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Mitiku A, Bekele A, Siraj J, Hasen G. The magnitude and associated factors of unused medications storage practice among households in Jimma city, southwest of Ethiopia: Community-based cross-sectional study. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2024; 15:100459. [PMID: 38983638 PMCID: PMC11231587 DOI: 10.1016/j.rcsop.2024.100459] [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: 04/21/2023] [Revised: 05/18/2024] [Accepted: 06/04/2024] [Indexed: 07/11/2024] Open
Abstract
Background Medicines are kept unused at home for many therapeutic reasons. Conversely, unused medication and subsequent wastage can be attributed to several primary factors such as medication change, death, and non-adherence. This study aimed to assess the magnitude and associated factors of unused medication storage practice among households in Jimma City, southwest Ethiopia. Methods A community-based cross-sectional study design was conducted among households (n = 397) in Jimma Town from July to August 2021. The data were collected using the pre-tested and interviewer-administered questionnaire. SPSS version 21.0 was used for data analysis. The multivariate logistic regression was used to determine the factors associated with the storage of unused medicine at a 5% level of significance. Results Out of 397 households that responded, (n = 90, 23%) of households were found to have unused medicine at home. This study showed that the majority of households dispose of unused drugs by burning them (32.2%) and burying them in the ground (29%). Antibiotics were the most (6.3%) unused medicines stored while the anti-diabetics (1.3%) were the least unused drugs stored among households. The presence of family members working in the health sector (AOR: 0.402, 95%, CI: 0.202, 0.800) and family size in households (AOR: 2.325, 95%, CI: 1.045, 5.174) were significantly associated with the magnitude of unused medicine storage. Conclusion The magnitude and improper disposal of unused medicines storage among households were significant in the study area. Therefore, it is important to educate the community and encourage health professionals to understand their role in problems and solutions.
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Affiliation(s)
- Andualem Mitiku
- Jimma University, Institute of Health, School of Pharmacy, Jimma, Oromia, Ethiopia
| | - Azmeraw Bekele
- Jimma University, Institute of Health, School of Pharmacy, Jimma, Oromia, Ethiopia
| | - Jafer Siraj
- Department of Pharmacology and Pharmaceutical Chemistry, School of Pharmacy, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Gemmechu Hasen
- Jimma University, Institute of Health, School of Pharmacy, Jimma, Oromia, Ethiopia
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Ikwara AE, Atwijukiire H. Self-medication and medication storage practices among Lira University students in Lira city, Northern Uganda. Front Public Health 2023; 11:1259279. [PMID: 38026339 PMCID: PMC10654784 DOI: 10.3389/fpubh.2023.1259279] [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: 07/15/2023] [Accepted: 10/12/2023] [Indexed: 12/01/2023] Open
Abstract
Background Self-medication (SM) is a global public health concern, particularly prevalent in developing nations. It involves the consumption of drugs without professional guidance, encompassing both over-the-counter and prescription medicines. Responsible SM can alleviate healthcare burdens, reduce costs, and empower individuals to manage minor ailments independently. However, improper SM practices can lead to adverse effects, contribute to antimicrobial resistance, and pose various health risks. This study aimed to evaluate the prevalence of SM and related practices of storing medications among students at Lira University, located in Lira City West Division, Northern Uganda. Methods This study adopted a quantitative cross-sectional design, focusing on students from various faculties. The sample size comprised 422 students, determined using the Kish Leslie formula. Data collection involved the administration of self-administered questionnaires, and subsequent data analysis was performed using SPSS version 25. Results The study involved participants from Lira University, primarily women (51.2%) with an average age of 23.82. A majority were Christians (59.7%) and single (87.9%). Most were from the Faculty of Health Sciences (63.7%), with third-year students being the largest group (48.3%). Regarding SM, 74.2% practiced SM, with antibiotics (69.2%) and tablets (69.2%) being commonly self-administered. In terms of medication storage, 93.4% kept medicines at home, mostly in cupboards (76.5%), but many were unsure about proper storage practices. Participants exhibited good knowledge of SM's risks and measures to reduce them. There was a significant association between the faculty of study and SM practices (p = 0.015), while other demographic factors showed no significant associations. Conclusion This study sheds light on the prevalent SM practices among students at Lira University in Northern Uganda. Notably, antibiotics were frequently self-medicated, raising concerns about antibiotic resistance. Additionally, medication storage practices emphasize the need for proper education on storage guidelines. However, the participants exhibited good knowledge of the risks associated with SM, suggesting the potential for effective awareness campaigns. The study recommends targeted health education programs, stricter regulations on medication sales, improved healthcare access, proper medication disposal, further research on the factors driving SM, collaborative efforts, and monitoring of antibiotic use to address this public health issue effectively.
