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Pitard M, Rouvière N, Leguelinel-Blache G, Chasseigne V. Contribution of hospital pharmacists to sustainable healthcare: a systematic review. Eur J Hosp Pharm 2024:ejhpharm-2024-004098. [PMID: 38777391 DOI: 10.1136/ejhpharm-2024-004098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 05/06/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND With a global annual carbon footprint of the healthcare sector of 2 gigatons of CO2e, healthcare systems must contribute to the fight against climate change. Hospital pharmacists could be key players in ecological transition due to their role in managing healthcare products. The aim of this study was to summarise the evidence on interventions implemented in healthcare facilities involving pharmacists to improve the environmental footprint of healthcare. METHODS This systematic review was conducted following PRISMA 2020 guidelines. The Medline, Web of Science and ScienceDirect databases were searched for studies published between 2013 and 2023. To be eligible for inclusion, studies had to include hospital pharmacists and present contributions aimed at reducing the environmental footprint of healthcare in healthcare facilities. Outcomes were the description of the contribution, the methods used and the stages of healthcare product lifecycle analysed. A Mixed Methods Appraisal Tool was used to assess the risk of bias for each study. RESULTS Seventeen studies were included. Pharmacists played a leading role in 15 (88%) and had a supporting role in the others. The healthcare products targeted were medicines (59%), medical devices (12%) or both (29%). The stages of the healthcare product cycle addressed by the contributions were elimination (71%), dispensing (35%), procurement and supply (35%), production (29%), and prescription (24%). Only two studies used life cycle assessment and only one assessed all three pillars of sustainability. Two studies had good methodological quality while the rest had at least one element of uncertainty. CONCLUSION This review confirms the central role of the pharmacist and the importance of a multidisciplinary approach in implementing eco-responsible actions. It could be useful to hospitals and other teams wanting to improve sustainable actions and it emphasises the importance of collaborating with pharmacists when planning sustainable initiatives. Future eco-responsible initiatives must use robust reproducible methods. TRIAL REGISTRATION PROSPERO #CRD42023406835.
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Affiliation(s)
- Maria Pitard
- Department of Pharmacy, Nimes University Hospital, University of Montpellier, Nimes, France
| | - Ninon Rouvière
- Department of Pharmacy, Nimes University Hospital, University of Montpellier, Nimes, France
| | - Géraldine Leguelinel-Blache
- Department of Pharmacy, Nimes University Hospital, University of Montpellier, Nimes, France
- Institute Desbrest of Epidemiology and Public Health, INSERM, University of Montpellier, Montpellier, France
| | - Virginie Chasseigne
- Department of Pharmacy, Nimes University Hospital, University of Montpellier, Nimes, France
- Institute Desbrest of Epidemiology and Public Health, INSERM, University of Montpellier, Montpellier, France
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Al Ghadeer HA, Alnajjar JS, Aldandan JK, Bokhamseen AA, Al Dandan AM, Almarzoq MA, Alnajjar HJ, Albuti AH, Almuhaini MA, Alsalman MA, Al Sabah SA. Prevalent Parental Practice Toward Drug Storage and Disposal. Cureus 2024; 16:e60449. [PMID: 38883089 PMCID: PMC11179737 DOI: 10.7759/cureus.60449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2024] [Indexed: 06/18/2024] Open
Abstract
Introduction The environment, healthcare services, and public safety can all be directly impacted by improper drug storage and disposal practices. It is unknown whether parents store drugs at home in accordance with recommended storage guidelines, despite the fact that storage conditions are strictly regulated and monitored at every stage of the drug supply chain prior to drug dispensing. Therefore, it is crucial to dispose of medications properly and store them at home to avoid the consequences. Aim The purpose of this study was to evaluate the drug storage safety measures used by parents to prevent unintentional drug poisoning in children. Methodology A structured questionnaire was used to conduct a cross-sectional, interview-based study on home medication storage, attitudes, and disposal practices between October 2023 and January 2024. We recruited parents who visited primary healthcare centers or pediatric clinics using a convenience sampling technique. Results All of the 353 returned questionnaires were valid for data entry and analysis. The mean age of the parents was 35.1 ± 11.9 years old and more than half of them 229 (64.9%) have bachelor's degrees. The majority of drugs (271, 88.6%) were stored in the fridge, followed by bedrooms (26.8%). The medication classes that were stored the most frequently were analgesics (92.2%) and antihistamines (62.1%). The majority of parents (214, 69.9%) kept medications above adult eye level, even though only 28% did not keep them in safe and secure locations like locked drawers or boxes. Eighty percent (80%) disposed of unwanted medicines by throwing them in the trash, and only 10 (2.8%) returned them to the pharmacy. Conclusions Drug storage at home encourages self-medication, which has a number of negative effects. Over time, there has been an increase in the use of medications due to a rise in people's health-seeking awareness and behavior on a global scale. Therefore, this study may be used as a guide by national policy-makers for pharmaceutical disposal and storage management. Moreover, it might help in raising public awareness of the importance of pharmacists in the society and the safe handling and storage of medications at home.
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Affiliation(s)
| | | | | | | | | | | | | | - Ali H Albuti
- College of Medicine, King Faisal University, Al-Ahsa, SAU
| | | | | | - Shifa A Al Sabah
- Nursing, Primary Health Care, Al-Ahsa Health Cluster, Al-Ahsa, SAU
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Alqassab FA, Alhujiri A, Alsheef G, Almosabeh A, Surour M, Alqurain A. Work experience, profession type, and perception of medication waste disposal among healthcare workers: A study in the Eastern Province, Saudi Arabia. Saudi Pharm J 2024; 32:101927. [PMID: 38223204 PMCID: PMC10787295 DOI: 10.1016/j.jsps.2023.101927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 12/17/2023] [Indexed: 01/16/2024] Open
Abstract
Background Improper disposal of medication waste is a global concern. Several published articles reported perceptions and barriers of the community or pharmacists towards proper medications waste disposal, but least are discussing the overall health workers' perception, particularly those in the Eastern Province in Saudi Arabia. Aim and objectives The current research aimed to identify the healthcare worker's perception, explore limitations and barriers, and proposed solutions towards proper medication waste disposal. The second aim is to investigate difference in the response among healthcare worker based on their profession type and years of work experience. Method This cross-sectional, descriptive study is based on an internet-based survey questionnaire. Questionnaires were adapted from previous study and were validated before distribution to participants. Respondents were classified based on their healthcare profession and based on the year of their work experience. Descriptive statistics analysis was carried out to assess difference in perception among respondents based on their profession or years of work experience. The Statistical Package for the Social Sciences (SPSS, version 26) package was used for conducting statistical analysis. Results 321 participants responded to the online survey. 60 % of the respondents were from clinical practice settings and 26 % had work experience between 0-2 years. 77 % of them had encountered medication waste issues, whereas 129 respondents reported that these issues raised from the workplace and 92 respondents reported that they raised personal source. Interestingly, respondents with limited work experience reported the lower perception and knowledge toward mediation waste compared to those with more work experience. 31 % agreed that logistic issues (availability of collection bins) and 28 % reported that the unavailable policies/guidelines that govern this proper medication waste disposal are barriers which limit proper practice. 211 participants strongly agreed on that policies from governmental bodies are very important to limit this issue, whereas training and the availability of logistics were the most recommended solutions from respondents to increase healthcare awareness towards proper medication waste disposal. Conclusion Proper perception about medication waste disposal is still an ongoing issue among healthcare workers, particularly those who recently joined their work. Training and enforcing policies and guidelines by governmental bodies could be one approach to ensure proper medication waste disposal.
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Affiliation(s)
| | | | | | - Ahmed Almosabeh
- Department of Pharmacy, Mohammed AL – Mana College for Medical Sciences, Dammam, Saudi Arabia
| | - Manal Surour
- Department of Pharmacy, Mohammed AL – Mana College for Medical Sciences, Dammam, Saudi Arabia
| | - Aymen Alqurain
- Department of Pharmacy, Mohammed AL – Mana College for Medical Sciences, Dammam, Saudi Arabia
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Michelin ADF, Bonifácio NA, Nagata WB, da Silva VMS, Gobbo LEM, Bresciani KDS. Guidance provided by pharmacists to customers regarding to destination of unused household medications: disposal of household medications. BMC Health Serv Res 2023; 23:1350. [PMID: 38049849 PMCID: PMC10694965 DOI: 10.1186/s12913-023-10319-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 11/14/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND Discarding pharmaceuticals in the garbage or into the sewage system are still the most common methods in many countries. This study aims to investigate the guidance provided by pharmacists to customers on the disposal of unused and expired household medications in São Paulo State, Brazil. METHOD The study population consisted of 630 pharmacists from the State of São Paulo, who work in community pharmacies. They answered an online questionnaire with questions composed in three blocks: demographic, work, and academic information on the pharmacist; guidance about the disposal of household medications; and knowledge regarding the reverse logistics of these medications. An invitation to participate in the questionnaire was made via WhatsApp, individually and collectively. Inferential statistics were performed using the chi-square test and were considered significant when p < 0.05%. RESULTS Among the participating pharmacists, the majority were women under 60 years old,56 (8.89%) stated that they never orient the customer regarding the disposal of unused and expired household medications, while 574 (91,12%) indicated that they almost provide guidance. The frequency with which they provided guidance was influenced by the number of years since graduation (p = 0.0047), the time they had worked in pharmacies and drugstores (p = 0.0007), and whether or not they had a graduate degree (p = 0.0181). Regarding the disposal of medications, among the 643 responses provided by the pharmacists,516 (80.25%) indicated that they oriented customers to return them to a pharmacy. CONCLUSION A small number of pharmacists always orient customers on the proper disposal that should be followed for unused and expired household medications, prioritizing their return to a pharmacy. In general, these pharmacists have longer periods of work experience and higher academic qualifications. Thus, it is important to increase knowledge through professional training and further education programs.
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Affiliation(s)
- Aparecida de Fatima Michelin
- School of Veterinary Medicine, São Paulo State University (Unesp), Rua Clóvis Pestana, no 793, Araçatuba, 16050-680, SP, Brazil.
