Disposal Practices of Unused and Leftover Medicines in the Households of Dhaka Metropolis

Background: This fact-finding study aimed to attain an overall idea and knowledge about medicine disposal practices in Dhaka Metropolitan households. Methods: This mixed study (both quantitative and qualitative) was orchestrated to inspect the household leftover medicine disposal pattern’s governing status. A cross-sectional survey was conducted following a structured questionnaire and key informant interview with a household person and in-depth interviews with the top pharmaceutical and government officials. Results: Findings disclose that, for most of the key informants, the terms “drug disposal” and “drug pollution” were unknown; more precisely, 67% and 74% of key informants even did not hear these two terms. Almost all (87%) households faced undesired incidents due to the insecure storage of medicines. People disposed of excess and expired medication in regular dustbins (47%), threw out of the window (19%), flushed within commode (4%), burnt in fire (2%), and reused (4%). A good percentage of people (21%) returned unexpired drugs to the pharmacy and bought other medicines on a need basis. A total of 72% wanted a medicine take-back program, and 100% agreed on mass education on this issue. Officials of pharmaceuticals conferred mixed opinion: top-ranked pharmaceuticals will adopt leftover medicine disposal practices; middle and low-ranked pharmaceutical companies are reluctant, merely denied mentioning the less important issue. Conclusions: The absence of mass awareness and standard laws and policies may explain these existing aberrant practices.

Implementation of medicine take-back concept at community level in Nepal: a pilot study

Background Most households may have leftover, unwanted, unused and expired (UUE) medicines. The present research aimed to analyze feasibility of implementation of medicine take-back in select communities in Nepal. Methods Exploratory (i.e. feasibility) study was conducted among 400 adults from July 2017 to January 2018. Study sites and participants were selected by simple random sampling and respondents were interviewed about their awareness about medicine disposal, hazards and willingness to support take-back program using semi-structured questionnaire. Multinomial logistic regression analysis was applied to explore relationship of take-back related outcomes with the predictors. The P-value < 0.05 was statistically significant at 95% confidence level. Results Land pollution and effect on health of children was significantly related with inappropriate disposal of medicines such as site of disposal (P value < 0.01), river (P value, 0.02), garbage (P value, 0.04) and dumping site (P value, 0.01). Analysis of willingness to follow take-back program with the techniques of support showed significant relationship with the establishment of collection center and participation on seminar (P value < 0.01). Conclusion Most participants were interested to support take-back, if implemented in their community but main constraint was the budget. Take-back concept could be initiated and implemented on government funding or other sources.

Evaluation of Medicine Reverse Logistics Practices in Hospitals

Initiatives related to reverse logistics are increasingly common in companies that produce tires, lubricating oils, batteries, and electronic equipment, among others. In the pharmaceutical sector, reverse logistics is also relevant, contributing to reduce medication exposure to other people and the environment. Thus, this research seeks to find out which practices related to reverse logistics are used in 13 hospitals in the state of Rio de Janeiro. Regarding the methodological procedures, this research is supported by interviews with those responsible for disposing of medicines from hospitals, and the best practices were ranked using the analytic hierarchy process (AHP) method. Among the main difficulties for performing Medicine Reverse Logistics practices in hospitals, the absence of a standard process for medicine disposal and medications held by nurses or satellite pharmacies—for being out of control—stand out.

Knowledge, Attitude, and Practice of Unused and Expired Medication Disposal among Patients Visiting Ayder Comprehensive Specialized Hospital

Background. Accumulation of unused and expired medicines at home is a source of environmental hazards and public health problems due to lack of awareness on appropriate medicine disposal methods. Therefore, the study was conducted to assess the knowledge, attitude, and practice of unused and expired medicine disposal among patients visiting Ayder Comprehensive Specialized Hospital. Methods. A descriptive cross-sectional study was conducted among 384 patients who visited Ayder Comprehensive Specialized Hospital outpatient pharmacy from April to June 2019. Convenience sampling was used to recruit the participants, and data was collected by a face-to-face interview using a structured questionnaire. The data were entered and analyzed by using SPSS version 21.0. Descriptive statistics on sample characteristics was computed, and results were presented in the form percentage using table and statements. Results. Out of the 384 respondents included in the study, 205 (53.4%) of them were males. More than half (199 (51.8%)) of the respondents did not correctly knew about medicine waste, and 233 (60.7%) of them did not have any prior information regarding medicine waste disposal instruction. But 351 (91.4%) of the participants correctly responded that inappropriate unused and expired medicine disposal can cause environmental harm. Above half (218 (56.8%)) of the respondents “agreed” about the potential risks related to having unused/expired medicines at home, and 206 (53.6%) of them “strongly agreed” that children are more vulnerable. One hundred fifty-nine respondents had unused/expired medicines in their homes. The most commonly used disposal practice for unused medicines were throwing them in a household trash as reported by 297 (77.3%) followed by flushing unused medications in toilet/sink 152 (39.6%). Throwing them away in household garbage and flushing them in toilet/sink were also the most commonly preferred disposal practice for expired medicines. Conclusion. The majority of the study participants dispose unused and expired medicine in household garbage and toilet/sink. This is against the recommendations of both national and international policies and guidelines on safe and appropriate pharmaceutical waste disposal.

MEDICATION DISPOSAL;

Introduction: Due to irresponsible and unsafe methods of drug disposal employedby consumers pharmaceutical waste enters the ecosystem, ultimately having a detrimentaleffect on both human health and environment. Objectives: The purpose of the study is tomeasure attitude and practice of local community in Karachi, Pakistan regarding safe disposalof unwanted medicines and assess willingness of participants to take part in a medicationtake-back program. Study Design: A two-phase observational study was conducted usingconvenience sampling. Period: January to February, 2016. Methodology: In Phase I (n = 200)students enrolled in various health sciences institutions in the study were asked to take part inthe survey. In Phase II(n = 300) household consumers were contacted by telephone and socialmedia. Results: Participants (response rate 84.4%) were given a questionnaire to explore theirattitudes towards medicine disposal. More than half of the consumers surveyed reported storingunused/expired medications in their homes, and majority threw away unwanted medicine in thegarbage. The most common reason was unawareness of expiry date (32.7%). Only 12.32%reported returning medication to a pharmacy for disposal. Majority of the consumers had neverreceived advice about medication disposal by a health care provider but were aware of thepossible negative consequences and were willing to participate in national pharmacy take-backprograms if implemented by the government. Conclusions: Our findings suggest that effectivecommunication and established protocols will promote appropriate disposal practices. Publicservices in Pakistan, and especially pharmacies, must play a more proactive role in this regard.