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Affiliation(s)
- Asher Emmanuel Ikwara
- Child Health and Development Centre, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
- Department of Epidemiology and Biostatistics, Faculty of Public Health, Lira University, Lira, Uganda
| | - Humphrey Atwijukiire
- Department of Nursing, Faculty of Nursing and Health Sciences, Bishop Stuart University, Mbarara, Uganda
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Gebeyehu E, Ararsie M. Assessment of home storage of antimicrobials and its predictors in Mecha demographic surveillance and field research center: a cross-sectional study. BMC Infect Dis 2023; 23:278. [PMID: 37138204 PMCID: PMC10155445 DOI: 10.1186/s12879-023-08227-7] [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: 01/13/2023] [Accepted: 04/05/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND Home storage of antimicrobials is a worldwide practice. Irrational storage and inappropriate use of antimicrobials should get special attention in low-income countries due to limited information, knowledge, and perceptions. This study was conducted to survey home storage of antimicrobials and assess its predictors in Mecha Demographic Surveillance and Field Research Center (MDSFRC), Amhara region, Ethiopia. METHODS A cross-sectional survey was conducted on 868 households. Predeveloped structured questionnaire was used to collect data on sociodemographics, knowledge on antimicrobials and perception about home stored antimicrobials. Data was analyzed using SPSS version 20.0 to execute descriptive statistics, and run binary and multivariable binary logistic regression. P-value < 0.05 was considered significant at 95% confidence level. RESULTS The total number of households included in this study were 865. Female respondents represent 62.6%. The mean age (±) of respondents was 36.2 (± 13.93) years. The mean family size (±) of the household was 5.1 (± 2.5). Nearly one-fifth (21.2%) of the households stored antimicrobials at home with a condition similar to any household material. Most commonly stored antimicrobials were: Amoxicillin (30.3%), Cotrimoxazole (13.5%), Metronidazole (12.0%), and Ampicillin (9.6%). The most common immediate source of home stored antimicrobials was discontinuation of therapy (70.7%) either from symptomatic improvement (48.1%) or missing doses (22.6%). Predictors of home storage of antimicrobials with corresponding p-value were: age (0.002), family size (0.001), education status (< 0.001), home distance from the nearby healthcare institution (0.004), counseling while obtaining antimicrobials (< 0.001), knowledge level on antimicrobials (< 0.001), and perception of home stored antimicrobials as a wisdom (0.001). CONCLUSION Substantial proportion of households stored antimicrobials in a condition that may exert selection pressure. To reduce home storage of antimicrobials and its consequences, stakeholders should give due attention to predictors variables related to sociodemographics, level of knowledge on antimicrobials, perception of home storage as a wisdom, and counseling service.
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Affiliation(s)
- Endalew Gebeyehu
- Department of Pharmacy, College of Medicine and Health Sciences, Bahir Dar University, P.O.Box 79, Bahir Dar, Ethiopia.