- Institute of Health Sciences, Paulista University, Araçatuba, SP, Brazil.
| | - Neuza Alves Bonifácio
- School of Veterinary Medicine, São Paulo State University (Unesp), Rua Clóvis Pestana, no 793, Araçatuba, 16050-680, SP, Brazil
- Institute of Health Sciences, Paulista University, Araçatuba, SP, Brazil
| | | | - Valéria Maria Savoya da Silva
- School of Veterinary Medicine, São Paulo State University (Unesp), Rua Clóvis Pestana, no 793, Araçatuba, 16050-680, SP, Brazil
| | | | - Katia Denise Saraiva Bresciani
- School of Veterinary Medicine, São Paulo State University (Unesp), Rua Clóvis Pestana, no 793, Araçatuba, 16050-680, SP, Brazil
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Alnsour M, Moqbel S. Enhancing environmental sustainability through a household pharmaceuticals take-back program in Jordan. ENVIRONMENTAL MONITORING AND ASSESSMENT 2023; 195:1424. [PMID: 37934353 DOI: 10.1007/s10661-023-12050-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 10/27/2023] [Indexed: 11/08/2023]
Abstract
Most homes have unwanted, discarded, unused, or expired pharmaceuticals. These pharmaceuticals can pose health risks if they are not properly disposed of. Active pharmaceutical ingredients have been detected in water resources at an alarming level globally and recently in Jordanian waters. Unfortunately, no programs or regulations are addressing this problem in Jordan. This study aims to provide a comprehensive evaluation of the stakeholders' potential involvement in establishing a pharmaceutical take-back program in Jordan. The study was designed to determine the focal points of establishing a pharmaceutical take-back program using a qualitative cross-sectional approach and using a force field analysis to put together a plan for a successful program in Jordan. The study conducted three surveys using structured questionnaires and interviews with officials to evaluate the attitude toward the pharmaceutical take-back program, awareness of environmental impacts, and current conditions of household pharmaceuticals in Jordan. The questionnaires were assigned to the public, pharmaceutical manufacturers, and pharmaceutical warehouses. The interviews were conducted with the Ministry of Environment, pharmaceutical manufacturers, and pharmaceutical warehouses. Most of the pharmaceutical producers (85% manufacturers and 94% warehouses) refused to participate voluntarily in the program due to the extra cost incurred. On the other hand, the public and the Ministry of Environment were supportive of establishing the program. The study revealed that there is a lack of awareness among the public toward household pharmaceuticals. About 77% of the public questionnaire respondents reported they had not received any information on how to dispose safely of their unwanted pharmaceuticals. Also, about 61% reported that they have concerns that household pharmaceuticals might contaminate the water resources in Jordan. Following the questionnaires' analysis, the study determined the main forces against establishing a pharmaceutical take-back program as the unwillingness of producers to participate, weak logistic support, lack of public awareness, and low public participation. A force field analysis (FFA) was conducted based on the forces determined from the questionnaires. Accordingly, the study recommends developing a comprehensive legislation and regulatory framework for household pharmaceuticals' recovery, establishing a monitoring entity, securing funds, and implementing a long-term awareness and education plan to support the establishment of a pharmaceutical take-back program in Jordan.
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Affiliation(s)
- Mohammad Alnsour
- Civil Engineering Department, School of Engineering, University of Jordan, Queen Rania St, Amman, 11942, Jordan
| | - Shadi Moqbel
- Civil Engineering Department, School of Engineering, University of Jordan, Queen Rania St, Amman, 11942, Jordan.
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Hassan MM, Al-Marzooq D, Al-Habsi H, Al-Hashar A, Al-Khabori M, Al-Moundhri M, Al-Zakwani I. Patients' knowledge and awareness of safe handling of oral anticancer agents at Sultan Qaboos University Hospital in Oman. J Oncol Pharm Pract 2023; 29:112-118. [PMID: 34791932 DOI: 10.1177/10781552211056238] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Safe handling of oral anticancer agents is of great concern. There is a lack of clear, national guidelines on how patients can safely handle and dispose of unwanted medications. We aimed to evaluate the safe handling, storage, and disposal of oral anticancer drugs among cancer patients and caregivers at home. METHOD This cross-sectional survey of adult cancer patients (or their adult caregivers) used a closed-ended questionnaire from May 2019 to March 2020. RESULTS A total of 257 patients (50 ± 15 years; range: 18-93 years) were enrolled; however, only 91% (233/257) reported self-administering oral anticancer medications. Caregivers were more likely to administer oral anticancer agents for patients ≥60 years than those <40 years old (63% vs. 8%; P = 0.001). Most patients (52%; 133/257) did not wash their hands after administering the drug; 74% (164/222) of the respondents reported that their medications were kept in a bedroom cabinet, while 18% (40/222) stored their medications in a refrigerator, and 5% (12/222) in a kitchen cabinet. A total of 55% (68/124) of patients returned their excess oral chemotherapy medications to the hospitals; however, 36% (45/124) disposed of their unused oral chemotherapy drugs in a household garbage container. CONCLUSION While two-thirds of patients stored their oral anticancer medications properly, more than half used inappropriate handling procedures. Disposal practices were inconsistent and did not adhere to the reported international guidelines.
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Affiliation(s)
- Moataz M Hassan
- Department of Pharmacy, 37611Sultan Qaboos University Hospital, Oman
| | - Dhabya Al-Marzooq
- 194179Department of pharmacy, Sultan Qaboos University Hospital, Oman
| | - Hanan Al-Habsi
- 194179Department of pharmacy, Sultan Qaboos University Hospital, Oman
| | - Amna Al-Hashar
- 588250Sultan Qaboos Comprehensive Cancer Care and Research Center, Oman
| | - Murtadha Al-Khabori
- Hematology Department, 37611College of Medicine and Health Science, Sultan Qaboos University, Oman
| | - Mansour Al-Moundhri
- 588250Sultan Qaboos Comprehensive Cancer Care and Research Center, Oman.,College of Medicine and Health Science, 108707Sultan Qaboos University College of Medicine and Health Science, Oman
| | - Ibrahim Al-Zakwani
- Department of Pharmacology & Clinical Pharmacy, 37611Sultan Qaboos University, Oman
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Ghemrawi R, Kharaba Z, Aldulaymi R, AlBataineh N, Alghaly F, Qasem N, Khair M. Expired medications and disposal practices in Arab households. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2022; 30:534-540. [PMID: 35946835 DOI: 10.1093/ijpp/riac066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 07/20/2022] [Indexed: 01/26/2023]
Abstract
OBJECTIVES Over the past few decades, the accumulation of expired and unused medications in households has become a concern. Most people are unaware of how to properly dispose of unused and/or expired medicines. Our objective was to inspect the extent of expired medications within Arab households in United Arab Emirates (UAE), to determine which therapeutic groups yield greater amounts of unused medications, and evaluate drugs' disposal practices. METHODS This descriptive study was written in accordance with the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) checklist for cross-sectional studies. It was conducted among Arab households in UAE (n = 503) using an online questionnaire between November 2020 and January 2021. Questions were related to participants' socio-demographics, the prevalence of expired medications in households and their disposal. KEY FINDINGS Around 58% of the respondents had expired medications in their houses and 74% had drugs that were never used. The most common medicines left unused were analgesics (34%) followed by cosmetics (27%) and antibiotics (26%). More than 42% of expired medications were in solid dosage forms, 28% were semisolid and 24% were liquid dosage forms. The predominant disposal method among the surveyed participants was throwing medications into the garbage (86%). CONCLUSIONS Large quantities of expired medications in Arab households exist with a high prevalence of analgesics, antibiotics and cosmetics. Arab households are unaware of the proper drug disposal procedures. Therefore, community pharmacists are recommended to offer training on proper medication disposal practices and to encourage the public to return medications to pharmacies.
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Affiliation(s)
- Rose Ghemrawi
- College of Pharmacy, Al Ain University, Abu Dhabi, United Arab Emirates.,AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi, United Arab Emirates
| | - Zelal Kharaba
- College of Pharmacy, Al Ain University, Abu Dhabi, United Arab Emirates.,AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi, United Arab Emirates
| | - Raghad Aldulaymi
- College of Pharmacy, Al Ain University, Abu Dhabi, United Arab Emirates.,AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi, United Arab Emirates
| | - Nezar AlBataineh
- College of Pharmacy, Al Ain University, Abu Dhabi, United Arab Emirates.,AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi, United Arab Emirates
| | - Fady Alghaly
- College of Pharmacy, Al Ain University, Abu Dhabi, United Arab Emirates
| | - Naji Qasem
- College of Pharmacy, Al Ain University, Abu Dhabi, United Arab Emirates
| | - Mostafa Khair
- Core Technology Platforms, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
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Hajj A, Domiati S, Haddad C, Sacre H, Akl M, Akel M, Tawil S, Abramian S, Zeenny RM, Hodeib F, Salameh P. Assessment of knowledge, attitude, and practice regarding the disposal of expired and unused medications among the Lebanese population. J Pharm Policy Pract 2022; 15:107. [PMID: 36585685 PMCID: PMC9802024 DOI: 10.1186/s40545-022-00506-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 12/16/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Medication waste is a public health problem affecting developed and developing countries. In Lebanon, a developing country in the Middle East, efforts are being deployed in hospitals but not in the community. OBJECTIVE This study aimed to validate a questionnaire to explore the knowledge, attitude, and practice (KAP) towards the disposal of unused and expired medicines among the Lebanese population and then identify the factors associated with these variables comparatively between the general population and healthcare professionals. METHODS A cross-sectional study was conducted among the general Lebanese population in May-June 2022 using a standardized questionnaire. The validity and reliability of the KAP scales were assessed, then a thorough statistical analysis was done to explore the factors associated with these scales. RESULTS The KAP scales generated by this study were valid and reliable. Using these scales, 24.5%, 22.6%, and 21% of participants demonstrated proper knowledge, attitude, and practice, respectively. Higher knowledge scores were significantly associated with female gender (Beta = 0.97), a high monthly income (Beta = 1.68), a secondary (Beta = 6.11) or university (Beta = 6.80) education level, and postgraduate education (Beta = 7.13). However, older age (Beta = - 0.06) and a low monthly income (Beta = - 3.06) were significantly associated with lower knowledge scores. A higher knowledge score (Beta = 0.06) was significantly associated with a more positive attitude regarding unused or expired medication disposal. Being a healthcare professional (Beta = 0.72) was significantly associated with a higher practice score, while being a female (Beta = - 0.32) and living in a rural area (Beta = - 0.37) were significantly associated with lower practice scores. CONCLUSION This study validated KAP scales regarding medication waste in Lebanon and showed low KAP scores in the majority of respondents. Factors associated with higher KAP scores in various aspects of medication disposal, including gender, age, education level, and profession (healthcare professionals), suggest the need to consider those when implementing targeted corrective measures. Although further studies are required to confirm our findings, this study could be the ground for a medication waste management national strategy in Lebanon.
