| Frailty awareness and assessment: exploring the link between pharmacists' beliefs and behaviourThis abstract was presented as a poster at the Pharmacy Practice Research (PxP) Conference (June 3-5, 2019) and published in the Canadian Pharmacists Journal (Can Pharm J 2019; 152(5):S20.
The objective was to examine associations between pharmacists’ beliefs and behaviours regarding frailty. Pharmacists across Canada strongly agreed that community pharmacists should understand frailty. Only a third of pharmacists reported incorporating this into their practice. Our findings suggest the importance of diverse experience and/or training in the care of older vulnerable patients. University of Waterloo, St. Michael's Hospital | Publication | 2019-06-03 | "Brittany Cook", "Yanling Guo", Nardine Nakhla, Mina Tadrous, Colleen Maxwell |
| Knowledge and Perceptions of Pharmacists Towards Frailty and Frailty AssessmentsReported on the results of the cross-sectional survey we conducted of licensed pharmacists currently practicing in Canada. The online survey instrument consisted of 43 questions. We reported descriptive statistics of all questions and conducted a multivariable logistic regression to explore relationships between characteristics and perceptions. University of Waterloo, St. Michael's Hospital | Publication | 2019-07-13 | Nardine Nakhla, Mina Tadrous, Areen Duqoum, Colleen Maxwell |
| Frailty in PharmacyA summary report of this CFN-funded initiative was published in the Ontario Pharmacist Magazine on December 7, 2018. University of Waterloo, St. Michael's Hospital | Specialized Publication | 2018-12-07 | Nardine Nakhla, Mina Tadrous, Colleen Maxwell |
| Frailty and unintended risks of medications. Frailty and unintended risks of medications.
Part of Journal Topical Collection on Epidemiology of Aging University of Calgary, University of Waterloo | Publication | 2020-04-07 | David Hogan, Colleen Maxwell |
| Pharmacists’ knowledge, perceptions and practices regarding frailty: A cross-sectional survey across practice settings in CanadaFrailty describes the health and resilience of older adults and is associated with risk of adverse drug events, especially related to polypharmacy. We surveyed Canadian pharmacists’ understanding, beliefs, and practices in the assessment of frailty. Integrating frailty into the pharmacists' workup, and the pathway to frailty-based medication interventions are discussed. University of Waterloo, St. Michael's Hospital, University of Calgary | Publication | 2023-02-22 | "paul malik", Nardine Nakhla, "Yanling Guo", Mina Tadrous, Areen Duqoum, David Hogan, Colleen Maxwell |
| Prevalence of Prescription and Non-Prescription Polypharmacy by frailty and sex among middle-aged and older CanadiansBackground:
Estimates of polypharmacy have primarily been derived from prescription claims, and less is known about the use of non-prescription medications (alone or in combination with prescription medications) across the frailty spectrum or by sex. Our objectives were to estimate the prevalence of polypharmacy (total, prescription, non-prescription, and concurrent prescription and non-prescription) overall, and by frailty, sex and broad age group.
Data:
Canadian Health Measures Survey, Cycle 5, 2016 to 2017.
Methods:
Among Canadians aged 40 to 79 years, all prescription and non-prescription medications used in the month prior to the survey were documented. Polypharmacy was defined as using five or more medications total (prescription and non-prescription), prescription only and non-prescription only. Concurrent prescription and non-prescription use was defined as two or more and three or more of each. Frailty was defined using a 31-item frailty index (FI) and categorized as nonfrail (FI ≤ 0.1) and pre-frail or frail (FI > 0.1). Survey-weighted descriptive statistics were calculated overall and age standardized.
Results:
We analyzed 2,039 respondents, representing 16,638,026 Canadians (mean age of 56.9 years; 51% female). Overall, 52.4% (95% confidence interval [CI] = 47.3 to 57.4) were defined as pre-frail or frail. Age-standardized estimates of total polypharmacy, prescription polypharmacy and concurrent prescription and non-prescription medication use were significantly higher among pre-frail or frail versus non-frail adults (e.g., total polypharmacy: 64.1% versus 31.8%, respectively). Polypharmacy with non-prescription medications was common overall (20.5% [95% CI = 16.1 to 25.8]) and greater among women, but did not differ significantly by frailty.
Interpretation:
Polypharmacy and concurrent prescription and non-prescription medication use were common among Canadian adults, especially those who were pre-frail or frail. Our findings highlight the importance of considering non-prescribed medications when measuring the exposure to medications and the potential risk for adverse outcomes. University of Waterloo, St. Michael's Hospital, University of Calgary, ICES (Institute for Clincial Evaluative Sciences) | Publication | 2022-06-08 | "Daniel Harris", "Yanling Guo", Nardine Nakhla, Mina Tadrous, David Hogan, "Deirdre Hennessy", "Kelly Langlois", "Rochelle Garner", Sarah Leslie, Susan Bronskill, George Heckman, Colleen Maxwell |
| “Fitting in the Pharmacist” – A qualitative analysis of the perceived relationship between community pharmacists and older adults with complex care needs. University of Waterloo, St. Michael's Hospital | Publication | 2021-06-15 | "Larkin Davenport Huyer ", "Laura Desveaux", Nardine Nakhla, Colleen Maxwell, Mina Tadrous |
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