1
|
Singh S, Sharma P, Pal N, Sarma DK, Kumar M. Antibiotic disposal challenges in India: investigating causes and effects. ENVIRONMENTAL MONITORING AND ASSESSMENT 2024; 196:325. [PMID: 38421517 DOI: 10.1007/s10661-024-12425-4] [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: 10/20/2023] [Accepted: 02/02/2024] [Indexed: 03/02/2024]
Abstract
Antibiotic resistance has become a global problem and India emerges as a key battlefield in the fight against it. While inappropriate use of antibiotics is well known, the review article deliberates a less recognized yet equally perilous facet of the crisis i.e. improper antibiotic disposal. An investigation of the sources of antibiotic pollution in Indian water bodies identifies discharge of pharmaceutical effluents, hospital waste, and agricultural runoff as major contributing factors. Furthermore, it discusses the repercussions of antibiotic pollution including those relating to human health, aquatic ecosystems, and antibiotic resistance. Reviewing the causes and consequences of improper antibiotic disposal practices emphasizes the necessity of rethinking antibiotic waste management practices. The review highlights the need for stringent rules and increased awareness, while also discussing the emerging technologies and strategies to mitigate the risks of antibiotic disposal in India.
Collapse
Affiliation(s)
- Samradhi Singh
- ICMR-National Institute for Research in Environmental Health, Bhopal, 462030, Madhya Pradesh, India
| | - Poonam Sharma
- ICMR-National Institute for Research in Environmental Health, Bhopal, 462030, Madhya Pradesh, India
| | - Namrata Pal
- ICMR-National Institute for Research in Environmental Health, Bhopal, 462030, Madhya Pradesh, India
| | - Devojit Kumar Sarma
- ICMR-National Institute for Research in Environmental Health, Bhopal, 462030, Madhya Pradesh, India
| | - Manoj Kumar
- ICMR-National Institute for Research in Environmental Health, Bhopal, 462030, Madhya Pradesh, India.
| |
Collapse
|
2
|
Getahun H, Belew S, Hasen G, Tefera Mekasha Y, Suleman S. Assessment of the extent and monetary loss in the selected public hospitals in Jimma Zone, Ethiopia: expired medicine perspectives. Front Med (Lausanne) 2024; 11:1283070. [PMID: 38435389 PMCID: PMC10906092 DOI: 10.3389/fmed.2024.1283070] [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] [Received: 08/25/2023] [Accepted: 01/19/2024] [Indexed: 03/05/2024] Open
Abstract
Introduction Medicine plays a crucial role in the field of healthcare as a therapeutically significant pharmaceutical product. By effectively preventing diseases, medicine has the power to save countless lives and improve the quality of life for people worldwide. However, despite hospitals' efforts to provide medical care to patients, a significant issue arises from the substantial amount of drugs that go unused due to expiration dates. This problem is particularly prevalent in resource-limited countries like Ethiopia, where the pharmaceutical supply system fails to adequately address the issue of expired drugs in public hospitals, leading to an unsatisfactory situation. Hence, the objective of this study was to assess the economic impact and volume of expired medicines in the selected public hospitals in Jimma Zone, Southwestern Ethiopia. Methods A hospital-based cross-sectional study design was conducted to assess the economic impact and volume of expired medicines available in the public hospitals in Jimma Zone. All available hospitals that fulfilled the EFDA guidelines were included. The medication expiration rate was calculated by dividing the total monetary value of expired medicines in a year by the total value of medicines received in the same year multiplied by 100. Then, the collected data was cleared, filtered, coded, and quantitatively analyzed using the Microsoft Excel 2010 version. Results The average medicine waste rate was 4.87% in the fiscal year of 2019/2020 and 2020/2021 in Jimma Zone public hospitals worth 32,453.3 US$. Additionally, the facility wasted an estimated of 2711.44 US$ on the disposal of expired medicines. The expiration of medicines has been linked to several issues, including near-expiry, irrational prescribing practices, and weak participation of clinicians in medicine selection and quantification of the facility. Additionally, only two hospitals had relatively good storage and handling practices. Conclusion Overall, the expiration rate of medicines in the public hospitals in Jimma Zone was greater than the allowed level of 2%. In order to optimize the allocation of healthcare funds and ensure the appropriate use of pharmacologically significant medications it is vital to conduct a comprehensive examination at the national level within a regional hospitals.
Collapse
Affiliation(s)
- Habtamu Getahun
- Tullu Bolo General Hospital, Oromia Regional Health Bureau, Addis Ababa, Oromia, Ethiopia
| | - Sileshi Belew
- Jimma University Laboratory of Drug Quality (JuLaDQ) and School of Pharmacy, Institute of Health, Jimma University, Jimma, Oromia, Ethiopia
| | - Gemmechu Hasen
- Jimma University Laboratory of Drug Quality (JuLaDQ) and School of Pharmacy, Institute of Health, Jimma University, Jimma, Oromia, Ethiopia
| | - Yesuneh Tefera Mekasha
- Veterinary Pharmacy, Pharmaceutical Quality Assurance and Regulatory Affairs, University of Gondar, Gondar, Amhara, Ethiopia
| | - Sultan Suleman
- Jimma University Laboratory of Drug Quality (JuLaDQ) and School of Pharmacy, Institute of Health, Jimma University, Jimma, Oromia, Ethiopia
| |
Collapse
|
3
|
Toe J, Orok E, Erah P. Assessment of knowledge and disposal practices of unused and expired household medicines in a community in Liberia. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2023; 12:100369. [PMID: 38058360 PMCID: PMC10696106 DOI: 10.1016/j.rcsop.2023.100369] [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: 07/29/2023] [Revised: 10/18/2023] [Accepted: 11/10/2023] [Indexed: 12/08/2023] Open
Abstract
Background Expansion of pharmaceutical industries and improved availability of pharmaceuticals across the world have contributed to an increase in drug usage and accumulation in homes. Improper disposal of expired and unused medications has several consequences such as environmental pollution, and childhood poisoning. Objectives The aim of the study was to assess the knowledge on disposal as well as disposal practices of unused and expired household medicines in the Parker Corner Road Community in Brewerville, Liberia. Methods This study was a cross-sectional survey conducted among 162 residents of Parker Corner Road Community using face-to-face interviews. Outcomes measured were knowledge of disposal as well as disposal practices of unused and expired household medicines. The data collected were analysed using descriptive statistics. Results Majority of respondents (55.6%) were female and 23.5% had university education. 71% of the respondents reported that they had not received any information on safe disposal practices while 64.2% admitted that they often did not read and follow disposal instructions. The most popular disposal practices were disposal of the drugs along with household waste (61.1%) and flushing them down the toilets or sinks (25.3%). Majority of the respondents (82.1%) were aware of the health effects arising from improper disposal of unused and expired medicines while 64.2% usually read medicine disposal instruction on the package. Only about 3% of them knew of expired medication take-back system and 33.3% knew nothing about medication expiration date. Conclusion The study revealed insufficient knowledge as well as inappropriate disposal practices of unused and expired medicines among residents of Parker Corner Road Community in Brewerville. There is need to organize a public enlightenment programme on safe, appropriate use, as well as disposal of unused and expired medicines.