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Affiliation(s)
- Aline Hajj
- grid.23856.3a0000 0004 1936 8390Faculty of Pharmacy, Université Laval, Québec City, Canada ,INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon ,grid.411081.d0000 0000 9471 1794Oncology Division, CHU de Québec-Université Laval Research Center, Québec City, QC Canada ,grid.42271.320000 0001 2149 479XLaboratoire de Pharmacologie, Pharmacie Clinique et Contrôle de Qualité Des Médicaments (LPCQM), Faculty of Pharmacy, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Souraya Domiati
- grid.18112.3b0000 0000 9884 2169Department of Pharmacology and Therapeutics, Faculty of Pharmacy, Beirut Arab University, Beirut, Lebanon
| | - Chadia Haddad
- INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon ,grid.411323.60000 0001 2324 5973School of Medicine, Lebanese American University, Byblos, Lebanon ,grid.512933.f0000 0004 0451 7867Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon ,grid.444428.a0000 0004 0508 3124School of Health Sciences, Modern University for Business and Science, Beirut, Lebanon
| | - Hala Sacre
- INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon ,Drug Information Center, Order of Pharmacists of Lebanon, Beirut, Lebanon
| | - Maria Akl
- grid.8991.90000 0004 0425 469XFaculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Marwan Akel
- INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon ,grid.444421.30000 0004 0417 6142Pharmacy Practice Department, School of Pharmacy, Lebanese International University, Beirut, Lebanon ,grid.475243.30000 0001 0729 6738International Pharmaceutical Federation, The Hague, Netherlands
| | - Samah Tawil
- grid.411323.60000 0001 2324 5973School of Medicine, Lebanese American University, Byblos, Lebanon ,Drug Information Center, Order of Pharmacists of Lebanon, Beirut, Lebanon
| | - Soula Abramian
- Drug Information Center, Order of Pharmacists of Lebanon, Beirut, Lebanon
| | - Rony M. Zeenny
- INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon ,grid.411654.30000 0004 0581 3406Department of Pharmacy, American University of Beirut Medical Center, Beirut, Lebanon
| | - Fadi Hodeib
- grid.444421.30000 0004 0417 6142Department of Biomedical Sciences, School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Pascale Salameh
- INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon ,grid.411323.60000 0001 2324 5973School of Medicine, Lebanese American University, Byblos, Lebanon ,grid.413056.50000 0004 0383 4764Department of Primary Care and Population Health, University of Nicosia Medical School, 2417 Nicosia, Cyprus ,grid.411324.10000 0001 2324 3572Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
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Rogowska J, Zimmermann A. Household Pharmaceutical Waste Disposal as a Global Problem-A Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192315798. [PMID: 36497873 PMCID: PMC9737308 DOI: 10.3390/ijerph192315798] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/18/2022] [Accepted: 11/24/2022] [Indexed: 05/31/2023]
Abstract
The negative effect of the pharmaceuticals presence (persistence?) in various components of the environment is a global problem today. These compounds are released into the environment as a result of, inter alia, their use and improper disposal. Therefore, it is important to reduce excessive drug consumption and to develop a system for the collection of unused/expired pharmaceuticals. The effectiveness of actions in this area is inextricably linked with the need to educate society on how to deal properly with unwanted medications. The aim of the study was to show that the inappropriate handling of unused/expired drugs by society is an important problem in waste management systems, and it impacts the state of the environment. Forty-eight scientific articles published between 2012 and 2021 were taken into account that discussed the systems in various countries for the collection of unused/expired pharmaceuticals. This literature review shows that the main method of disposing of unused/expired medications, according to respondents from different countries, is either by disposing of them in household waste or flushing them into the sewage system. This is also the case in countries with systems or programs for the return of redundant drugs, which indicates that these systems are not sufficiently effective. This may be influenced by many factors, including the lack or ineffective education of the society.
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Althagafi A, Alshibani M, Alshehri S, Noor A, Baglagel A, Almeleebia T. Assessment of Knowledge and Awareness of Safe Disposal of Unused or Expired Medication in Saudi Arabia: A Cross-sectional Study. Saudi Pharm J 2022; 30:1672-1678. [DOI: 10.1016/j.jsps.2022.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 09/13/2022] [Indexed: 11/26/2022] Open
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Knowledge, Attitude, and Practices of Unused Medications Disposal among Patients Visiting Public Health Centers in Gondar Town, Ethiopia: A Cross-Sectional Study. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2022; 2021:5074380. [PMID: 35003272 PMCID: PMC8739181 DOI: 10.1155/2021/5074380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/14/2021] [Accepted: 12/21/2021] [Indexed: 12/02/2022]
Abstract
Background The improvement of healthcare systems has brought the subsequent increase in people access to medications. The consumers are not able to use all the dispensed medications because of various reasons. The improper disposal of these unused medicines has led to environmental contamination to an alarming extent. Therefore, the study was conducted to assess the knowledge, attitude, and practice of unused medications disposal among patients visiting public health centers in Gondar town, Ethiopia. Methods A descriptive cross-sectional study was conducted among 404 patients visiting public health centers in Gondar town, Ethiopia, from August to September 2021, by using standardized and a locally translated semistructured questionnaire. The data were entered and analyzed by using the SPSS version of 21.0. The variable of interest was described in the form of statements and tables. Result Out of 404 respondents included in the study, 221 (54.7%) of them were female. More than half (226 (55.9%)) of the respondents had unused medicine at home. The common methods of disposal practice were throwing into a household garbage (150 (31.4%)), followed by flushed into toilet/sinks (88 (21.8%)). More than half (286 (70.8%)) of the respondents knew about medication waste and 239 (59.2%) of them checked their medication expiry date. More than half (215 (53.5%)) of the participants strongly agreed that unused medicine can cause potential risk at home and 279 (69.1%) of study participants strongly agreed that children are more vulnerable to the potential risk of unused medicine at home. Conclusion There was a high practice of keeping medication at home, and most disposal approach indicated by the participants was not recommended methods. Awareness about the proper disposal of unused medicines among the public should be created. Guidelines on safe disposal are required, and an organized method of collecting unused and expired pharmaceuticals needs to be introduced.
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OUP accepted manuscript. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2022; 30:247-252. [DOI: 10.1093/ijpp/riac006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 02/02/2022] [Indexed: 11/12/2022]
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Hassan ELWEL, Taisan AAA, Abualhommos AK. Knowledge and practices concerning the storage and disposal of home medications among people in the eastern region of Saudi Arabia: A cross-sectional study. Saudi Pharm J 2021; 30:172-179. [PMID: 35528849 PMCID: PMC9072702 DOI: 10.1016/j.jsps.2021.12.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 12/27/2021] [Indexed: 11/29/2022] Open
Abstract
Background Medications are widely used and stored in people’s homes throughout the year. Inappropriate storage of home medications is a worldwide problem and may affect the effectiveness and stability of medications, which impacts the activity and capability of these medications to treat diseases. This study aimed to assess the awareness of the public in the eastern region of Saudi Arabia concerning the appropriate storage of used medications and the proper disposal of unwanted medications. Method A cross-sectional survey was conducted in the eastern region of Saudi Arabia between February and June 2018. The study questionnaire tool was constructed based on several previous studies regarding medication storage, recycling, and the correct and safe disposal of expired, unwanted, or unused medication. Results A total of 820 responses was collected. The results showed that 91.0% of the respondents keep their medications in the original container, and only 4.5% of them write the expiry date on the new containers. While 47.1% of the respondents read the storage instructions written in the medication leaflet, only 16.2% of the respondents ask the pharmacist about the storage instructions. A majority of the respondents (84.4%) check the expiry date of medications before use, and 70.1% of them periodically check the expiry date of stored medications. Age, gender, and education level were important factors that affected medication storage practices. Conclusion This work underpinned the lack of awareness among the public regarding the appropriate way to store home medications and the proper way to dispose of unwanted and expired medications.
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Hendaus MA, Darwish S, Saleh M, Mostafa O, Eltayeb A, Al-Amri M, Siddiqui FJ, Alhammadi A. Medication take-back programs in Qatar: Parental perceptions. J Family Med Prim Care 2021; 10:2697-2702. [PMID: 34568157 PMCID: PMC8415692 DOI: 10.4103/jfmpc.jfmpc_1141_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 08/23/2020] [Accepted: 08/30/2020] [Indexed: 12/04/2022] Open
Abstract
Purpose: To identify parental perception of a take-back program for medications. Materials and Methods: A cross-sectional study using a questionnaire was conducted at Hamad Medical Corporation, the only tertiary pediatric hospital in the State of Qatar at the time of the study. Qatar is a rapidly developing country with limited national data on the awareness of medication misuse among adults living with children at home and on the safety practices regarding medication disposal. Results: 305 questionnaires were completed (response rate = 90%). More than 80% of parents were in between 20 and 39 years of age, 70% of them were females, and 80% were college graduates. Approximately 90% of participants have immediate relatives who were taking medications for chronic diseases. Almost 60% of parents stated that they keep unused medications at home, whereas 10% were not aware of the fate of the left over medications. Approximately 95% of the parents dispose the expired medications. In terms of the mode of disposing the medications, 66% of caregivers dispose the medication bottle or package in the trash can, whereas 14% remove the medications from the bottles or packages and throw them in the trash, and 15% put them through the drain. When asked if participants read disposal measures in the medication pamphlet, only 10% answered “always,” whereas 26% answered “sometimes.” Participants were asked if they have heard of any medications take-back programs, 75% answered no, whereas 14% were not sure. However, almost 60% of them will use the take-back program if available and 18% were not sure. Conclusion: Parents residing in the State of Qatar have deficiencies in knowledge about medication disposal. Parent's attitudes and perceptions are considered indispensable targets for community health intervention. Our next step is to share our data with the ministry of health to spread awareness about the proper disposal of medicines and take-back programs in Qatar.
