Success determinants of a provincial approach for the optimal use of anti-psychotics in long-term care residents according to the key players involved in the implementation

Quebec has the highest rate of antipsychotic prescriptions among people aged 65 or over in Canada. The Optimiser les pratiques, les usages, les soins et les services - antipsychotiques (OPUS-AP) initiative aims to address this issue. Given its promising initial results, our study aimed to identify the determinants of these results. Our study was based on a case study design and involved a literature review and 21 individual interviews with key stakeholders of the OPUS-AP initiative. The results highlight five central determinants: 1) an integrated, collaborative and evidence-based approach; 2) communications and networks to support the process; 3) a climate of implementation that favours change; 4) stakeholder's commitment and involvement; and 5) an integrated and supported knowledge translation strategy. Challenges were also identified and recommendations made to ensure the sustainability and scaling-up of this initiative and to inspire similar projects.