Collapse
Affiliation(s)
- Jerry Toe
- School of Pharmacy, University of Liberia, Liberia
| | - Edidiong Orok
- Department of Clinical Pharmacy and Public Health, College of Pharmacy, Afe Babalola University, Ado-Ekiti, Ekiti State, Nigeria
| | - Patrick Erah
- Department of Clinical Pharmacy & Pharmacy Practice, Faculty of Pharmacy, University of Benin, Benin, Nigeria
| |
Collapse
|
4
|
Hashmi FK, Khadka S, Yadav GK, Khan MM, Khan SU, Saeed H, Saleem M, Giri S, Rasool MF, Mansoor HUH, Riboua Z. Non-prescription antibiotics dispensing by community pharmacies: implications for antimicrobial resistance. Ann Med Surg (Lond) 2023; 85:5899-5907. [PMID: 38098592 PMCID: PMC10718340 DOI: 10.1097/ms9.0000000000001388] [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] [Received: 05/11/2023] [Accepted: 09/28/2023] [Indexed: 12/17/2023] Open
Abstract
Introduction The non-prescription antibiotics dispensing (NPAD) from pharmacies is on the rise in low- and middle-income countries, which contributes to the emergence of antimicrobial resistance (AMR). This study was conducted with the objective to determine the community pharmacy personnel's perspectives on NPAD and its implications for AMR. Methods A questionnaire-based cross-sectional survey was conducted in Pakistan among 336 pharmacies. The data were analyzed using SPSS v21 and MedCalc for Windows v12.3.0. Modified Bloom's cut-off point was utilized to categorize the participants' overall knowledge, attitude, and practice. For univariable logistic regression analyses, odds ratio (OR) was calculated at 95% confidence interval (CI). For multivariable logistic regression analyses, adjusted OR was calculated at 95% CI. Spearman's rank correlation coefficient test was used to assess the relationships among knowledge, attitude, and/or practice scores. Results The majority of the respondents were staff pharmacists (45.5%). About four-fifths (78.9%) and half (50.9%) of the participants demonstrated moderate to good knowledge and practice, respectively. However, about only one-third (33.1%) had a moderate to good attitude. Staff pharmacists had higher odds of moderate to good knowledge (OR: 2.4, 95% CI: 1.2-4.7) and practice (OR: 2.3, 95% CI: 1.4-3.8). Total knowledge and practice (Spearman's ρ: 0.280; P <0.001) and total attitude and practice (Spearman's ρ: 0.299; P <0.001) scores were significantly correlated. Conclusion The qualified pharmacists had satisfactory knowledge, attitude, and practices toward antibiotics. However, non-pharmacist staff lacked knowledge and had probable NPAD practice, which has a negative impact on public health. Regular refresher training, seminars, and strict enforcement of rules and regulations are essential.
Collapse
Affiliation(s)
- Furqan K. Hashmi
- Punjab University College of Pharmacy, University of the Punjab, Lahore, Punjab
| | - Sitaram Khadka
- Shree Birendra Hospital, Nepalese Army Institute of Health Sciences, Kathmandu
| | | | | | - Saif Ullah Khan
- Punjab University College of Pharmacy, University of the Punjab, Lahore, Punjab
| | - Hamid Saeed
- Punjab University College of Pharmacy, University of the Punjab, Lahore, Punjab
| | - Mohammad Saleem
- Punjab University College of Pharmacy, University of the Punjab, Lahore, Punjab
| | | | - Muhammad Fawad Rasool
- Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan
| | | | - Zineb Riboua
- McCourt School of Public Policy, Georgetown University, Washington, District of Columbia, USA
| |
Collapse
|
5
|
Akande-Sholabi W, Olaoye DQ, Adebisi YA. Drug take-back program: assessment of knowledge, practices, and barriers to safe disposal of unused medication among healthcare students in a Nigerian university. BMC MEDICAL EDUCATION 2023; 23:810. [PMID: 37891609 PMCID: PMC10605967 DOI: 10.1186/s12909-023-04788-y] [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: 07/15/2023] [Accepted: 10/18/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND The safe disposal of unused medication is a critical public health issue, with risks including environmental pollution, accidental ingestion, and misuse. Inadequate adherence to proper disposal methods among healthcare students could affect the practice of safe disposal of unused medicines as future healthcare professionals. This study, conducted at a Nigerian university, aimed to assess the knowledge, adherence to safe disposal practices, and barriers faced by healthcare professional students regarding unused medication disposal. METHODS A cross-sectional study was carried out among 930 healthcare students in a Nigerian University, comprising medical and surgery, nursing, pharmacy, physiotherapy, and medical laboratory science students. Information was gathered from respondents using a self-administered questionnaire. Multivariate analyses were used to evaluate the relationship between specific variables and participants' knowledge and practice scores, while chi-square and logistic regression tests were used for categorical variables at p < 0.05. RESULTS A total of 930 students participated in this study. The results revealed a significant gap in knowledge, with (67.7%; 630) of the participants unaware of proper disposal methods and most scoring either 0 (31.9%; 297) or 1 (46.0%; 428) out of 4 on a knowledge-based questionnaire. Pharmacy students were the most knowledgeable, with 44.4% falling into the high knowledge category. However, their knowledge did not always correspond to correct practices, with only (10.1%; 94) of participants reporting use of recommended disposal methods such as returning unused medicine to a pharmacy or a drug take-back program. Significant associations were found with course of study (χ²=12.14, p = 0.033) and awareness of correct disposal methods (χ²=4.035, p = 0.045). Those aware of the correct disposal method had a higher odds ratio of high knowledge score (OR = 1.62, 95% CI: 1.1-2.41, p = 0.018) compared to those who were not aware. In terms of disposal practices, those who had received training on safe disposal had significantly higher odds of good practice score (OR = 2.25, 95% CI: 1.36-3.74, p = 0.002). Major barriers identified included lack of access to drug take-back programs (50.4%; 469), lack of knowledge (36.8%; 342), and inconvenience (10.3%; 14). CONCLUSION A knowledge gap was revealed among the respondents regarding the safe disposal of unused medications. Despite the presence of knowledge and awareness, these do not necessarily translate into good disposal practices. This call for strategies to overcome identified barriers, with the aim to bridge the knowledge-practice gap and promote safe disposal of unused medication. The study underscores the urgent need for improved public health policies and educational programs on safe medication disposal.