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Affiliation(s)
- Mohamed A Hendaus
- Department of Pediatrics Section of Academic General Pediatrics, Sidra Medicine, Doha, Qatar.,Department of Pediatrics, Section of Academic General Pediatrics, Hamad Medical Corporation, Doha, Qatar.,Department of Clinical Pediatrics, Weill-Cornell Medicine, Doha, Qatar
| | - Shereen Darwish
- Department of Medical Education, Hamad Medical Corporation, Doha, Qatar
| | - Manar Saleh
- Department of Medical Education, Hamad Medical Corporation, Doha, Qatar
| | - Omar Mostafa
- Department of Medical Education, Hamad Medical Corporation, Doha, Qatar
| | - Ahmed Eltayeb
- Department of Medical Education, Hamad Medical Corporation, Doha, Qatar
| | - Mohammed Al-Amri
- Department of Pediatrics, Section of Academic General Pediatrics, Hamad Medical Corporation, Doha, Qatar
| | - Faisal J Siddiqui
- Department of Medical Education, Hamad Medical Corporation, Doha, Qatar
| | - Ahmed Alhammadi
- Department of Pediatrics Section of Academic General Pediatrics, Sidra Medicine, Doha, Qatar.,Department of Pediatrics, Section of Academic General Pediatrics, Hamad Medical Corporation, Doha, Qatar.,Department of Clinical Pediatrics, Weill-Cornell Medicine, Doha, Qatar
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Wang LS, Aziz Z, Chik Z. Disposal practice and factors associated with unused medicines in Malaysia: a cross-sectional study. BMC Public Health 2021; 21:1695. [PMID: 34530791 PMCID: PMC8447783 DOI: 10.1186/s12889-021-11676-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 08/29/2021] [Indexed: 12/04/2022] Open
Abstract
Background The improper disposal of unused medicines is a worldwide concern because of its impact on the environment, economy, and health. This study aims to describe the disposal practice of unused medicine and identify factors associated with unused medicines in Malaysia. Methods This was a cross-sectional, face to face interview-based survey using a structured questionnaire. We used a convenience sampling method to recruit participants from Kuala Lumpur and Selangor in Malaysia. Results We interviewed 1184 participants, and the response rate was 96%. Out of the total respondents, 995 (84%) reported having unused medicines. About a quarter of respondents kept unused medicines in the cabinet, and another quarter disposed of them into the trash or toilet. Only half of the respondent who used medicines for chronic illnesses had unused medicines compared to about 90% of respondents who used medicines for acute illnesses. The main reason for having unused medicines among those who used medicines for chronic illness was non-adherence (69%, p < 0.05). Only 27% of these respondents returned unused medicines under the “Medicine Return Programme (MRP)”. The other group who used medicines for acute illnesses had unused medicines because their health conditions improved. Thus, most of the unused medicines will eventually end up in household waste. A multivariate logistic regression analysis identified respondents who used medicines for acute illnesses as the strongest predictor of having unused medicines (Odds Ratio (OR) = 29.8; p < 0.001), followed by those who pay for their medicines (OR = 6.0; p < 0.001) and those who were willing to participate the Medicine Return Programme (OR = 2.5; p = 0.009). Conclusion The prevalence of unused medicines and their improper disposal were high in Malaysia. Unused medicines are associated with people who use medicines for acute illnesses, pay for their medication, and are willing to participate in an MRP. Rationale prescription and optimal dispensing practice, together with a broader MRP facilities coverage, could reduce unused medicine possession. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11676-x.
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Affiliation(s)
- Leong Seng Wang
- Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.,School of Pharmacy, Monash University, 47500, Bandar Sunway, Selangor, Malaysia
| | - Zoriah Aziz
- Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia. .,Faculty of Pharmacy, MAHSA University, 42610, Jenjarom, Selangor, Malaysia.
| | - Zamri Chik
- Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
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Nepal S, Giri A, Bhandari R, Chand S, Nepal S, Aryal S, Khanal P, Moktan JB, Shastry CS. Poor and Unsatisfactory Disposal of Expired and Unused Pharmaceuticals: A Global Issue. Curr Drug Saf 2021; 15:167-172. [PMID: 32589562 DOI: 10.2174/1574886315666200626164001] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 04/27/2020] [Accepted: 05/29/2020] [Indexed: 01/16/2023]
Abstract
Pharmaceuticals are beneficial to humankind and emerged as crucial arms to treat/manage multiple disease pathogenesis in the present era. In analogous, these medicines/ medical devices should be used cautiously as they possess a potential threat to induce multiple undesired effects that may be related to human health or the environment. Daunting effects may arise due to the improper disposal of unused/expired medicines. Hence, to minimize such harm, there should be adequate knowledge and practice among the population regarding the safe disposal of unused/expired medicines or related pharmaceutical devices. The lack of approved information regarding safe disposal of such substances may invite serious concerns like environmental pollution, which may induce immediate health hazards to the present population and upcoming future generations. There are numerous ways to dispose of, or manage the unused and expired pharmaceutical substances. Sharing the medicines among siblings, friends, and family members are never free from serious health risks. Storing the unused and expired medicines in the home increases the risk of intentional or accidental ingestion of such substances and may create a health emergency. Disposing medicines like household and municipal waste may lead to environmental pollution and harm to humans and animals. The present review finds the multiple unsafe ways of disposal of unutilized medications/tools. Furthermore, it also summarizes the disposal pattern of unutilized medications among the few developed and undeveloped nations.
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Affiliation(s)
- Sunil Nepal
- Department of Clinical Pharmacy, School of Health and Allied Sciences, Pokhara University, Lekhnath 33700, Nepal
| | - Anil Giri
- Department of Clinical Pharmacy, School of Health and Allied Sciences, Pokhara University, Lekhnath 33700, Nepal
| | - Ramesh Bhandari
- Department of Pharmacy Practice, KLE College of Pharmacy, Belagavi, KLE Academy of Higher Education and Research (KAHER), Belagavi, India
| | - Sharad Chand
- Department of Pharmacy Practice, NGSM Institute of Pharmaceutical Sciences, NITTE (Deemed to be University), Paneer, Deralakatte, Mangaluru, Karnataka 575018, India
| | - Sudip Nepal
- District Coordinator- The Leprosy Mission Nepal, Rupandehi, Butwal, Nepal
| | - Santosh Aryal
- District Coordinator- The Leprosy Mission Nepal, Rupandehi, Butwal, Nepal
| | - Pukar Khanal
- Department of Pharmacology and Toxicology, KLE College of Pharmacy, Belagavi, KLE Academy of Higher Education and Research (KAHER), Belagavi, India
| | - Jeet Bahadur Moktan
- Department of Pharmacy Practice, Sri Adichunchanagiri College of Pharmacy, Adichunchanagiri University, B.G. Nagara-571448, India
| | - Chakrakodi Shashidhara Shastry
- Department of Pharmacy Practice, NGSM Institute of Pharmaceutical Sciences, NITTE (Deemed to be University), Paneer, Deralakatte, Mangaluru, Karnataka, India
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Hendaus MA, Saleh M, Darwish S, Mostafa O, Eltayeb A, Al-Amri M, Siddiqui FJ, Alhammadi A. Parental perception of medications safe storage in the State of Qatar. J Family Med Prim Care 2021; 10:2969-2973. [PMID: 34660433 PMCID: PMC8483110 DOI: 10.4103/jfmpc.jfmpc_1259_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 09/05/2020] [Accepted: 09/07/2020] [Indexed: 12/01/2022] Open
Abstract
PURPOSE The purpose of this study is to identify parental perception of household medication storage. METHODS A prospective cross-sectional study utilizing a questionnaire was carried out at Hamad Medical Corporation, the solely tertiary pediatric hospital in the State of Qatar at the time of the study. Qatar is a young developing country with limited data on the awareness of medication storage among adults with children at home and on the safety practices regarding medication storage. RESULTS Three hundred and five questionnaires were completed. The vast majority of parents were married, one-third of them were males, and more than three quarters were college graduates and younger than 40 years of age. Almost 80% of the parents had more than three children but less than seven. In addition, 23% of participants were health-care workers. Almost 90% of the participants stored medications in a place that is easy to reach. However, the same percentage stated that those medications were stored in a locked place and that children did not have access to them. Approximately 10% of caregivers store multiple medications in one bottle, and the same percentage of participants do not check the expiration date on the medication labels. In terms of the most common medications stored at home, antihypertensives were on top of the list. Our study has shown that parental education and being a health-care worker were each associated with the difficulty in reaching medications (P = 0.006 and P = 0.011, respectively). Moreover, the percentage of participants who shared medications was significantly higher among those who were not working in the health-care section compared to those who were (P = 0.004). In addition, being a female parent and a college graduate was associated with the possibility of keeping excess or leftover medications at home (P = 0.025). CONCLUSION Parents residing in the State of Qatar have some deficiencies in knowledge about medication storage. Parent's attitudes and perceptions are deemed vital objectives for population's health intervention.
