Understanding the factors influencing antipsychotic medication use in continuing care during the COVID-19 pandemic: a qualitative descriptive study.

Abstract

The objective of this project was to examine factors reported to affect changes in antipsychotic medication prescription and use in long-term care during the COVID-19 pandemic. Qualitative descriptive study. Continuing care (CC) facilities in Alberta, Canada. Participants were staff from CC who had worked during the pandemic, recruited from homes stratified by change in antipsychotic usage (decreased use, no change or increased use based on the Canadian Institute of Health Information (CIHI) quality indicator for potentially inappropriate antipsychotic medication use). Virtual interviews were conducted using a semi-structured guide. Data were inductively coded then mapped into the components of the Capability, Opportunity, Motivation-Behaviour system, which served as our lens to understand the factors influencing change in medication use over the pandemic. 44 staff members participated. Half worked at sites that experienced change in antipsychotic medication use. Many factors affected medication use. Primary motivations driving use included the need for staff to protect themselves and residents and increased staff stress. Opportunities to appropriately use antipsychotics were affected by policies requiring physical and social isolation and use of personal protective equipment. However, respondents demonstrated their capability of enacting appropriate use when describing their perspectives toward these medications. Staff attempted to provide quality care to residents aligned with antipsychotic medication guidelines while simultaneously complying with the restrictions and policies imposed during the COVID-19 pandemic. These findings highlight the factors influencing antipsychotic medication use among CC residents during the pandemic and may inform future planning or outbreak responses.