BC Patient Safety & Quality Council

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Clear’s Story

Many residents in British Columbian long-term care homes may have their quality of life affected because they are taking inappropriate antipsychotic medications without being diagnosed with psychosis.

To address this, in 2013 we launched a Call for Less Antipsychotics in Residential Care (CLeAR), a voluntary, provincial quality improvement initiative, with support from the Shared Care Committee. Through Clear, which the initiative is now called, we provide leadership and improvement support to residential care teams to reduce the number of residents who are prescrived antipsychotics.

Wave 1
Wave 1, which featured 48 participating care homes, ran from October 2013 to December 2014. Action & Improvement teams made significant progress towards their goals by adapting existing knowledge to their own environments, with many individual facilities seeing dramatic reductions in their use of antipsychotic medications. Read a report of Wave 1 here.

Wave 2
Next, Clear’s second wave ran from September 2015 through December 2016.


This time, to help participating care homes measure CLeAR’s impact, they divided residents into two groups: an “Original Cohort” of residents who were admitted prior to the start of CLeAR, and an “Additional Cohort” of residents who were admitted to a care home after the start of CLeAR.

33.1% (895 of 2,705) of the residents in the Original Cohort were being prescribed antipsychotics. That number was reduced to 18.6% (502 of 2,705).

And the prescriptions were reduced for another 11.7% (316 of 2,705) of residents.

Furthermore, 46.9% (562 of 1,198) of the residents in the Additional Cohort were being prescribed antipsychotics. The prescriptions of antipsychotics were discontinued or reduced for 51.9% (292 of 562) of them.

We made a short video to capture some of the stories from Wave 2:

Wave 3
Clear’s story will continue in October 2017, when registration is open for its third wave. Your care home can sign up here.