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Affiliation(s)
- Mohamed A. Hendaus
- Department of Pediatrics, Section of Academic General Pediatrics, Sidra Medicine, Doha, Qatar
- Department of Pediatrics, Section of Academic General Pediatrics, Hamad Medical Corporation, Doha, Qatar
- Department of Clinical Pediatrics, Weill-Cornell Medicine, Doha, Qatar
| | - Manar Saleh
- Department of Medical Education. Hamad Medical Corporation, Doha, Qatar
| | - Shereen Darwish
- Department of Medical Education. Hamad Medical Corporation, Doha, Qatar
| | - Omar Mostafa
- Department of Medical Education. Hamad Medical Corporation, Doha, Qatar
| | - Ahmed Eltayeb
- Department of Medical Education. Hamad Medical Corporation, Doha, Qatar
| | - Mohammed Al-Amri
- Department of Pediatrics, Section of Academic General Pediatrics, Hamad Medical Corporation, Doha, Qatar
| | | | - Ahmed Alhammadi
- Department of Pediatrics, Section of Academic General Pediatrics, Sidra Medicine, Doha, Qatar
- Department of Pediatrics, Section of Academic General Pediatrics, Hamad Medical Corporation, Doha, Qatar
- Department of Clinical Pediatrics, Weill-Cornell Medicine, Doha, Qatar
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Alghadeer S, Al-Arifi MN. Community Pharmacists' Practice, Awareness, and Beliefs about Drug Disposal in Saudi Arabia. Healthcare (Basel) 2021; 9:healthcare9070823. [PMID: 34209499 PMCID: PMC8306795 DOI: 10.3390/healthcare9070823] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/13/2021] [Accepted: 06/25/2021] [Indexed: 11/21/2022] Open
Abstract
The awareness among Saudi people regarding the good and safe practice of drug disposal is fairly low. Community pharmacists’ potential toward drugs disposal directions and practice are not emphasized enough. Therefore, a cross sectional study was conducted in Riyadh, Saudi Arabia, to evaluate the practice, awareness and beliefs of community pharmacists about disposal of unused drugs. Out of 360 subjects who participated in the study, more than 70% returned the unused drugs to the pharmaceutical distributors. Around 80% of the participants confirmed the risk of environmental damage due to the inappropriate disposal of drugs, and 87.5% of them held themselves responsible for preventing such risk. Approximately 85% of surveyed pharmacists believed community pharmacies to be an appropriate location for the collection of unused drugs. There was no significant association between the community pharmacists’ age group and years of practice as community pharmacists with either the awareness of unused medication disposal on environmental hazards, or the beliefs about the appropriate location for collecting unused drugs (p > 0.05). The awareness and proactive accountable responsibility, along with community pharmacists’ belief of appointing pharmacies to collect unused drugs, strongly support the institution of drug take-back programs.
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Affiliation(s)
- Sultan Alghadeer
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia;
- Research Center, Basic Sciences Department, Prince Sultan College for EMS, King Saud University, Riyadh 11451, Saudi Arabia
- Correspondence:
| | - Mohammed N. Al-Arifi
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia;
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Makki M, Hassali MAA, Awaisu A, Chemaitelly H. Development, translation, and validation of a bilingual questionnaire on unused medications in homes. Saudi Pharm J 2021; 29:648-655. [PMID: 34400858 PMCID: PMC8347668 DOI: 10.1016/j.jsps.2021.04.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 04/21/2021] [Indexed: 11/19/2022] Open
Abstract
Background Unused medications in homes pose significant health, economic, and environmental risks. Patients are the medications end users and their knowledge, attitude, and practices (KAP) play an important role towards medication use, unuse and wastage. Thus, a valid instrument to reliably measure patients’ KAP towards unused medications in homes may help manage the associated risks. Objective To develop, translate, and validate a questionnaire for the assessment patients’ KAP towards unused medications in Qatar homes (i.e., QUM-Qatar). Setting This cross-sectional validation study was conducted among randomly selected outpatients visiting various public and private pharmacies in Qatar between September 2019 and February 2020. Method Nine experts in the field of pharmacy practice with Qatar contextual background established the content validity of the instrument. The validity was quantified using content validity index (CVI). Furthermore, construct validity was performed using principal component analysis (PCA), whereas internal consistency reliability of items was determined using Cronbach’s alpha. Statistical analyses were performed using STATA 15 statistical software. Main outcome measure The psychometric properties of the QUM-Qatar assessment instrument. Results An English/Arabic questionnaire was developed and validated. Content validity in the form of scale-level-CVI (S-CVI)/Average and S-CVI/UA was 0.88 and 0.84, respectively, suggesting adequate relevant content of the questionnaire. Variation explained by the multivariate model was 85.0% for knowledge, 94.8% for attitude, and 89.8% for practice. Cronbach’s alpha coefficients were 0.68, 0.82, and 0.84, for knowledge, attitude, and practice domains, respectively. From the psychometric results obtained, the questionnaire's validity and reliability were attained. Conclusion The QUM-Qatar instrument has acceptable psychometric properties and has the potential for future use in research and practice to assess KAP towards unused medications in Qatar and elsewhere. It may consequently help in improving medication use and mitigating the negative health, economic, and environmental impacts of unused medications. Impacts on practice.There is now a valid and reliable English/Arabic language questionnaire to assess patients’ KAP towards unused medications. Policymakers can utilize this questionnaire to develop evidence-based policies and strategies for managing unused medications and their disposal. To improve medication use review, rational use of medicines, and adherence, it is necessary to consider patient-reported outcomes that may eventually reflect on saving health, economic resources, and environment.
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Affiliation(s)
- Mutaseim Makki
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang 11800, Malaysia
- Corresponding author.
| | | | - Ahmed Awaisu
- Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, P.O.Box 2713, Doha, Qatar
| | - Hiam Chemaitelly
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar
- World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine–Qatar, Cornell University, Qatar Foundation – Education City, Doha, Qatar
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Mahara G, Wu Z, Ge Q, Li Z, Zhang J. Assessment on the Impact on Human Health, Environment, Water and Soil by Disposing Household Expired Drugs: A Cross-Sectional Study in China. Risk Manag Healthc Policy 2021; 14:1711-1721. [PMID: 33935525 PMCID: PMC8079354 DOI: 10.2147/rmhp.s301910] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 03/29/2021] [Indexed: 11/23/2022] Open
Abstract
Background The household expired drugs disposal has been a huge public issue in many countries, including China, which may affect various side and toxic effects on human health and environment, water resources, and soil too. This paper explores the knowledge, attitude, and practice of Guangzhou city residents regarding household expired drugs and their effect on human health and provided the scientific pieces of evidence to carry out the long-term recovery mechanism for expired medicines. Methods An observational, cross-sectional study was conducted using a self-structured questionnaire. Descriptive analysis, including univariate and unconditional logistic regression models, was carried out to analyze the data. Results A total of 613 community residents with a 99.4% response rate enrolled for the study. More than half 60.2% of residents stated that expired drugs pollute the environment, soil, and water resources, where 81.2% of respondents knew that it would produce side effects or toxic effects. However, still, 71.6% of respondents disposed of directly into the trash bin or sink, and, only 24.8% had good practice that they use a designed recycling bin. Likewise, only 8.3% of respondents placed expired drugs into collection points nearly 3-5 times in a year, while 65.1% of participants never disposed of in the collection point, which found a worse practice. Conclusion Overall, the knowledge, attitude, and practice of Guangzhou residents regarding household expired drugs disposal were not ideal. To improve the resident's awareness about family expired drugs disposal, ensure the financial support for the recycling process, establish an accessible and acceptable recycling point, and introduce relevant laws and regulations for the long-term mechanism.
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Affiliation(s)
- Gehendra Mahara
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, People's Republic of China
| | - Zhihong Wu
- Research Center, Baiyunshan Hejigong Pharmaceutical Factory, Guangzhou Baiyunshan Pharmaceutical Holdings Co., Ltd, Guangzhou, 510080, People's Republic of China
| | - Qi Ge
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, People's Republic of China
| | - Zhiwei Li
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, People's Republic of China
| | - Jinxin Zhang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, People's Republic of China
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de Campos EAR, Tavana M, Ten Caten CS, Bouzon M, de Paula IC. A grey-DEMATEL approach for analyzing factors critical to the implementation of reverse logistics in the pharmaceutical care process. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:14156-14176. [PMID: 33206293 DOI: 10.1007/s11356-020-11138-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 10/04/2020] [Indexed: 06/11/2023]
Abstract
There is an increasing interest in product recovery, closed-loop supply chains, and reverse logistics (RL) for mitigating environmental impairment. Although RL is becoming a mandatory policy in developed countries, it is still in an embryonic stage in some industrial sectors of emerging economies. The purpose of this study is twofold: (1) identify the critical factors to the successful implementation of RL in the Brazilian pharmaceutical care process (PCP) and (2) determine the cause-and-effect relationships among them. We use snowball sampling to select the relevant RL studies and deductive reasoning and classification to identify the critical factors and a grey decision-making trial and evaluation laboratory (DEMATEL) to evaluate the cause-and-effect relationships among them. The study revealed management, collaboration, information technology, infrastructure, policy, financial and economic, end-of-life management practices, and logistic performance factors as the most relevant factors to the successful implementation of RL in the Brazilian PCP. The end-of-life management practices were identified as the most critical factor, and information technology was identified as the least critical factor. We further determined the end-of-life management practices and policy have the strongest casual relationship. The municipal PCP coordinators can use the findings of this study to formulate mitigating strategies to identify and eliminate barriers to the successful implementation of RL in the Brazilian PCP.
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Affiliation(s)
| | - Madjid Tavana
- Business Systems and Analytics Department, Distinguished Chair of Business Analytics, La Salle University, Philadelphia, PA, 19141, USA.