Collapse
Affiliation(s)
- Wuraola Akande-Sholabi
- Department of Clinical Pharmacy and Pharmacy Administration, Faculty of Pharmacy, University of Ibadan, Ibadan, Nigeria.
| | | | - Yusuff A Adebisi
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| |
Collapse
|
6
|
Mohammed AUM, Al-Hamadani F. Assessment of general population knowledge, attitude, and practice on safe unused and expired drugs disposal: a cross-sectional study. F1000Res 2023; 12:1333. [PMID: 38515859 PMCID: PMC10955187 DOI: 10.12688/f1000research.142146.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/09/2023] [Indexed: 03/23/2024] Open
Abstract
Background The appropriate disposal of medication is a well-recognized issue that has convened growing recognition in several contexts. Insufficient awareness relating to appropriate methods for the disposal of unneeded medicine may result in notable consequences. The current research was conducted among the public in Iraq with the aim of examining their knowledge, attitude, and practices regarding the proper disposal of unused and expired medicines. Methods The present study used an observational cross-sectional design that was community-based. The data were obtained from using an online questionnaire. The study sample included people of diverse genders, regardless of their race or occupational status. The study mandated that all participants meet two criteria: firstly, they had to be a minimum of 18 years old, and secondly, they needed to have permanent residency status in Iraq. Results The research population consisted of 591 participants from general population. The majority of participants were men (64.8%) with average age of 33.5±9.1 years. The majority of participants (˃50%) answered four out of eight knowledge questions correctly. There were significant (P-value ˂0.05) differences in four knowledge items about disposing of unused/expired medications according to the educational level. Elder participants had significantly higher knowledge about the disposing of unused/expired medications compared to younger ones. More than 84% correctly agreed that improper disposal of unused and expired medication has adverse effects on environment. Although the majority of the participants had positive attitude toward the safe disposal of unused/expired medications, their actual practice was improper for these medications. Approximately 70% of the participants have disposed unused/expired medications into their home trash can. Conclusion Despite increasing awareness from the general populace about the possible harm and substantial hazards linked to expired medicines, there is an absence of understanding concerning the proper techniques for disposing of and managing these prescriptions.
Collapse
Affiliation(s)
| | - Fadya Al-Hamadani
- Clinical Pharmacy, College of Pharmacy, University of Baghdad, Baghdad, 10045, Iraq
| |
Collapse
|
7
|
Nairat LL, Abahri NA, Hamdan YA, Abdel-Khaliq RT, Odeh SM, Abutaha S, Al-Jabi SW, Koni AA, Abushanab AS, Zyoud SH. Assessment of practices and awareness regarding the disposal of unwanted pharmaceutical products among community pharmacies: a cross-sectional study in Palestine. BMC Health Serv Res 2023; 23:1035. [PMID: 37759203 PMCID: PMC10537554 DOI: 10.1186/s12913-023-09888-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 08/08/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND The improper disposal of pharmaceutical preparations substantially threatens human health and environmental safety. Pharmacists are responsible for properly disposing of unwanted medications and educating patients about how to do so themselves. This study aimed to assess community pharmacists' knowledge, determine their views on how to dispose of unwanted pharmaceuticals, and assess the extent to which they realize that it is their responsibility to guide patients toward the safe disposal of expired medications. METHODS A descriptive cross-sectional study was conducted between December 2021 and April 2022 among 400 practicing pharmacists who were chosen to participate by random cluster sampling. Community pharmacists' practices, awareness, and beliefs about disposing of unused drugs were evaluated. The Statistical Package for Social Sciences (IBM-SPSS) version 21 was used for data entry and analysis. RESULTS Of 400 pharmacists, 348 stated that they did not participate in courses on the safe disposal of unwanted medications. Disposal of drugs in the garbage, an unsafe method, was very frequently recommended by pharmacists to patients, especially regarding inhalers, antibiotics, hormonal drugs, and solid and semisolid drugs. However, many pharmacists advised patients to return their hormonal, category B, and category C drugs to the pharmacy. A total of 61.3% of pharmacists agreed and 26% strongly agreed that unsafe disposal of drugs negatively affects the environment. A total of 54.3% of the participants agreed that improper disposal of antibiotics might be a reason for increased antimicrobial resistance, and 54.5% of them agreed that improper disposal of hormonal drugs might contribute to the development of certain cancers. A total of 80.3% of the participants perceived that most unwanted drugs in pharmacies were those returned from patients. A total of 97.3% of the participants supported establishing a drug disposal system, with 77.5% choosing to have the district health board responsible for funding this system. A total of 48.5% of the participants indicated that a lack of education and awareness on the issue of getting rid of unused drugs constitutes a challenge to the safe disposal of medicines, and 66% of them said that a lack of law enforcement constitutes another challenge. A total of 95.5% of the participants agreed or strongly agreed that good training for health sector workers and organizing workshops to develop knowledge on this subject would improve practices. A total of 93.3% supported distributing educational brochures, and 92.8% supported placing special containers in every pharmacy to collect unwanted drugs. CONCLUSIONS Most pharmacists in our study returned drugs to manufacturing companies and stores, and few followed the correct methods of incineration and return of drugs to the Ministry of Health. Current data emphasize the issue of improper disposal of medicine in Palestine and the need for improved education among healthcare workers.
Collapse
Affiliation(s)
- Lamees L Nairat
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Noor A Abahri
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Yosr A Hamdan
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Razan T Abdel-Khaliq
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Sawsan M Odeh
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Shatha Abutaha
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Samah W Al-Jabi
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Amer A Koni
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
- Division of Clinical Pharmacy, Department of Hematology and Oncology, An-Najah National University Hospital, Nablus, 44839, Palestine
| | - Amani S Abushanab
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine.
| | - Sa'ed H Zyoud
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine.
- Poison Control and Drug Information Center (PCDIC), College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine.
- Clinical Research Center, An-Najah National University Hospital, Nablus, 44839, Palestine.
| |
Collapse
|
8
|
Mouloudj K, Njoku A, Asanza DM, Bouarar AC, Evans MA, Mouloudj S, Bouarar A. Modeling Predictors of Medication Waste Reduction Intention in Algeria: Extending the Theory of Planned Behavior. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6584. [PMID: 37623170 PMCID: PMC10454758 DOI: 10.3390/ijerph20166584] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 08/08/2023] [Accepted: 08/15/2023] [Indexed: 08/26/2023]
Abstract
COVID-19 caused an increase in the demand for medications, which led to an increase in pharmaceutical waste and there is no doubt that this contributes to environmental pollution. Hence, it became necessary to search for how to protect and improve the environment by encouraging the behavior of medication waste reduction. Accordingly, this study aims to investigate the factors affecting intentions to reduce medication waste. Considering this, we develop an extended theory of planned behavior (TPB) framework by incorporating the constructs of moral obligation, environmental awareness, and medication waste risk perception. Using the convenience sampling method and based on a self-administered questionnaire, a total of 225 usable responses were collected in five Algerian cities. The results showed that positive attitudes (β = 0.316, p < 0.001), moral obligation (β = 0.291, p < 0.001), environmental awareness (β = 0.227, p < 0.001), perceived behavior control (PBC) (β = 0.151, p = 0.001), greater perceived risks (β = 0.127, p < 0.001), and subjective norm (β = 0.096, p < 0.05) significantly and positively influence the medication waste minimization intention. Furthermore, our analyses revealed that the extended TPB model explained 73.40% of the intention variance. In conclusion, we have explored the intentions, and there may be a gap between intent and actual behavior. Therefore, we recommend future studies to examine the factors affecting the actual behavior of medication waste reduction and to investigate environmental ethics and religious commitment as predictors of waste reduction intentions.
