{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T16:53:15Z","timestamp":1782492795396,"version":"3.54.5"},"reference-count":33,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:00:00Z","timestamp":1774483200000},"content-version":"unspecified","delay-in-days":25,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Healthcare Excellence Canada (LTC+ Acting on Pandemic Learning Together Program.","award":["LTC-528"],"award-info":[{"award-number":["LTC-528"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,2,25]]},"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Qualitative descriptive study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Continuing care (CC) facilities in Alberta, Canada.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>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\u2014Behaviour system, which served as our lens to understand the factors influencing change in medication use over the pandemic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-102751","type":"journal-article","created":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T14:20:44Z","timestamp":1774534844000},"page":"e102751","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Understanding the factors influencing antipsychotic medication use in continuing care during the COVID-19 pandemic: a qualitative descriptive study"],"prefix":"10.1136","volume":"16","author":[{"given":"Mehri","family":"Karimi-Dehkordi","sequence":"first","affiliation":[{"name":"Nursing Foundations and Science, MacEwan University, Edmonton, Alberta, Canada"},{"name":"Nursing and Health, Keyano College, Fort McMurray, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prosper","family":"Asaana","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5372-530X","authenticated-orcid":false,"given":"Adrian","family":"Wagg","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Alberta, Edmonton, Alberta, Canada"},{"name":"Assisted Living Alberta, Edmonton, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2297-7253","authenticated-orcid":false,"given":"Heather M","family":"Hanson","sequence":"additional","affiliation":[{"name":"Community Health Sciences, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada"},{"name":"Provincial Seniors Health and Continuing Care, Assisted Living Alberta, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4260-5270","authenticated-orcid":false,"given":"Patricia","family":"Harasym","sequence":"additional","affiliation":[{"name":"University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,3,26]]},"reference":[{"key":"2026062609364050000_16.3.e102751.1","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1016\/j.jamda.2024.03.007","article-title":"Guideline Recommendations on Behavioral and Psychological Symptoms of Dementia: A Systematic Review","volume":"25","author":"Watt","year":"2024","journal-title":"J Am Med Dir Assoc"},{"key":"2026062609364050000_16.3.e102751.2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.21926\/obm.geriatr.1904080","article-title":"Naming and Framing the Behavioural and Psychological Symptoms of Dementia (BPSD) Paradigm: Professional Stakeholder Perspectives","volume":"03","author":"Wolverson","year":"2019","journal-title":"OBM Geriatr"},{"key":"2026062609364050000_16.3.e102751.3","doi-asserted-by":"crossref","first-page":"915","DOI":"10.3233\/JAD-140579","article-title":"The efficacy and safety of atypical antipsychotics for the treatment of dementia: a meta-analysis of randomized placebo-controlled trials","volume":"42","author":"Ma","year":"2014","journal-title":"J Alzheimers Dis"},{"key":"2026062609364050000_16.3.e102751.4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3233\/ADR-170042","article-title":"Increased All-Cause Mortality by Antipsychotic Drugs: Updated Review and Meta-Analysis in Dementia and General Mental Health Care","volume":"2","author":"Ralph","year":"2018","journal-title":"J Alzheimers Dis Rep"},{"key":"2026062609364050000_16.3.e102751.5","doi-asserted-by":"publisher","DOI":"10.1177\/2040622316658463"},{"key":"2026062609364050000_16.3.e102751.6","doi-asserted-by":"crossref","DOI":"10.1136\/bmj-2023-076268","article-title":"Multiple adverse outcomes associated with antipsychotic use in people with dementia: population based matched cohort study","volume":"385","author":"Mok","year":"2024","journal-title":"BMJ"},{"key":"2026062609364050000_16.3.e102751.7","first-page":"17","article-title":"Deprescribing antipsychotics for behavioural and psychological symptoms of dementia and insomnia: Evidence-based clinical practice guideline","volume":"64","author":"Bjerre","year":"2018","journal-title":"Can Fam Physician"},{"key":"2026062609364050000_16.3.e102751.8","unstructured":"Canadian Coalition for Seniors\u2019 Mental Health . 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