- Business Information Systems Department, Faculty of Business Administration and Economics, University of Paderborn, Paderborn, Germany.
| | - Carla Schwengber Ten Caten
- Department of Industrial Engineering, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Marina Bouzon
- Department of Production and Systems Engineering, Federal University of Santa Catarina (UFSC), Santa Catarina, Brazil
| | - Istefani Carísio de Paula
- Department of Industrial Engineering, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
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Naser AY, Amara N, Dagash A, Naddaf A. Medications disposal and medications storage in Jordan: A cross-sectional study. Int J Clin Pract 2021; 75:e13822. [PMID: 33159356 DOI: 10.1111/ijcp.13822] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 10/30/2020] [Indexed: 11/28/2022] Open
Abstract
AIMS Many concerns arise from the improper disposal of medications, which is associated with a negative impact on health and wildlife. The majority of the consumers of pharmaceutical products remain unaware of the procedures of disposal of unused or expired medicines. This study aimed to explore the practices of Jordanian individuals regarding the disposal and storage of unused or expired medications. METHODS A cross-sectional study was conducted in Jordan for the period between July and November 2019 of patients who reported having unused, leftover or expired medications in their homes. The questionnaire tool was constructed based on a number of studies concerning medication recycling and international guidelines about correct and safe disposal of expired, unwanted or unused medication. RESULTS A total of 1092 participants were included in the study. Their mean age was 32.4 (SD = 13.6) years and 56.8% (n = 620) were males. More than half of the participants (58.1%, n = 634) reported that they had unused, leftover or expired medications in their homes. The bedroom, kitchen and store room were the three most commonly reported places for the storage of unused, leftover or expired medications. The pharmacist was the main source for information regarding the storage of medications. The three most common reasons reported by the participants regarding having unused/leftover medications at home were change or discontinuation by the doctor (29.4%), self-discontinuation as the illness symptoms improved or resolved (28.2%) and forgetfulness (25.1%). CONCLUSION A high percentage of the Jordanian population improperly handles their unused, leftover or expired medications. More restrictions are needed on the prescribing and dispensing of medications by the authorities concerned and there is a need to establish public guidelines regarding the use and correct disposal of pharmaceuticals.
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Affiliation(s)
- Abdallah Y Naser
- Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman, Jordan
| | - Noor Amara
- Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman, Jordan
| | - Ayah Dagash
- Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman, Jordan
| | - Ahmad Naddaf
- Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman, Jordan
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Laganà IR, Sharifi S, Khademi M, Salimi M, Ferrara M. Analysis of some incentives on two‐echelon reverse supply chain with a strategic consumer: The case of unwanted medications in households. JOURNAL OF MULTI-CRITERIA DECISION ANALYSIS 2021. [DOI: 10.1002/mcda.1736] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Iside Rita Laganà
- DiGiES & Decisions Lab Università Mediterranea di Reggio Calabria Reggio Calabria Italy
| | - Somayeh Sharifi
- DiGiES & Decisions Lab Università Mediterranea di Reggio Calabria Reggio Calabria Italy
- Institut für Numerische Mathematik Technische Universität Dresden Dresden Germany
| | - Mehrnoosh Khademi
- DiGiES & Decisions Lab Università Mediterranea di Reggio Calabria Reggio Calabria Italy
| | - Mehdi Salimi
- Department of Mathematics & Statistics McMaster University Hamilton Ontario Canada
- Center for Dynamics, Faculty of Mathematics Technische Universität Dresden Dresden Germany
| | - Massimiliano Ferrara
- DiGiES & Decisions Lab Università Mediterranea di Reggio Calabria Reggio Calabria Italy
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Alhomoud FK, Alsadiq Y, Alghalawin L, Alhifany A, Alhomoud F. Pharmacy students' knowledge and practices concerning the storing and disposal of household medication in Saudi Arabia. CURRENTS IN PHARMACY TEACHING & LEARNING 2021; 13:5-13. [PMID: 33131618 DOI: 10.1016/j.cptl.2020.08.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 07/05/2020] [Accepted: 08/10/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Pharmacists, and thus pharmacy students, must participate in promoting awareness about proper storage and disposal of expired or unused medications. This study aimed to determine Saudi Arabian pharmacy students' knowledge and personal practices regarding storing and disposing of household medications. METHODS This was a descriptive, cross-sectional, questionnaire-based study of pharmacy undergraduates or postgraduates across Saudi Arabia. The online survey was distributed to a convenience sample of participants and supplemented with snowball sampling on social media. RESULTS Of 807 pharmacy students who viewed the questionnaire, 464 students completed it (response rate 57.5%). Common reasons for keeping medications included having left-over medication (74%) and self-discontinuation of therapy (63.5%). The majority of students (79%) stored their medication in a bedroom or kitchen. Gender-specific variables revealed a gender difference in storing and disposing of these medications. Many students reported previously discarding medicines in the garbage (89%) or giving them to someone else to use (22%). More than half of the sample (60%) had not received any information on how to store or dispose of medications. CONCLUSIONS The current practice and knowledge of Saudi Arabian pharmacy students regarding storage and disposal of household medications was inappropriate. Concerned authorities (e.g., Ministry of Health, Ministry of Education) should provide proper education to all students on the safe storage and disposal of medications, which may necessitate curriculum reform.
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Affiliation(s)
- Farah Kais Alhomoud
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, 2835 King Faisal Road, Dammam 34212, Saudi Arabia.
| | - Yara Alsadiq
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Laila Alghalawin
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Abdullah Alhifany
- Clinical Pharmacy Department, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Faten Alhomoud
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Alhomoud F. "Don't Let Medicines Go to Waste"-A Survey-Based Cross-Sectional Study of Pharmacists' Waste-Reducing Activities Across Gulf Cooperation Council Countries. Front Pharmacol 2020; 11:1334. [PMID: 32982744 PMCID: PMC7485414 DOI: 10.3389/fphar.2020.01334] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 08/11/2020] [Indexed: 11/13/2022] Open
Abstract
Objectives Medication waste has a negative environmental and economic impact. From avoiding unnecessary supply to recycling medicines that are no longer needed, pharmacists are placed in an advantageous position to minimise medication waste. Thus, the aim of this study was to detect waste-minimising activities undertaken by pharmacists to limit medication waste and to evaluate their importance for medication waste minimisation and feasibility for implementation. Methods A cross-sectional survey of 277 participants, conveniently selected from six Gulf countries. The eligibility criteria were pharmacists or pharmacy technicians, Arabic- or English-speaking individuals, aged ≥18 years, and living in the Gulf countries. An online self-administered survey was distributed during December 2019 and February 2020, via e-mail and social networks; it included the purpose of the study with a link to the webpage that hosted the questionnaire. Data were collected through the online survey site QuestionPro.com. All analyses were performed in SPSS Version 23 and Microsoft Excel. Results The majority of participants were female (175/277; 63%), hospital pharmacists (206/277; 74%), and had more than 10 years of work experience (100/277; 36%). This study indicates that most of the suggested activities (14/21) were implemented by the majority of pharmacists for minimising medication waste, except four activities in the dispensing stage and three activities in the leftover stage. Activities performed at the prescribing, dispensing and leftover stages were considered very important or important for reducing medication waste and very feasible or feasible for implementation in practice. Conclusions Many waste-minimising activities were undertaken by pharmacists in the prescribing, dispensing, and leftover stages. However, although waste-minimising activities were perceived as important for reducing waste and feasible for implementation in practice, not all activities were implemented in daily practice.
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Affiliation(s)
- Faten Alhomoud
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Knowledge, Attitude, and Practice of Unused and Expired Medication Disposal among Patients Visiting Ayder Comprehensive Specialized Hospital. BIOMED RESEARCH INTERNATIONAL 2020; 2020:9538127. [PMID: 32908927 PMCID: PMC7463377 DOI: 10.1155/2020/9538127] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 08/13/2020] [Indexed: 12/24/2022]
Abstract
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.
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Prevalence and Practice of Unused and Expired Medicine-A Community-Based Study among Saudi Adults in Riyadh, Saudi Arabia. BIOMED RESEARCH INTERNATIONAL 2020; 2020:6539251. [PMID: 32724806 PMCID: PMC7364235 DOI: 10.1155/2020/6539251] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 03/23/2020] [Accepted: 06/26/2020] [Indexed: 02/07/2023]
Abstract
Purpose The objective of the current study was to determine the prevalence and practice of unused and expired medicine among Saudi adults. Subjects and Methods. The study used cross-sectional web-based design to collect the data, over a period of 4 months among people who are living in Riyadh, Saudi Arabia. Results A total of 337 questionnaires were obtained during the study period. The majority of respondents were university graduates n = 251 (74.7%). The prevalence of unused medicine was n = 301 (89.3%). The most commonly used drugs were nonsteroidal anti-inflammatory drugs n = 272 (80.7%) and antibiotics n = 164 (48.7%). Of the participants, 186 (55.2%) checked the expiry date of the medicine before they purchase. Most of them n = 305 (90.5%) obtained medicine through prescription. About n = 219 (65%) of them keep the medicine until it expired; 48.1% throw away in the household garbage while only 18 (5.4%) of the respondents said to give it back to the medical store. Conclusion The study revealed a high prevalence of unused medications among Saudi community. However, the disposable practice among the Saudi community was inadequate. Increasing awareness through education programs about proper disposable guidelines is necessary for controlling the medication wastage.
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Kassahun H, Tesfaye D. Disposal Practices of Unused Medications Among Patients in Public Health Centers of Dessie Town, Northeast Ethiopia: A Cross-sectional Study. Curr Drug Saf 2020; 15:105-110. [PMID: 32228428 DOI: 10.2174/1574886315666200331140400] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 03/16/2020] [Accepted: 03/20/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Disposal of pharmaceutical waste among patients is a global challenge especially in developing countries like Ethiopia. Improper medication disposal can lead to health problems and environmental contaminations. Therefore, the present study aimed to assess disposal practices of unused medications among patients in public health centers of Dessie town, Northeast Ethiopia. METHODS A descriptive cross-sectional study was conducted among 263 patients in four public health centers of Dessie town, Ethiopia from March to June, 2019. Face-to-face interviews using structured questionnaires were used to collect data from each study subject. RESULTS The majority of the respondents, 224 (85.17%) had unused medications at their home during the study period. The most commonly reported disposal method in the present study was flushing down into a toilet 66 (25.09%). None of the respondents practiced returning unused medications to Pharmacy. Moreover, 85 (32.31%) of the respondents reported never disposing their medications and believed that it is acceptable to store medications at home for future use. CONCLUSION In the present study, there was a high practice of keeping medications at home and most of the disposal practices were not recommended methods. In addition, most of the respondents did not get advice from pharmacists and other health care professionals on how to dispose off unused medications. Hence, there is a need for proper education and guidance of patients regarding disposal practices of unused medications.