Collapse
Affiliation(s)
- Kamel Mouloudj
- Department of Commercial Sciences, College of Economic, University Yahia Fares of Medea, Medea 26000, Algeria; (K.M.); (A.C.B.); (S.M.)
| | - Anuli Njoku
- Department of Public Health, College of Health and Human Services, Southern Connecticut State University, New Haven, CT 06515, USA;
| | - Dachel Martínez Asanza
- Department of Scientific-Technical Results Management, National School of Public Health (ENSAP), Havana Medical Sciences University, Havana 10800, Cuba;
| | - Ahmed Chemseddine Bouarar
- Department of Commercial Sciences, College of Economic, University Yahia Fares of Medea, Medea 26000, Algeria; (K.M.); (A.C.B.); (S.M.)
| | - Marian A. Evans
- Department of Public Health, College of Health and Human Services, Southern Connecticut State University, New Haven, CT 06515, USA;
| | - Smail Mouloudj
- Department of Commercial Sciences, College of Economic, University Yahia Fares of Medea, Medea 26000, Algeria; (K.M.); (A.C.B.); (S.M.)
| | - Achouak Bouarar
- Department of Medicine, College of Medical, University Saad Dahleb Blida 1, Blida 09000, Algeria;
| |
Collapse
|
9
|
Sitotaw B, Philipos W. Knowledge, Attitude, and Practices (KAP) on Antibiotic Use and Disposal Ways in Sidama Region, Ethiopia: A Community-Based Cross-Sectional Survey. ScientificWorldJournal 2023; 2023:8774634. [PMID: 37546378 PMCID: PMC10397485 DOI: 10.1155/2023/8774634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 07/15/2023] [Accepted: 07/20/2023] [Indexed: 08/08/2023] Open
Abstract
Antibiotic resistance has been among the top public health threats elsewhere. Scientific information on knowledge, attitudes, and practices (KAP) at the community level towards antibiotic use and disposal ways is a vital step for effective intervention. This study aimed at determining the levels of KAP and associated risk factors for antibiotics in and around Hawassa City, southern Ethiopia. A community-based cross-sectional study was conducted, and data were collected using a structured questionnaire. Descriptive statistics, chi-square test, and logistic regression were used to analyze and interpret the results. A total of 504 participants with a mean age of 35.32 ± 9.03 years were included in the study. Most of the participants were urban dwellers (59.5%); more than half (55.6%) of the participants were male; most of the participants (62.7%) were at least college graduates; about half were employed (52.4%); about 41.7% of the participants had a large family size (≥7) with a mean family size of 5.7 ± 2.7; the average family monthly income was ETB 7213.71 ± 3673, and over three-fourth (74.8%) of the study participants were married. In addition, about 83.13% of the study participants heard about antibiotics; almost all of them (99.8%) had ever used antibiotics at some point in their life (75% of which used antibiotics within 6 months), and all of them could name at least one common type of antibiotic. Moreover, most of the participants (86.5%) did not receive any training related to antibiotics, and 29.4% of them obtained antibiotics without a prescription. Most participants had poor knowledge (64%), negative attitudes (60.4%), and poor practices (55%) towards antibiotic use, resistance, and disposal methods. Significant and positive linear correlations between knowledge and attitude (r = 0.539, P ≤ 0.001), knowledge-practice (r = 0.532, P ≤ 0.001), and attitude-practice (r = 0.786, P < 0.001) were also observed. Most of the sociodemographic variables were significantly associated with the mean KAP scores of the study participants. Living in a rural area, having a large family size, and being female, married, illiterate, and farmer resulted in a very low level of knowledge. Similarly, living in a rural area, having a small family size, and being older and married resulted in a negative attitude. Furthermore, having a smaller family size, having a low family monthly income, and being married, illiterate, and self-employed resulted in poor practice. A very low level of KAP towards antibiotics among people living in and around Hawassa City calls for urgent and effective intervention strategies.
Collapse
Affiliation(s)
- Baye Sitotaw
- Bahir Dar University, Department of Biology, P.O. Box 79, Bahir Dar, Ethiopia
| | - Workneh Philipos
- Bahir Dar University, Department of Biology, P.O. Box 79, Bahir Dar, Ethiopia
| |
Collapse
|
10
|
Diriba G, Hasen G, Tefera Y, Suleman S. Assessment of the magnitude and contributing factors of expired medicines in the public pharmaceutical supply chains of Western Ethiopia. BMC Health Serv Res 2023; 23:791. [PMID: 37491251 PMCID: PMC10367394 DOI: 10.1186/s12913-023-09776-y] [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: 04/03/2023] [Accepted: 07/03/2023] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND The magnitude of expired medicines in supply chains are increasing globally due to lack of strict control of the supply chain, poor storage management and oversupply of medicines. This situation is very serious in resource-poor countries, including Ethiopia, where the supply of medicines is limited. Therefore, this study aimed to assess the magnitude and the contributing factors of expired medicines in the Public Pharmaceutical Supply Chains of Western Ethiopia. METHODS Explanatory sequential study design involving mixed quantitative and qualitative approach were employed among 62 public pharmaceutical supply chains of Western Ethiopia from July1 to August 30, 2021. An observational checklist and the self-administered questionnaire were used to review all records of the expired medicine file and to abstract secondary data on the extent, types of expired medicines and its contributing factors. The collected data was cleared, filtered, and coded using Microsoft Excel® 2010, and exported to SPSS version-23 (Amsterdam, Netherland) for statistical analysis. Bivariate logistic regression was used to check association between the outcome and independent variables. Multivariate logistic regression was analyzed when p-value is less than or equal to 0.25 in bivariate binary logistic regression, considering the statistical at p-value < 0.05. Moreover, audio recordings were transcribed and coded for emergent themes using thematic analysis. RESULTS The study revealed 5% expire rate over past two financial (2012 up to 2013) years and the total amount of expired drugs is estimated at 20 million Ethiopian Birr (ETB). Tetanus antitoxin (TAT), in terms of single drug value, had the highest drug expiry (4,110,426.43ETB: 20%), followed by liquid dosage forms (11,614,266.11 ETB: 57%). The Binary logistic regression result indicated that, poor store management were more likely associated with the magnitude of expired medicine than those with good store management (COR: 10.706, 95% CI: 2.148, 53.348). Multivariate logistic regression revealed that poor store management (AOR: 9.718, 95% CI: 1.474, 64.082) was a significant contributor to the expire rate at 5% (P < 0.05). Most facilities did not have a procedure, and programme for disposing of expired medicines. According to key informants, inadequate inventory management, lack of policy and implementation of standards are the main contributing factors of the medicine's expiration. CONCLUSION AND RECOMMENDATIONS The current study found that the overall rate of medication expiration is high, at a significant cost to the budget. Inadequate inventory management, lack of policy, and implementation of standards are the main contributing factors to the medicine's expiration, as cited by key informants. Further research is necessary to determine the quality and efficacy of these expired drugs to extend their shelf life to ensure adequate access to drugs in resource-limited settings.