| | - Misgan Ararsie
- Department of Pharmacy, College of Medicine and Health Sciences, Bahir Dar University, P.O.Box 79, Bahir Dar, Ethiopia
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Kahssay SW, Hammeso WW, Getachew D, Woldeselassie BD. Prevalence and Determinants of Household Medication Storage During the COVID-19 Outbreak in Southwest Ethiopia. Drug Healthc Patient Saf 2023; 15:1-11. [PMID: 36699285 PMCID: PMC9869910 DOI: 10.2147/dhps.s392564] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 12/25/2022] [Indexed: 01/20/2023] Open
Abstract
Background Most households worldwide keep medicines on hand for various reasons, including emergency use, treatment of acute and chronic diseases, and anticipated future use. Being infected or fear of getting COVID-19 in the current pandemic could increase the storage of drugs at home. Thus, this study aimed to assess the prevalence of household storage of medicines and associated factors in southwest Ethiopia during the COVID-19 outbreak. Methods A cross-sectional household survey was conducted from February 1 to May 30, 2022. Data on the extent of storage, storage conditions, their current status, disposal methods, among others, were collected through structured interviews and observations. The data were entered into EPI info, exported, and analyzed using Statistical Packages for Social Sciences (SPSS). Bivariate followed by multivariate logistic regression was used to identify associated factors. P-value <0.05 was used as a cut-off point to decide statistical significance. Results The magnitude of household medication storage was 48% (95% CI). Analgesics (28.7%) and antibacterial (21.1%) agents were the most predominant class of drugs stored in the households. The most significant proportion of the home-stored medications (34.7%) was reserved for future use, and 31.8% were for treating current medical conditions. The majority of the respondents (84.1%) had never heard/learned about the safe disposal ways of drugs. The presence of children aged less than 5 years in a household [AOR = 1.90 (1.19, 3.05)] and the existence of chronically sick patients in a household [AOR = 4.3 (2.25, 8.45)] were factors significantly associated with household medication storage. Conclusion The current study revealed a high prevalence of home medication storage; thus, to lessen or eliminate the negative consequences of storing medications at home, it is necessary to review the medication utilization chain and offer community-based training on proper medication storage and disposal techniques, including establishing take-back programs.
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Affiliation(s)
- Semere Welday Kahssay
- Department of Pharmacognosy and Pharmaceutical Chemistry, School of Pharmacy, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan-Aman, Ethiopia,Correspondence: Semere Welday Kahssay, Department of Pharmacognosy and Pharmaceutical Chemistry, School of Pharmacy, College of Medicine and Health Sciences, Mizan-Tepi University, P.O.Box 5140-260, Mizan-Teferi, Ethiopia, Tel +251904296810, Email
| | | | - Dawit Getachew
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan-Aman, Ethiopia
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Opare-Addo MNA, Marfo AFA, Owusu-Daaku FT. Disposal of leftover and expired medicines by community pharmacies and their clients in Ghana. WASTE MANAGEMENT & RESEARCH : THE JOURNAL OF THE INTERNATIONAL SOLID WASTES AND PUBLIC CLEANSING ASSOCIATION, ISWA 2022; 40:1539-1545. [PMID: 35296196 DOI: 10.1177/0734242x221084060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Improper and unsafe disposal of expired and unwanted medicines could cause harm to both people and the environment and therefore it is of public health importance. The objective of the study was to determine the methods employed by community pharmacist and their clients in the disposal of unwanted and expired medicines. Furthermore, the role of the pharmacists in the assessment of clients left over medicines was also explored. A cross sectional study design was employed with a sample of 120 pharmacy staff and 200 clients. Semi structured questionnaires were developed and administered to the two groups. Ethical approval was obtained. Data collected were analyzed using the Statistical Package for Social Sciences (SPSS v.24). Two hundred and eighty medicines were assessed from 131 respondents (65.5%) who brought their unused or left-over medicines to the pharmacy. These included analgesics 102(36.4%), antibiotics 50 (17.9%) and antacids 22 (7.9%). Disposal of expired and left-over medicines cited by respondents were the general-purpose bin 58(77.0%) and down the sink 11(14.3%). The majority 99(82.9%) of community pharmacies also disposed of solid dosage forms through the general-purpose bin. In addition, 90(75%) community pharmacies disposed of liquid waste in general purpose bin. Lack of enforcement of legislation was cited by community pharmacy staff as a barrier to the proper disposal of pharmaceutical waste. The predominant method of disposal of expired/unwanted medicines by community pharmacies and their clients was via the general-purpose bin. Implementation of interventions such as take back programmes that will enhance proper disposal of expired and left over medicines should be initiated.