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Affiliation(s)
- Haile Kassahun
- Department of Pharmacy, College of Medicine and Health Sciences, Wollo University, P.O. Box 1145, Dessie, Ethiopia
| | - Dugessa Tesfaye
- Department of Pharmacy, College of Medicine and Health Sciences, Wollo University, P.O. Box 1145, Dessie, Ethiopia
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Kassahun H, Tesfaye D. Disposal Practices of Unused Medications Among Patients in Public Health Centers of Dessie Town, Northeast Ethiopia: A Cross Sectional Survey. INTEGRATED PHARMACY RESEARCH AND PRACTICE 2020; 9:65-70. [PMID: 32280626 PMCID: PMC7125303 DOI: 10.2147/iprp.s243069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 03/20/2020] [Indexed: 11/26/2022] Open
Abstract
Background Disposal of pharmaceutical waste among patients is a global challenge, especially in developing countries like Ethiopia. Improper medication disposal can lead to health problems and environmental contamination. Therefore, the present study was aimed to assess disposal practices of unused medications among patients in public health centers of Dessie town, Northeast Ethiopia. Methods A descriptive cross-sectional survey was conducted among 263 patients in four public health centers of Dessie town, Ethiopia from March to June 2019. Face-to-face interviews using structured questionnaires were used to collect data from each study subject. Results The majority of the respondents, 224 (85.17%), had unused medications at their home during the study period. The most commonly reported disposal method in the present study was flushing down into a toilet, 66 (25.09%). None of the respondents practiced returning unused medications to the pharmacy. Moreover, 85 (32.31%) of the respondents reported never disposing of their medications and believed that it is acceptable to store medications at home for future use. Conclusion In the present study, there was a high practice of keeping medications at home and most of the disposal practices were not recommended methods. In addition, most of the respondents did not receive advice from pharmacists and other health-care professionals on how to dispose of unused medications. Hence, there is a need for proper education and guidance of patients about disposal practices of unused medications.
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Affiliation(s)
- Haile Kassahun
- Department of Pharmacy, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Dugessa Tesfaye
- Department of Pharmacy, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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Knowledge and Disposal Practice of Leftover and Expired Medicine: A Cross-Sectional Study from Nursing and Pharmacy Students' Perspectives. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17062068. [PMID: 32244973 PMCID: PMC7142560 DOI: 10.3390/ijerph17062068] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 03/17/2020] [Accepted: 03/18/2020] [Indexed: 11/17/2022]
Abstract
The objective of the present study was to investigate the knowledge and practices concerning unused and expired medicine among pharmacy and nursing students at King Saud University, Riyadh, Saudi Arabia. A cross-sectional study design was used. The study used a validated paper-based, self-administered questionnaire. Statistical analyses were performed using SPSS, Version 24. The response rate was 70.4% (n = 352). The results indicated that 57.4% of pharmacy students and 53.4% of nursing students check the expiry date of medicine before procuring, and 37.6% of pharmacy students and 52.5% of nursing students keep unused medicine until it expires. With regard to disposal, 78.9% of pharmacy students and 80.5% of nursing students reported discarding expired medicine in household garbage or flushing it down a sink or toilet. Only a small percentage returns leftover medicine to a medical store. There was a statistically significant difference between pharmacy and nursing students in regard to checking the expiry date of medicine before procuring (p = 0.01), and keeping unused medicine until it expires (p = 0.03). The study concluded that the majority of respondents dispose of medicine unsafely. The findings suggest that creating awareness regarding proper medicine disposal procedures among university health care students in Saudi Arabia is needed.
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Holub A, Abar CC, Kamali M, Conner K, Abar B. What do I do with this stuff now? Drug retention and disposal practices among ED patients. Am J Emerg Med 2019; 37:2111-2112. [DOI: 10.1016/j.ajem.2019.06.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 06/17/2019] [Accepted: 06/20/2019] [Indexed: 11/30/2022] Open
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Albaroodi KAI. Pharmacists' Knowledge Regarding Drug Disposal in Karbala. PHARMACY 2019; 7:pharmacy7020057. [PMID: 31185586 PMCID: PMC6630420 DOI: 10.3390/pharmacy7020057] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 05/11/2019] [Accepted: 06/03/2019] [Indexed: 11/16/2022] Open
Abstract
Background: Consumers and caregivers should remove expired, or unwanted, medications to minimize the chance for misuse or accidentally using those medicines. This study investigated pharmacists' knowledge regarding drug disposal in Karbala, Iraq. Methods: This study was a cross-sectional survey among pharmacists in Karbala. It was performed from December 2018 until January 2019. A standardized, 12-item, self-administered questionnaire was designed, developed and validated to assess pharmacists' knowledge when generating pharmaceutical waste in pharmacies. Results: One hundred twenty-nine participants enrolled in the study. The mean age of participants was 33 ± 9.3 years-more than two-thirds (65.9%)-agreed that the return of medications to the source would be appropriate drug disposal. A good proportion of participants agreed with disposing of drugs in the trash. Further, 63.6% believe that education is the main barrier opposing the implementation of a medicine-take-back program in Iraq. Conclusion: Pharmacists had relatively poor knowledge regarding drug disposal methods. Health care providers (not only pharmacists) need educational courses and workshops to improve their knowledge regarding medication disposal in Iraq.
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Ayele Y, Mamu M. Assessment of knowledge, attitude and practice towards disposal of unused and expired pharmaceuticals among community in Harar city, Eastern Ethiopia. J Pharm Policy Pract 2018; 11:27. [PMID: 30459955 PMCID: PMC6236888 DOI: 10.1186/s40545-018-0155-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 10/04/2018] [Indexed: 11/17/2022] Open
Abstract
Background Pharmaceuticals are produced and consumed in increasing volume every year. Unfortunately, not all medications that go in to the hand of the consumers get consumed; large quantities remain unused or expire. The accumulation of medication at household and unsafe disposal of unwanted medicines could lead to inappropriate medicine sharing, accidental childhood poisonings and diversion of medicines to illicit use. Methods A descriptive cross-sectional study was conducted among 695 residents in kebele(ward) 16 of Jinela woreda(district), Harar city from February 27–April 27. A multi-stage sampling technique was used to select individual households. Face-to-face interview using structured questionnaires were conducted to collect data from each study subject. The cleaned data was entered in to epidata analyzed using SPSS version 20 software. Descriptive statistics on sample characteristics was computed including frequencies and percentage and presented using tables and figures. Results Most participants displayed correct understanding toward medication waste (72.9%) and its effect on environmental if disposed improperly (86%). A large portion of the respondents did not know about drug-take-back system 464 (66.9%). In order to minimize the entry of pharmaceuticals into environment, 68.6% of the participants suggested the need for proper guidance to the consumer. Majority of the respondents believed risk related to the presence of unwanted drug in home, potential harm to children, lack of adequate information on safe disposal practice and need for take-back program. Approximately 66% of the respondents had unused medicine stored at home and the common types of medicines kept in households were analgesics (62.7%) and antibiotics (24%). Preferred ways of disposal of both unused and expired medicine was throwing away in household garbage (53.2%) and two third of them disposed the pharmaceuticals in its original package and dosage form. Conclusion In present study, there was high practice of keeping medication at home and most disposal approach indicated by the participants was not recommended methods. Awareness about proper disposal of unused and expired medicines among the public should be created. Guidelines on safe disposal are required and an organized method of collecting unused and expired pharmaceuticals needs to be introduced.
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Affiliation(s)
- Yohanes Ayele
- Department of Clinical Pharmacy, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, P.O. Box 235, Harar, Ethiopia
| | - Mulu Mamu
- Department of Clinical Pharmacy, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, P.O. Box 235, Harar, Ethiopia
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Kelly F, McMillan S, Spinks J, Bettington E, Wheeler AJ. 'You don't throw these things out:' an exploration of medicines retention and disposal practices in Australian homes. BMC Public Health 2018; 18:1026. [PMID: 30119656 PMCID: PMC6098630 DOI: 10.1186/s12889-018-5753-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 06/26/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Consumers most commonly discard unwanted medicines in household rubbish or drains, however, there are global concerns over the extent, environmental impact and health risks. When consumers procure or store medicines for future use, this can impact negatively on quality use of medicines and consumer safety. We sought greater insight into the extent of these practices by exploring the volume and types of medicines in Australian homes, and self-reported practices related to medicine accumulation, use and disposal. This qualitative study formed part of a larger project that included a general population survey on household medicine disposal practices. METHODS Semi-structured telephone interviews were undertaken with a subset of respondents (n = 166) from the survey. Participants were eligible if they were experienced medicine users, i.e. used five or more prescribed, over the counter, and/or complementary and alternative medicines. Participants were asked to collect and name all medicines in their household; further detail was obtained about medicines used only when required or no longer used, such as expiry dates and quantity remaining. The quantitative data on the number and type of medicines stored at home were analysed descriptively. All interviews were transcribed verbatim and thematically analysed. RESULTS A total of 2301 medicines were identified as 1424 medicines not in everyday use (unused, unwanted, expired or when required) in 166 households, and 877 regularly used medicines by 119 participants. Medicines were often stored in multiple locations, particularly kitchens. Although accidental ingestion in children and pets and decreased efficacy were recognised health risks, this did not always translate to appropriate storage, usage or disposal practices. Individual risk-benefit assessments were applied to decisions to retain, use or dispose of medicines, including expired medicines. CONCLUSIONS Inappropriate medicine storage, use, and/or disposal practices raises public health concerns, particularly as there is a free returned medicines scheme available, and that this particular participant group were considered experienced medicine users. Healthcare professionals must act to address consumer misconceptions around the quality use of medicines, including medicine retention, storage and disposal. Future research is warranted to explore consumer practices in this context and confirm these findings in a younger, or healthier population.