Collapse
Affiliation(s)
- Gamachu Diriba
- Pharmaceutical Quality Assurance, and Regulatory Affairs, Madda Walabu University, Goba Referral Hospital, Oromia Regional State, Robe, Ethiopia
| | - Gemmechu Hasen
- Jimma University Laboratory of Drug Quality (JuLaDQ) and School of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia.
| | - Yesuneh Tefera
- Pharmaceutical Sciences, Pharmaceutical Quality Assurance and Regulatory Affairs, University of Gondar, Gondar, Ethiopia.
| | - Sultan Suleman
- Jimma University Laboratory of Drug Quality (JuLaDQ) and School of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia
| |
Collapse
|
11
|
Gangannagaripalli J, McIver L, Abutheraa N, Brewster R, Dixon D, Watson MC. National initiative to promote public involvement in medicine safety: the use of a cross-sectional population survey to identify candidate behaviours for intervention development in Scotland. BMJ Open 2023; 13:e058966. [PMID: 37169507 DOI: 10.1136/bmjopen-2021-058966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/13/2023] Open
Abstract
OBJECTIVES The aim of this study was to explore the public's current awareness of the safe use of medicines in general, and over-the-counter (OTC) analgesics (painkillers) in particular, as well as their information-seeking and advice-seeking, medicine use and disposal. SETTING General population, Scotland. PARTICIPANTS Adults (aged >16 years) living in Scotland. INTERVENTIONS A cross-sectional survey was undertaken in collaboration with Ipsos MORI (a market research company). The content was informed by a multi-stakeholder prioritisation event and supplemented with information from earlier studies. RESULTS The survey was completed in March 2020 by 1000 respondents, most of whom had used a pharmacy in the previous 12 months to obtain a medicine. Of the 1000 respondents, 39% (n=389) were 55 years and over; 52% (n=517) were women; and 58% were degree-educated.On receipt of a new prescription, up to 29.8% (95% CI 27.0% to 32.7%) of respondents proactively sought specific information or advice from the pharmacist. Few (5.2% (95% CI 4.0% to 6.8%) respondents 'always' discussed their new prescription medicine with pharmacy staff and 28.9% (95% CI 26.2% to 31.8%) reported 'never' engaging in this behaviour. Respondents aged >35 years were less likely to engage in this behaviour.Just over half (53% (95% CI 50.5% to 56.7%)) the respondents reported oral OTC analgesic use at least once in the previous month.In terms of medicine disposal, 29.3% (95% CI 26.6% to 32.2%) of respondents considered waste bin disposal to be of low or no harm. CONCLUSIONS This study identified low levels of information-seeking and advice-seeking from pharmacy personnel especially on receipt of new prescription medicines. Potentially unsafe behaviours were identified in the use and disposal of medicines. These results will inform the development of interventions to promote advice-seeking and increase awareness regarding safe medicine use.
Collapse
Affiliation(s)
| | - Laura McIver
- Healthcare Improvement Scotland Glasgow, Glasgow, UK
| | - Nouf Abutheraa
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | | | - Diane Dixon
- Institute of Applied Health Sciences, Health Psychology, University of Aberdeen, Aberdeen, UK
| | - Margaret C Watson
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK
| |
Collapse
|
12
|
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.
Collapse
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
| |
Collapse
|
13
|
Kharaba Z, Khasawneh LQ, Aloum L, Ghemrawi R, Jirjees F, Al Bataineh N, Al-Azayzih A, Ali Buabeid M, Zain Al-Abdin S, Alfoteih Y. An assessment of the current practice of community pharmacists for the disposal of medication waste in the United Arab Emirates: A deep analysis at a glance. Saudi Pharm J 2022; 30:1773-1780. [PMID: 36601509 PMCID: PMC9805962 DOI: 10.1016/j.jsps.2022.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 10/08/2022] [Indexed: 11/07/2022] Open
Abstract
Objective The study aimed to identify the current practice carried out by community pharmacists to dispose of expired medications in their workplace and assess any practical steps utilized to reduce medication waste. Method A cross-sectional study was conducted among community pharmacists in the United Arab Emirates (UAE). The participants were asked about their routine practice in disposing of different expired medications and the current actions taken to reduce the number of disposed medicines. Results The study included (n = 418) community pharmacists. More than a third of expired liquid, solid, and semi-solid dosage forms were collected by licensed contractors. In addition, more than a third of the pharmacists disposed of different dosage forms via unauthorized methods (general garbage, sink and toilet). Most expired drugs were skin and hair products, antibiotics and analgesics. The majority of pharmacists (68.4 %, n = 286) agreed that expired pharmaceutical and non-pharmaceutical products, other than those disposed of via contractor, should be done through a specialized centre. This opinion was found to be strongly associated with years of practice as community pharmacists (P < 0.05). Conclusion Part of the existing disposal practices for expired pharmaceutical products in the UAE is carried out by contractors licensed by health authorities. However, concern remains regarding some pharmaceutical and non-pharmaceutical products that have not been disposed of correctly. Additionally, there is a need for a specialized center for medication disposal (p < 0.05). A stock limitation is the best practice for managing medication quantities in stock (p < 0.05).
Collapse
Affiliation(s)
- Zelal Kharaba
- Department of Clinical Pharmacy, College of Pharmacy, Al Ain University, Abu Dhabi 112612, UAE,AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi, UAE,Honorary Associate Lecturer, Faculty of Medical Sciences, Newcastle University, Newcastle upon tyne, UK,Corresponding author at: Department of Clinical Sciences, College of Pharmacy, Al Ain University, Abu Dhabi 112612, UAE.
| | - Lubna Q. Khasawneh
- Department of Genomics and Genetics, Collage of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, UAE
| | - Lynn Aloum
- Department of Pharmaceutical Sciences, School of Pharmacy, Kingston University, London, UK
| | - Rose Ghemrawi
- AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi, UAE,Department of Pharmaceutical Sciences, College of Pharmacy, Al Ain University, Abu Dhabi 112612, UAE
| | - Feras Jirjees
- College of Pharmacy, University of Sharjah, Sharjah, UAE
| | - Nezar Al Bataineh
- AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi, UAE,Department of Pharmaceutical Sciences, College of Pharmacy, Al Ain University, Abu Dhabi 112612, UAE
| | - Ahmad Al-Azayzih
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Manal Ali Buabeid
- Medical and Health Sciences/ Pharmacy and Pharmaceutical Sciences, Fatima College of Health Sciences, Abu-Dhabi, UAE
| | - Sham Zain Al-Abdin
- Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, UAE
| | - Yassen Alfoteih
- Department of Dental Surgery, City University College of Ajman, Ajman, UAE
| |
Collapse
|
14
|
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.