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Affiliation(s)
- Mercy Naa Aduele Opare-Addo
- Department of Pharmacy Practice, Faculty of Pharmacy, Kwame Nkrumah University of Science & Technology (KNUST), Kumasi, Ghana
| | - Afia Frimpomaa Asare Marfo
- Department of Pharmacy Practice, Faculty of Pharmacy, Kwame Nkrumah University of Science & Technology (KNUST), Kumasi, Ghana
| | - Frances Thelma Owusu-Daaku
- Department of Pharmacy Practice, Faculty of Pharmacy, Kwame Nkrumah University of Science & Technology (KNUST), Kumasi, Ghana
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Magagula BK, Rampedi IT, Yessoufou K. Household Pharmaceutical Waste Management Practices in the Johannesburg Area, South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127484. [PMID: 35742731 PMCID: PMC9223455 DOI: 10.3390/ijerph19127484] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 06/15/2022] [Accepted: 06/16/2022] [Indexed: 11/17/2022]
Abstract
Pharmaceutical wastes are expected to increase given the increasing population growth rates and rapidly rising economic burden of human diseases. This challenge calls for appropriate measures for the management of such hazardous wastes. The purpose of this survey was to document and investigate existing practices for the handling, storage, and disposal of household pharmaceutical wastes (HPWs) in the Johannesburg area. Primary data were collected via online surveys with self-administered questionnaires completed by respondents. The research found that 77% (n = 286) of respondents claimed some knowledge about HPWs. Types of medicines that contributed to HPWs included painkillers or analgesics (73%, n = 270) and drugs for treating colds and flu-related illnesses (52%; n = 193). Although there were a few exceptions, the respondents generally exhibited strong disagreements with environmentally unfriendly and health-threatening disposal practices. Moreover, most participants were willing to return expired medicines to pharmacies (40.7%, n = 151), whereas only 8.6% (n = 32) opposed this solution. Awareness levels tended to vary with employment status, educational qualifications, and place of residence. However, place of residence and household size did not correlate with types of pharmaceutical waste. Additionally, the study found that education attainments significantly influenced the willingness of respondents to return pharmaceutical wastes. Finally, there were no significant differences amongst respondents in terms of waste disposal practices. Altogether, the findings suggest the need for targeted efforts to bring about sustainable waste management at a household level.
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Alfian SD, Insani WN, Halimah E, Qonita NA, Jannah SS, Nuraliyah NM, Supadmi W, Gatera VA, Abdulah R. Lack of Awareness of the Impact of Improperly Disposed Of Medications and Associated Factors: A Cross-Sectional Survey in Indonesian Households. Front Pharmacol 2021; 12:630434. [PMID: 33981221 PMCID: PMC8107817 DOI: 10.3389/fphar.2021.630434] [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: 11/17/2020] [Accepted: 03/31/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Disposal of unused medications through environmentally unsafe routes is common in Indonesia. The lack of awareness of the impact of improperly disposed of medications is a significant contributing factor. The objectives of this study were to identify factors associated with lack of awareness of the impact of improperly disposed of unused medications and to assess the associations of awareness with medication disposal practices among the general population in Indonesia. Patients and methods: An observational cross-sectional survey was conducted using nonprobability sampling in Bandung, Indonesia, from November 2017 to January 2018 among respondents who were older than 18 years, had used any medication in the past, were literate, and had signed an informed consent document. Disposal practices and awareness regarding the impact of improperly disposed of unused medications were collected using an online- and a paper-based pre-validated questionnaire. The paper-based questionnaires were distributed to respondents in public places such as city center, markets, and religious places. Binary logistic regression was performed to assess associations of sociodemographic and other related factors with a lack of awareness. Odds ratios (ORs) with 95% confidence intervals (CIs) are reported. Results: Of 497 participating respondents, 433 and 64 respondents filled an online- or a paper-based questionnaire, respectively. Most respondents were female, aged between 18 and 30 years, and students/university students. Of 497 respondents, more than half (53.1%) were not aware that improper medication disposal could harm the environment and population health. Most respondents (79.5%) had never received information about proper medication disposal practices. The education level, the number of stored medications at home, and previous education about medication disposal practices were significantly associated with awareness of proper practices. In the multivariate analysis, only those with previous education about medication disposal practices were less likely to report a lack of awareness (OR: 0.043; 95% CI: 0.02–0.09). Respondents with a lack of awareness tended to dispose of their unused medications in the garbage or shared them with friends or relatives. Conclusion: There is a clear need to increase awareness of the importance of proper medication disposal practices, in particular among the student population of Bandung city, Indonesia. Healthcare providers can play an important role by educating this specific population on the proper disposal of unused medications.
