Geriatric Pharmacists: Essential partners in caring for an aging population in Canada

HN Summary

• Geriatric pharmacists improve medication safety and outcomes for older adults, reducing adverse events and preventable hospitalizations. 

• They play a critical role in managing polypharmacy and complex chronic conditions, including deprescribing and optimizing therapy. 

• Their involvement supports better patient experience and more sustainable health care, as Canada’s aging population drives increasing demand.

Pharmacists working with older adults—often referred to as geriatric pharmacists—play a vital role in strengthening Canada’s health care system by improving medication safety, optimizing therapy for complex chronic disease, reducing preventable hospitalizations, and supporting sustainable use of health system resources. Canada’s population is aging rapidly, with adults aged 65 and older now representing nearly 19per cent of the population, a proportion projected to rise to approximately 24per cent by the late 2030s. Older adults are among the highest users of medications and health care services, making medication optimization a cornerstone of high-quality, person-centred care.

Aging, multimorbidity, and the growing burden of polypharmacy

Older adults account for a disproportionate share of health system utilization in Canada. Seniors represent more than 40per cent of provincial and territorial health care expenditures, driven largely by multimorbidity, frequent hospitalizations, and complex medication regimens. More than 70per cent of Canadians aged 65 and older live with at least one chronic condition, and many live with several concurrently, including cardiovascular disease, diabetes, osteoporosis, dementia, and chronic respiratory disease. 

As chronic disease burden increases, so does polypharmacy, commonly defined as the use of five or more medications. Canadian data show that over 45per cent of older adults experience polypharmacy, with rates exceeding 60per cent among those who are frail or living with multiple chronic conditions. While multiple medications may be clinically appropriate, polypharmacy significantly increases the risk of adverse drug events, drug–drug interactions, poor adherence, cognitive impairment, falls, and hospitalization.

Medication related harm and preventable hospital use

Medication related harm is a major and largely preventable driver of health system burden among older adults. Studies using Canadian administrative data have identified tens of thousands of medication related emergency department visits and hospitalizations among seniors, with anticoagulants, cardiovascular medications, opioids, and anti-infectives among the most frequently implicated drug classes. Research from the Canadian Longitudinal Study on Aging estimates that approximately one in eight older adults experiences an adverse drug event requiring medical care, with up to one-third of these events considered preventable.

Potentially inappropriate medications (PIMs) remain a persistent concern. In 2021, 42per cent of Canadians aged 65 and older were exposed to at least one PIM, despite well-established deprescribing guidance and national initiatives to reduce unnecessary medication use. These patterns underscore the need for specialized medication expertise embedded within care teams serving older adults.

Improving outcomes through geriatric pharmacist led care

Geriatric pharmacists are uniquely trained to address the intersection of aging physiology, multimorbidity, and medication risk. Through comprehensive medication reviews, deprescribing initiatives, and close collaboration with physicians, nurses, and allied health professionals, pharmacists help reduce inappropriate prescribing and improve medication adherence among older adults. Systematic reviews and Canadian studies show that pharmacist led polypharmacy interventions are associated with reductions in potentially inappropriate medications, improved medication appropriateness, and lower health care utilization and costs.

Pharmacists practicing in geriatrics also play a key role in falls prevention, delirium management, dementia care, and transitions of care, where medication changes frequently occur and risk is highest. Their involvement is particularly valuable in acute care, long-term care, and community-based models that support aging in place, aligning with national priorities to improve quality of life while reducing avoidable hospital admissions.

Enhancing system efficiency and patient centred care

By optimizing medication regimens, geriatric pharmacists improve both patient experience and system efficiency. Older adults benefit from clearer education, simplified regimens, and shared decision making that reflects their goals of care. From a system perspective, pharmacist involvement supports safer prescribing, reduced emergency visits, fewer hospital readmissions, and more appropriate use of high-cost medications—critical advantages as Canada faces growing demand and workforce constraints.

As the population aged 85 and older continues to grow rapidly, the need for scalable, interprofessional solutions to medication complexity will only intensify. Geriatric pharmacists represent a high value, evidence-based response to this demographic shift.

Leadership in practice: Grazia Prochazka, BScPharm, ACPR, EPPh

National leadership in geriatric pharmacy practice is represented by Grazia Prochazka, Chair of CSHP’s Geriatrics Community of Practice. Grazia supports pharmacists working with older adults across acute care, long-term care, ambulatory clinics, and community integrated settings—areas where medication complexity and risk are particularly high. 

This forum provides a national space for pharmacists to exchange expertise in polypharmacy management, deprescribing, medication safety, and person-centred care for seniors. The community fosters peer learning and practice alignment in response to Canada’s rapidly aging population.

This leadership demonstrates how CSHP Communities of Practice support scalable, evidence-based approaches that improve safety, quality, and system efficiency for older Canadians while supporting pharmacists facing growing clinical demands. 

A high value role in a rapidly aging health system

As Canada’s population continues to age, pharmacists working with older adults are essential members of the health care team. Their contributions improve safety, enhance quality of care, and support sustainable use of health system resources—while delivering meaningful benefits to older Canadians and their caregivers.

By combining specialized clinical expertise, interprofessional collaboration, and national leadership through organizations like CSHP, geriatric pharmacists are uniquely positioned to help Canada meet the complex demands of an aging population with quality, dignity, and value.

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