Rates of Potentially Inappropriate Antipsychotic Use Remains High, New Data Shows

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Rates of Potentially Inappropriate Antipsychotic Use Remains High, New Data Shows

January 22, 2025

Newly released data shows that the proportion of Canadian long-term care residents on antipsychotic medications potentially inappropriately remains high at 24.4% in 2024-2025. This is well above the rate of 20.2% just five years earlier, and significantly higher than those reported in comparable countries.

The findings were prepared by the Appropriate Use Coalition using data from the Canadian Institute for Health Information (CIHI).

Antipsychotics are often prescribed as the first choice for managing behaviours associated with dementia, such as aggression and resisting care. Canadian guidelines caution against their frequent use in older adults without a psychosis diagnosis, as the risks, including increased likelihood of strokes, falls, fractures, and death, outweigh the benefits.

Key Findings:

Use of antipsychotics in LTC residents without a psychosis diagnosis had fallen from 27% in 2014-15 to 20% in 2019-20, reflecting efforts to manage dementia behaviours through other approaches. Rates have risen since then, with the national average now sitting at 24.4%.
Rates vary across provinces and territories. In 2024-25, most jurisdictions were above the national average of 24.4%, with the exception of Alberta and Ontario.
Variation is most pronounced at the level of individual LTC homes. Among the 1,400 sites that reported antipsychotic use data in 2024-2025, rates ranged from zero to 86.3%.

In 2025, the Appropriate Use Coalition set a national target of 15% to provide long-term care homes with a clear and measurable objective. This year, homes that meet the target will be recognized nationally, based on a verified data review by the Appropriate Use Coalition.

“With rates remaining high, there is a need for a more coordinated national approach that gives long-term care homes clear targets and practical support,” says Dr. Wendy Levinson, Chair of the Appropriate Use Coalition Long-Term Care Subgroup. “Recognizing homes that have reached the 15% target helps encourage improvement and acknowledge efforts to deliver person-centred care across the sector.”