Collapse
|
15
|
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.
Collapse
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
| |
Collapse
|
16
|
Aluko OO, Imbianozor GT, Jideama CO, Ogundele OV, Fapetu TE, Afolabi OT, Odewade OL. The perception and disposal practices of unused and expired medicines by households in an urban municipality, southwest Nigeria: A comparative cross-sectional study. WASTE MANAGEMENT (NEW YORK, N.Y.) 2022; 140:121-132. [PMID: 35078076 DOI: 10.1016/j.wasman.2022.01.022] [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: 10/29/2021] [Revised: 12/22/2021] [Accepted: 01/16/2022] [Indexed: 06/14/2023]
Abstract
Unused, damaged, and expired medicines (UEMs) pose disposal challenges globally, despite their importance. The environmental disposal of UEMs portends public health consequences, hence, this study in high-density (HDS) and low-density (LDS) urban households in Southwest Nigeria. The comparative, cross-sectional study utilised multi-stage samplingto enrol 404 females, experienced in use and medicines safekeeping. The response rate was 93%. Data were analysed by IBM-SPSS, version 20. Continuous and categorical variableswere presentedin tables as mean(±SD), proportions (%), respectively while χ2 and logistic regression statistics determined differences between LDS and HDS (Pα > 0.05). 53.4% and 71.2% of respondents respectively had good knowledge and positive attitudes to safe disposal of UEMs. At least 31.5% of households don't stock medicines while antimalarial (57.3%), analgesics (52.7%) and antibiotics (49.7%) predominate in households and significantly different between LDS and HDS. 72.9% and 67.8%; 47.9% and 55.6% respondents in LDS and HDS, respectively, disposed of solid and liquid UEMs in storage bins, though 34.9% (LDS) and 16.7% (HDS) disposed of liquid UEMs in toilet/sink. There were significant differences in medicines abundance and disposal practices between LDS and HDS for solid and liquid medicines. 37.1% of respondents perceived consequences for the poor UEMs disposal, including accidental ingestion (76.6% vs 26.7%), land pollution (69.6% vs 36.7%), water pollution (72.4% vs 32.8%) and toxicity (58.3% vs 32.8%), respectively in LDS and HDS. Respondents' good knowledge and positive attitudes contrasted with poor UEMs disposal practices, which compromise public health. Legislation, compliance monitoring and enforcement are germane for incentive-driven UEMs recovery.
Collapse
Affiliation(s)
- O O Aluko
- Department of Community Health, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria.
| | - G T Imbianozor
- Department of Community Health, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - C O Jideama
- Department of Community Health, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - O V Ogundele
- Department of Community Health, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - T E Fapetu
- Department of Community Health, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - O T Afolabi
- Department of Community Health, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - O L Odewade
- Department of Environmental Management, Faculty of Earth and Environmental Sciences, Bayero University, Kano, Nigeria
| |
Collapse
|
17
|
Adeleye AS, Xue J, Zhao Y, Taylor AA, Zenobio JE, Sun Y, Han Z, Salawu OA, Zhu Y. Abundance, fate, and effects of pharmaceuticals and personal care products in aquatic environments. JOURNAL OF HAZARDOUS MATERIALS 2022; 424:127284. [PMID: 34655870 DOI: 10.1016/j.jhazmat.2021.127284] [Citation(s) in RCA: 99] [Impact Index Per Article: 49.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 09/06/2021] [Accepted: 09/16/2021] [Indexed: 06/13/2023]
Abstract
Pharmaceuticals and personal care products (PPCPs) are found in wastewater, and thus, the environment. In this study, current knowledge about the occurrence and fate of PPCPs in aquatic systems-including wastewater treatment plants (WWTPs) and natural waters around the world-is critically reviewed to inform the state of the science and highlight existing knowledge gaps. Excretion by humans is the primary route of PPCPs entry into municipal wastewater systems, but significant contributions also occur through emissions from hospitals, PPCPs manufacturers, and agriculture. Abundance of PPCPs in raw wastewater is influenced by several factors, including the population density and demography served by WWTPs, presence of hospitals and drugs manufacturers in the sewershed, disease burden of the population served, local regulations, and climatic conditions. Based on the data obtained from WWTPs, analgesics, antibiotics, and stimulants (e.g., caffeine) are the most abundant PPCPs in raw wastewater. In conventional WWTPs, most removal of PPCPs occurs during secondary treatment, and overall removal exceeds 90% for treatable PPCPs. Regardless, the total PPCP mass discharged with effluent by an average WWTP into receiving waters (7.35-20,160 g/day) is still considerable, because potential adverse effects of some PPCPs (such as ibuprofen) on aquatic organisms occur within measured concentrations found in surface waters.
Collapse
Affiliation(s)
- Adeyemi S Adeleye
- Department of Civil and Environmental Engineering, University of California, Irvine, CA 92697-2175, USA.
| | - Jie Xue
- Department of Civil and Environmental Engineering, University of California, Irvine, CA 92697-2175, USA
| | - Yixin Zhao
- Department of Civil and Environmental Engineering, University of California, Irvine, CA 92697-2175, USA
| | - Alicia A Taylor
- Ecological and Biological Sciences Practice, Exponent, Inc., Oakland, CA 94612, USA
| | - Jenny E Zenobio
- Department of Civil and Environmental Engineering, University of California, Irvine, CA 92697-2175, USA
| | - Yian Sun
- Department of Civil and Environmental Engineering, University of California, Irvine, CA 92697-2175, USA; Water-Energy Nexus Center, University of California, Irvine, CA 92697-2175, USA
| | - Ziwei Han
- Department of Civil and Environmental Engineering, University of California, Irvine, CA 92697-2175, USA
| | - Omobayo A Salawu
- Department of Civil and Environmental Engineering, University of California, Irvine, CA 92697-2175, USA
| | - Yurong Zhu
- Department of Chemical and Biomolecular Engineering, University of California, Irvine, CA 92697-2580, USA
| |
Collapse
|
18
|
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.