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Affiliation(s)
- Sofa D Alfian
- Department of Pharmacology and Clinical Pharmacy, Universitas Padjadjaran, Jatinangor, Indonesia.,Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Widya N Insani
- Department of Pharmacology and Clinical Pharmacy, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Eli Halimah
- Department of Pharmacology and Clinical Pharmacy, Universitas Padjadjaran, Jatinangor, Indonesia.,Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Nabilla A Qonita
- Department of Pharmacology and Clinical Pharmacy, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Siti S Jannah
- Department of Pharmacology and Clinical Pharmacy, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Nisa M Nuraliyah
- Department of Pharmacology and Clinical Pharmacy, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Woro Supadmi
- Department of Pharmacology and Clinical Pharmacy, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Vesara A Gatera
- Department of Pharmacology and Clinical Pharmacy, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Rizky Abdulah
- Department of Pharmacology and Clinical Pharmacy, Universitas Padjadjaran, Jatinangor, Indonesia.,Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Jatinangor, Indonesia
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Alhamad H, Patel N, Donyai P. Towards Medicines Reuse: A Narrative Review of the Different Therapeutic Classes and Dosage Forms of Medication Waste in Different Countries. PHARMACY 2020; 8:E230. [PMID: 33271889 PMCID: PMC7712270 DOI: 10.3390/pharmacy8040230] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 11/24/2020] [Accepted: 11/27/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Medicines reuse, the idea of re-dispensing returned medicines to others following quality control, is yet to be implemented in the UK. This practice is potentially a sustainable way of dealing with returned medicines, which are otherwise classed as medication waste and destroyed. To inch towards medicines reuse, it is important to know more about the different therapeutic classes and dosage forms that make up medication waste. For example, it is helpful to know if medicines being returned are mostly solid-dosage forms and thus have the potential to be reused or are from therapeutic classes that would make medicines reuse cost-effective. Little is known about the therapeutic classes and the dosage forms of wasted medicines. This study aimed to narratively review and report findings from the international literature on the different therapeutic classes and the dosage forms of medicines that are returned by patients to community pharmacies, hospitals, general practitioners' clinics, or collected through waste campaigns. Studies based on surveys without physically returning medicines were also included where relevant. METHODS A comprehensive electronic search of databases, including PubMed and Google Scholar, was carried out over one month in 2017 and updated by 5 November 2020, using a combination of carefully created keywords. RESULTS Forty-five studies published in English between 2002 and 2020, comprising data from 26 countries were included and reviewed. Oral solid dosage forms (mostly tablets) were the commonly reported dosage form of all wasted medicines in 14 studies out of the 22 studies (64%) that described the dosage form, with percentages ranging from 40.6% to 95.6% of all wasted medicines. Although there was variability among the levels of medication waste reported in different countries, findings from the UK and Ethiopia were relatively consistent; in these, medicines for the cardiovascular system and anti-infective medicines, respectively, were the most common therapeutic classes for medication waste. CONCLUSION This narrative review provides insights about the different therapeutic classes and dosage forms of medication waste either returned by patients, collected through waste campaigns, or indicated in survey responses. The findings could help policy makers understand the potential implications of treating most unused medicines as medication waste and whether therefore pursuing a medicines reuse scheme could be environmentally or financially logical. The quality and the safety of these returned medicines using criteria related to the storage conditions (such as heat and humidity), physical shape (such as being sealed, unopened, unused, and in blister packaging), and tampering are other important considerations for a medicines reuse scheme.
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Affiliation(s)
- Hamza Alhamad
- Department of Pharmacy, University of Reading, Reading RG6 6AP, UK; (N.P.); (P.D.)
- Department of Pharmacy, Zarqa University, 132222 Zarqa, Jordan
| | - Nilesh Patel
- Department of Pharmacy, University of Reading, Reading RG6 6AP, UK; (N.P.); (P.D.)
| | - Parastou Donyai
- Department of Pharmacy, University of Reading, Reading RG6 6AP, UK; (N.P.); (P.D.)
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