Assessing and understanding frailty and high-risk non-prescription drug use in community pharmacy practice

Non-prescription medications, though often viewed as safe, may pose risks when they are combined with other medications, used in more vulnerable persons or not used according to instructions. The potential risks of these medications may be greater for older adults with existing health or physical issues especially if they are also using several medications prescribed from their family doctor.

About the Project

Older adults with many health and physical difficulties are believed to be the heaviest users of non-prescription and prescription medications, however, recent data on their actual use in Canada is not currently available. It is also unclear whether and how older patients seek and obtain information and advice on the safety of their non-prescription medications. Community pharmacists may play an important role in assessing the health and resilience of older patients and in ensuring the safe use of their non-prescription medications. Whether they currently do so also remains unknown. To help answer these questions, our team of clinicians and researchers will: 1) examine how older patients communicate with community pharmacists about their medications through focus groups and observation; 2) distribute a survey to pharmacists across Canada to determine their understanding, beliefs, and practices in assessing older patients; 3) obtain current data on the use of non-prescription medications among Canadians of varying ages and health status; and, 4) gather preliminary information on whether pharmacists may play a bigger role in assessing the health of older adults and any non-prescription medication concerns.

Project Team

Principal Investigators:

Colleen Maxwell, PhD, MA, BSc, Professor, University of Waterloo

Nardine Nakhla, Clinical Lecturer, University of Waterloo

Mina Tadrous, Assistant Professor & Research Associate, University of Toronto


Jamie Joseph, Associate Professor, University of Waterloo

Susan Bronskill, Senior Scientist & Project Leader, ICES

David Hogan, Professor, University of Calgary

George Heckman, Associate Professor, University of Waterloo

Lisa Guirguis, Associate Professor, University of Alberta


Areen Duqoum

Sarah Leslie


Canadian Pharmacists Association

Consumer Health Products Canada

Fares Health Group

Health Canada

University of Waterloo

Project Contact: Colleen Maxwell —


Keywords: community pharmacies, non-prescription drugs, aged, frail; caregivers; cognitive function