Collapse
|
19
|
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]
|
20
|
Han J. Barcoding drug information to recycle unwanted household pharmaceuticals: a review. ENVIRONMENTAL CHEMISTRY LETTERS 2022; 20:2989-3003. [PMID: 35496467 PMCID: PMC9043091 DOI: 10.1007/s10311-022-01420-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 02/15/2022] [Indexed: 05/02/2023]
Abstract
Huge quantities of unwanted pharmaceuticals are left in households, notably as a consequence of the rising drug demand caused by improved healthcare and the aging population. Unwanted pharmaceuticals may thus easily end up polluting ecosystems upon disposal. This pharmaceutical waste issue has been aggravated during the coronavirus disease pandemic (COVID-19) by excess prescription and panic buying. Unwanted household pharmaceuticals are normally collected by owners and volunteers, then incinerated in centralized facilities, yet with low efficiency during the COVID-19 lockdowns. Most pharmaceuticals could be recycled because they are rather stable, however there is actually no sustainable strategy to manage unwanted pharmaceuticals in a pandemic. Here I review the management of unwanted pharmaceuticals in households during the pandemic, with emphasis on drug take-back programs, waste minimization and recycling efforts. Reducing pharamaceutical waste could be done by informing people on what to do with unwanted pharmaceutical products; using machine-readable codes for automatic sorting; and applying existing techniques for recovery of active pharmaceutical ingredients for reuse. I propose a new strategy where owners sort their unwanted pharmaceuticals and submit information online. This will generate coded mailing labels that allow the owner to separate pharmaceuticals into categories such as opened, unused, expired, and non-expired. Once collected by recycling facilities and manufacturers, active ingredients will be extracted to create new pharmaceuticals which will be recycled to other patients.
Collapse
Affiliation(s)
- Jie Han
- School of Human Settlements and Civil Engineering, Xi’an Jiaotong University, Xi’an, 710049 People’s Republic of China
| |
Collapse
|
21
|
Russom M, Bahta M, Debesai M, Bahta I, Kessete A, Afendi A, Fitsum Y, Nambozi J, Kidane SN, Tesfamariam EH. Knowledge, attitude and practice of antibiotics and their determinants in Eritrea: an urban population-based survey. BMJ Open 2021; 11:e046432. [PMID: 34561253 PMCID: PMC8475161 DOI: 10.1136/bmjopen-2020-046432] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To measure knowledge, attitude and practice of antibiotics and antibiotic resistance (ABR) and their determinants in the Eritrean urban population. DESIGN A population-based, nation-wide, cross-sectional study. SETTING Urban settings of Eritrea. PARTICIPANTS Members of the general public aged ≥18 years and living in 13 urban places of Eritrea. Three-stage stratified cluster sampling was used to select the study participants. DATA COLLECTION AND ANALYSIS Date were collected from July 2019 to September 2019 in a face-to-face interview using a structured questionnaire. The collected data were double entered and analysed using Census and Survey Processing system (V.7.0) and SPSS (V.23), respectively. Descriptive statistics, χ2 test, t-tests, analysis of variance, factorial analysis and multivariable logistic regression were performed. All analyses were weighted and p<0.05 was considered significant. PRIMARY AND SECONDARY OUTCOME MEASURES Main outcome variables were knowledge, attitude and practice of antibiotics and ABR. Secondary outcome measure was the determinants of knowledge, attitude and practice. RESULTS A total of 2477 adults were interviewed. The mean score of knowledge and attitude of antibiotics and ABR was 10.36/20 (SD=3.51, minimum=0 and maximum=20) and 22.34/30 (SD=3.59, minimum=6 and maximum=30), respectively. Of those who used antibiotics, the proportion of at least one inappropriate practice (use of antibiotics without prescription and/or discontinuation of prescribed antibiotics before completing the full course) was 23.8%. Young age <24 years (adjusted odds ratio (AOR)=1.61, 95% CI: 1.08 to 2.41), male sex (AOR=1.48, 95% CI: 1.14 to 1.91), higher level of education (AOR=1.76, 95% CI: 1.08 to 2.88), and negative attitude towards appropriate use of antibiotics (AOR=0.95, 95% CI: 0.92 to 0.97) were found to be the significant determinants of inappropriate practice of antibiotics. CONCLUSION The gap in knowledge and inappropriate practice of antibiotics in the Eritrean urban population was widespread; requiring immediate attention from policy-makers and healthcare professionals.
Collapse
Affiliation(s)
- Mulugeta Russom
- National Medicines and Food Administration, Ministry of Health, Asmara, Eritrea
- Department of Medical Informatics, Erasmus Medical Centre, Rottordam, Netherlands
| | - Merhawi Bahta
- National Medicines and Food Administration, Ministry of Health, Asmara, Eritrea
| | - Merhawi Debesai
- National Medicines and Food Administration, Ministry of Health, Asmara, Eritrea
| | - Iyassu Bahta
- National Medicines and Food Administration, Ministry of Health, Asmara, Eritrea
| | - Abrahalei Kessete
- National Medicines and Food Administration, Ministry of Health, Asmara, Eritrea
| | - Aziza Afendi
- National Medicines and Food Administration, Ministry of Health, Asmara, Eritrea
| | - Yodit Fitsum
- National Medicines and Food Administration, Ministry of Health, Asmara, Eritrea
| | | | | | | |
Collapse
|
22
|
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.
Collapse
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
| |
Collapse
|
23
|
Egbuna C, Amadi CN, Patrick-Iwuanyanwu KC, Ezzat SM, Awuchi CG, Ugonwa PO, Orisakwe OE. Emerging pollutants in Nigeria: A systematic review. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2021; 85:103638. [PMID: 33757839 DOI: 10.1016/j.etap.2021.103638] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 03/07/2021] [Accepted: 03/18/2021] [Indexed: 06/12/2023]
Abstract
Emerging pollutants represent a group of synthetic or naturally occurring compounds that are not normally monitored within the environment but can enter into the environment and cause different adverse ecological and health effects. This systematic review identified the various emerging pollutants in Nigeria. The following databases, ScienceDirect, PubMed, Google Scholar, and African Journals OnLine (AJOL) were searched to identify studies on pollutants of emerging concerns in Nigeria. A total of 933 articles were identified out of which 30 articles were selected to be eligible for the study. Over 250 emerging pollutants were identified and divided into 9 major groups which are personal care products, pharmaceuticals, industrial chemicals, polycyclic aromatic hydrocarbons, volatile organic compounds, pesticides, mycotoxins, radionuclides and electromagnetic radiations (Gamma radiation) and other pollutants of emerging concerns such as microbes, microplastics, and particulate matter. These pollutants are found in water bodies and underground waters, soils and sediments, biological systems, and ambient air at different concentrations with seasonal variations. Some of these pollutants act as endocrine disruptors, β-adrenergic receptors agonist blockers, oxidative stress inducers and can cause genetic alterations in DNA and epigenetic reprogramming through global DNA methylation, gene-specific CpG methylation and microRNA expression. Emerging pollutants of public health concern in Nigeria are on the increase and are threat to both ecological and human health.