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Affiliation(s)
- Fiona Kelly
- Quality Use of Medicines (QUM) Network, School of Pharmacy and Pharmacology, Griffith University, Brisbane, Australia
| | - Sara McMillan
- School of Pharmacy and Pharmacology, Menzies Health Institute, Griffith University, Brisbane, Australia
| | - Jean Spinks
- Centre for Applied Health Economics, School of Medicine, and Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Emilie Bettington
- Centre for Applied Health Economics, School of Medicine, and Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Amanda J. Wheeler
- Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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Akici A, Aydin V, Kiroglu A. Assessment of the association between drug disposal practices and drug use and storage behaviors. Saudi Pharm J 2017; 26:7-13. [PMID: 29379327 PMCID: PMC5783817 DOI: 10.1016/j.jsps.2017.11.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 11/14/2017] [Indexed: 10/27/2022] Open
Abstract
Objective Keeping unnecessary drugs at home is a situation showing both causes and consequences of irrational use of medicine. This study aimed to evaluate the approaches of a company's employees regarding drug storage, use, and disposal. Method This online-based descriptive study was held in a multi-centered private-sector company in a voluntary basis. The survey assessing participants' drug handling and storage behaviors was answered by 1121 employees from across eight provinces of Turkey in 2016. Main outcome measures were storage and disposal of unused/unwanted drugs at home in a rational way. Results The percentage of participants who declared that they keep unused/unwanted drugs at home was 28.0%. About one-third of participants disposed their unused/unwanted drugs via the "garbage, sink, toilet, etc.". Participants ≥30 years old and living with <4 household members significantly tended to bring their unused/unwanted drugs to the company's drug-box. Nearly half of all participants (46.5%) stated a recent change in their disposal behavior. The vast majority of participants (94.6%) who previously took drugs back to the company's drug-box stated that they either had, or would, help their contacts adopt such behaviors. These participants were also significantly less likely to dispose of drugs inappropriately, practice self-medication, be unaware of expired drugs at home, or fail to store drugs according to the labelling. Conclusion While our findings showed that a substantial number of participants still had unused drugs at home and disposed of them inappropriately, it is understood that they started to exhibit more favorable behaviors in recent years.
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Affiliation(s)
- Ahmet Akici
- Department of Medical Pharmacology, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Volkan Aydin
- Department of Medical Pharmacology, Marmara University Faculty of Medicine, Istanbul, Turkey
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Game Theoretic Analysis of Pricing and Cooperative Advertising in a Reverse Supply Chain for Unwanted Medications in Households. SUSTAINABILITY 2017. [DOI: 10.3390/su9101902] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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AlAzmi A, AlHamdan H, Abualezz R, Bahadig F, Abonofal N, Osman M. Patients' Knowledge and Attitude toward the Disposal of Medications. JOURNAL OF PHARMACEUTICS 2017; 2017:8516741. [PMID: 29130019 PMCID: PMC5654249 DOI: 10.1155/2017/8516741] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 06/16/2017] [Accepted: 07/16/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND Safe disposal of medications is of high concern as malpractice may lead to harmful consequences such as undesirable effects, prescription drug abuse, overstocking, self-medication, accidental overdose, and even death. There is a lack of uniform and nationwide guidance on how patients should safely dispose their leftover medications. This study aims to assess patients' knowledge and attitude regarding the disposal of medications. METHOD This research is a cross-sectional study. A self-administered questionnaire was used to collect data from various outpatient pharmaceutical services in King Abdulaziz Medical City (KAMC), Jeddah. RESULTS The study revealed that 73% of the respondents throw the medications in the trash, 14% return the medications to a pharmacy, 5% never dispose them, and 3% donate the medications to a friend or charity centers. More than 80% of the respondents never received any information or advice from healthcare providers about safe and proper disposal of medications. CONCLUSION Our findings suggest that there is an immediate requirement for the establishment of collaborative and uniform guidelines for the safe disposal of leftover medications. A policy for drug donation needs to be included in routine patient education as well as educational and collective programs for the public.
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Affiliation(s)
- Aeshah AlAzmi
- Ministry of National Guard Health Affairs (MNGHA), King Abdulaziz Medical City (KAMC 6255), Pharmaceutical Care Services Department, P.O. Box 9515, Jeddah 21423, Saudi Arabia
| | - Hani AlHamdan
- Ministry of National Guard Health Affairs (MNGHA), King Abdulaziz Medical City (KAMC 6255), Pharmaceutical Care Services Department, P.O. Box 9515, Jeddah 21423, Saudi Arabia
| | - Rayf Abualezz
- Ministry of National Guard Health Affairs (MNGHA), Prince Mohamed Bin Abdulaziz Hospital, Pharmaceutical Care Services Department, P.O. Box 40740, Madinah 41511, Saudi Arabia
| | - Faiz Bahadig
- Ministry of National Guard Health Affairs (MNGHA), King Abdulaziz Medical City (KAMC 6255), Pharmaceutical Care Services Department, P.O. Box 9515, Jeddah 21423, Saudi Arabia
| | - Noha Abonofal
- Ministry of National Guard Health Affairs (MNGHA), King Abdulaziz Medical City (KAMC 6255), Pharmaceutical Care Services Department, P.O. Box 9515, Jeddah 21423, Saudi Arabia
| | - Mohamed Osman
- Ministry of National Guard Health Affairs (MNGHA), King Abdulaziz Medical City (KAMC 6255), Pharmaceutical Care Services Department, P.O. Box 9515, Jeddah 21423, Saudi Arabia
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Redispensing of medicines unused by patients: a qualitative study among stakeholders. Int J Clin Pharm 2017; 39:196-204. [PMID: 28070689 DOI: 10.1007/s11096-017-0424-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 01/02/2017] [Indexed: 01/11/2023]
Abstract
Background Medication waste has undesirable economic and environmental consequences. This waste is partly unavoidable, but might be reduced by redispensing medicines unused by patients. However, there is little knowledge of stakeholders' views on the redispensing. Objective To identify the stakeholders' views on the redispensing of medicines unused by patients. Setting Dutch healthcare system. Method Semi-structured interviews were conducted with 19 Dutch stakeholders from September 2014 until April 2015. The interview guide included two themes: medication waste and redispensing of unused medicines. The latter included qualitative-, legal- and financial aspects and stakeholder involvement, with specific attention to the patient. Interview transcripts were subjected to thematic content analysis. Main outcome measure Requirements related to the redispensing of unused medicines. Results All stakeholders considered the redispensing of medicines desirable if the implementation is feasible and the requirements for the safe redispensing are met. All of them pointed out that the product quality of redispensed medicines should be guaranteed and that it should be clear who is responsible for the quality of redispensed medicines. The stakeholders stated that transparent communication to patients is essential to guarantee trust in the redispensing system and that patients should be willing to use redispensed medicines. Moreover, the redispensing system's benefits should outweigh the costs and a minimal economic value of medicines suitable for redispensing should be determined. Conclusion Redispensing unused medicines could decrease medication waste if several requirements are met. For successful implementation of a redispensing system, all relevant stakeholders should be involved and cooperate as a joint-force.
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Barnett-Itzhaki Z, Berman T, Grotto I, Schwartzberg E. Household medical waste disposal policy in Israel. Isr J Health Policy Res 2016; 5:48. [PMID: 27766144 PMCID: PMC5057219 DOI: 10.1186/s13584-016-0108-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 09/29/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Large amounts of expired and unused medications accumulate in households. This potentially exposes the public to hazards due to uncontrolled use of medications. Most of the expired or unused medications that accumulate in households (household medical waste) is thrown to the garbage or flushed down to the sewage, potentially contaminating waste-water, water resources and even drinking water. There is evidence that pharmaceutical active ingredients reach the environment, including food, however the risk to public health from low level exposure to pharmaceuticals in the environment is currently unknown. In Israel, there is no legislation regarding household medical waste collection and disposal. Furthermore, only less than 14 % of Israelis return unused medications to Health Maintenance Organization (HMO) pharmacies. METHODS In this study, we investigated world-wide approaches and programs for household medical waste collection and disposal. RESULTS In many countries around the world there are programs for household medical waste collection. In many countries there is legislation to address the issue of household medical waste, and this waste is collected in hospitals, clinics, law enforcement agencies and pharmacies. Furthermore, in many countries, medication producers and pharmacies pay for the collection and destruction of household medical waste, following the "polluter pays" principle. CONCLUSIONS Several approaches and methods should be considered in Israel: (a) legislation and regulation to enable a variety of institutes to collect household medical waste (b) implementing the "polluter pays" principle and enforcing medical products manufactures to pay for the collection and destruction of household medical waste. (c) Raising awareness of patients, pharmacists, and other medical health providers regarding the health and environmental risks in accumulation of drugs and throwing them to the garbage, sink or toilet. (d) Adding specific instructions regarding disposal of the drug, in the medication label and leaflet. (e) Examining incentives for returning medications to pharmacies. (f) Examining drug collection from deceased in retirement homes and hospitals.
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Affiliation(s)
- Zohar Barnett-Itzhaki
- Public Health Services, Ministry of Health, 39 Yirmiyahu St, Jerusalem, Israel
- Mimshak, The Israel society of ecology and environmental sciences, 19 Kehilat New York St, Tel Aviv, Israel
| | - Tamar Berman
- Public Health Services, Ministry of Health, 39 Yirmiyahu St, Jerusalem, Israel
| | - Itamar Grotto
- Public Health Services, Ministry of Health, 39 Yirmiyahu St, Jerusalem, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O.B. 653, Beer-Sheva, Israel
| | - Eyal Schwartzberg
- Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O.B. 653, Beer-Sheva, Israel
- Pharmaceutical Division, Ministry of Health, 39 Yirmiyahu St, Jerusalem, Israel
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