs participated (one unit per CHSLD);  
• Phase 2 (January 2019 to April 2020): 129 CHSLDs participated (329 units);  
• Phase 3 (September 2022 to March 2026): all 313 publicly funded CHSLDs, long-term care homes and alternative homes participating. 

Phase 1

In Phase 1 of the OPUS-AP collaborative, 85.9% of residents for whom deprescription was attempted had their antipsychotic medication dosage reduced or discontinued entirely. Among the participating CHSLDs, the collaborative also had a positive impact on patient experience, population health, and healthcare provider work-life balance.  

For more details about phase 1 of OPUS-AP, including a testimonial from one of our participating unit chiefs and project managers, you can watch the video below.  

Download the transcript of the video

You can read more about phase 1 results in the OPUS-AP Results Poster for Phase 1.

Phase 2 

In Phase 2 of the OPUS-AP collaborative, the team supported an additional 129 CHSLDs in Quebec in rolling out the AUA approach. To learn about the train-the-trainer approach being implemented as part of this collaborative, you can watch the video below.

Download the transcript of the video 

Phase 2 took place between March 2019 and April 2020 in 329 units of 129 CHSLDs. It was successful in 77.1% of the 1,402 residents for whom deprescription was attempted (47.1% discontinued their use entirely and 30% reduced their dosage). 

Phase 2 Regions

Phase 3 

After a two-year pause due to the pandemic, Phase 3 will be launched under the auspices of Quebec’s Ministry of Health and Social Services and will integrate the PEPS program, an initiative of the CIUSSS de la Capitale-Nationale also begun in 2017, and aimed at reducing the use of all types of medications for all CHSLD residents through the optimization of professionals’ roles. The integrated OPUS-AP – PEPS approach for optimal use of medication in long-term care centres will be rolled out in all publicly funded CHSLDs in the province, under the auspices of the Ministry of Health and Social Services and in partnership with the CIUSSS de l’Estrie - Centre hospitalier universitaire de Sherbrooke and Healthcare Excellence Canada. It is also part of Measure 9 of Quebec’s action plan for long-term care (Plan d’action pour l’hébergement de longue durée 2021-2026 - Pour le mieux-être des personnes hébergées)

Read the MSSS press release (French)