Collapse
Affiliation(s)
- Chukwuebuka Egbuna
- Africa Centre of Excellence for Public Health and Toxicological Research (ACE-PUTOR), University of Port Harcourt, PMB, 5323, Port Harcourt, Rivers State, Nigeria; Department of Biochemistry, Faculty of Science, University of Port Harcourt, Port Harcourt, Nigeria; Department of Biochemistry, Faculty of Natural Sciences, Chukwuemeka Odumegwu Ojukwu University, Uli Campus, Anambra State -431124, Nigeria
| | - Cecilia N Amadi
- Department of Experimental Pharmacology & Toxicology, Faculty of Pharmacy, University of Port-Harcourt, PMB, 5323 Port Harcourt, Rivers State, Nigeria
| | - Kingsley C Patrick-Iwuanyanwu
- Africa Centre of Excellence for Public Health and Toxicological Research (ACE-PUTOR), University of Port Harcourt, PMB, 5323, Port Harcourt, Rivers State, Nigeria; Department of Biochemistry, Faculty of Science, University of Port Harcourt, Port Harcourt, Nigeria
| | - Shahira M Ezzat
- Department of Pharmacognosy, Faculty of Pharmacy, Cairo University, Cairo 11562, Egypt; Department of Pharmacognosy, Faculty of Pharmacy, October University for Modern Sciences and Arts (MSA), Giza 12451, Egypt
| | | | - Peter Okechukwu Ugonwa
- Department of Biochemistry, Faculty of Natural Sciences, Chukwuemeka Odumegwu Ojukwu University, Uli Campus, Anambra State -431124, Nigeria
| | - Orish E Orisakwe
- Africa Centre of Excellence for Public Health and Toxicological Research (ACE-PUTOR), University of Port Harcourt, PMB, 5323, Port Harcourt, Rivers State, Nigeria; Department of Experimental Pharmacology & Toxicology, Faculty of Pharmacy, University of Port-Harcourt, PMB, 5323 Port Harcourt, Rivers State, Nigeria.
| |
Collapse
|
24
|
Alshemari A, Breen L, Quinn G, Sivarajah U. Can We Create a Circular Pharmaceutical Supply Chain (CPSC) to Reduce Medicines Waste? PHARMACY 2020; 8:E221. [PMID: 33218038 PMCID: PMC7712437 DOI: 10.3390/pharmacy8040221] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 11/13/2020] [Accepted: 11/16/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The increase in pharmaceutical waste medicines is a global phenomenon and financial burden. The Circular Economy, as a philosophy within the pharmaceutical supply chain, aims to promote waste reduction, maximise medicines value, and enable sustainability within this supply chain (increasing circularity). Circularity strategies for pharmaceuticals are not currently implemented in many countries, due to quality and safety barriers. The aim of this study was to determine whether the application of circular economy principles can minimise pharmaceutical waste and support sustainability in the pharmaceutical supply chain; Methods: a detailed narrative literature review was conducted in order to examine pharmaceutical waste creation, management, disposal, and the application of circular economy principles; Results: the literature scrutinised revealed that pharmaceutical waste is created by multiple routes, each of which need to be addressed by pharmacists and healthcare bodies through the Circular Economy 9R principles. These principles act as a binding mechanism for disparate waste management initiatives. Medicines, or elements of a pharmaceutical product, can be better managed to reduce waste, cost, and reduce negative environmental impacts through unsafe disposal. CONCLUSIONS the study findings outline a Circular Pharmaceutical Supply Chain and suggests that it should be considered and tested as a sustainable supply chain proposition.
Collapse
Affiliation(s)
- Abdullah Alshemari
- School of Management, Faculty of Management, Law and Social Sciences, University of Bradford, Bradford BD7 1DP, UK;
| | - Liz Breen
- School of Pharmacy and Medical Sciences, University of Bradford, Bradford BD7 1DP, UK; (L.B.); (G.Q.)
| | - Gemma Quinn
- School of Pharmacy and Medical Sciences, University of Bradford, Bradford BD7 1DP, UK; (L.B.); (G.Q.)
| | - Uthayasankar Sivarajah
- School of Management, Faculty of Management, Law and Social Sciences, University of Bradford, Bradford BD7 1DP, UK;
| |
Collapse
|
25
|
Unused and Expired Medications Disposal Practices among the General Public in Selangor, Malaysia. PHARMACY 2020; 8:pharmacy8040196. [PMID: 33114172 PMCID: PMC7712208 DOI: 10.3390/pharmacy8040196] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 10/19/2020] [Accepted: 10/23/2020] [Indexed: 01/19/2023] Open
Abstract
The appropriate disposal practice of unused and expired medications has become a global challenge that has caught the attention of health policymakers, pharmaceutical organizations, healthcare professionals, and the wider community. The current study aimed to evaluate the awareness, attitudes, and behaviors relating to the disposal practice of unused and expired medications and medication wastage issues among the general public in Selangor, Malaysia. The quantitative, cross-sectional study was conducted using a pre-validated structured survey form. Among the approached individuals, 426 showed their willingness to participate in the study. More than 80% of the study population reported being aware of the medication wastage issue and its impact on patients and the economy. The respondents with a higher level of education (OR = 1.85; 95% CI = 1.18–2.52; p < 0.003) were more likely to be cognizant of the detrimental consequences of inappropriate waste disposal. The female respondents were more likely to report comprehending that the availability of free healthcare resources is contributing to medication waste (OR = 1.33, 95% CI = 1.015–2.34; p < 0.005). The majority of respondents reported throwing away unused medications (202; 47.4%) and expired medications (362; 84.9%) in the garbage. The respondents believed that the provision of appropriate directions by healthcare professionals (312; 73.2%) and prescribing/dispensing medications in quantities for the duration that ensures patient adherence (114; 26.7%) could minimize medication wastage. The Ministry of Health (258; 60.5%), pharmaceutical organizations (212; 49.7%), and pharmacists (193; 45.3%) were the respondents’ perceived responsible sources of information. The current findings reported that respondents were familiar that inappropriate practices of medication wastage might have harmful consequences. However, a gap exists between their awareness and practice, and the disposal approaches practiced by the respondents were generally not appropriate.
Collapse
|
26
|
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: 15] [Impact Index Per Article: 3.8] [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.
Collapse
|
27
|
Anwar M, Iqbal Q, Saleem F. Improper disposal of unused antibiotics: an often overlooked driver of antimicrobial resistance. Expert Rev Anti Infect Ther 2020; 18:697-699. [DOI: 10.1080/14787210.2020.1754797] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Muhammad Anwar
- Faculty of Pharmacy & Health Sciences, University of Balochistan, Quetta, Pakistan
| | - Qaiser Iqbal
- Faculty of Pharmacy & Health Sciences, University of Balochistan, Quetta, Pakistan
| | - Fahad Saleem
- Faculty of Pharmacy & Health Sciences, University of Balochistan, Quetta, Pakistan
| |
Collapse
|
28
|
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.
Collapse
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
| |
Collapse
|
29
|
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.
Collapse
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
| |
Collapse
|