Abstract
BackgroundIrrational household storage of medicines is a world-wide problem, which triggers medicine wastage as well as its associated harms. This study aimed to include all available evidences from literature to perform a focused examination of the prevalence and factors associated with medicine storage and wastage among urban households. This systematic review and meta-analysis mapped the existing literature on the burden, outcomes, and affective socio-economic factors of medicine storage among urban households. In addition, this study estimated pooled effect sizes for storage and wastage rates.MethodsHousehold surveys evaluating modality, size, costs, and affective factors of medicines storage at home were searched in PubMed, EMBASE, OVID, SCOPUS, ProQuest, and Google scholar databases in 2019. Random effect meta-analysis and subgroup analysis were used to pool effect sizes for medicine storage and wastage prevalence among different geographical regions.ResultsFrom the 2604 initial records, 20 studies were selected for systematic review and 16 articles were selected for meta-analysis. An overall pooled-prevalence of medicine storage and real wastage rate was 77 and 15%, respectively. In this regard, some significant differences were observed between geographical regions. Southwest Asia region had the highest storage and wastage rates. The most common classes of medicines found in households belonged to the Infective agents for systemic (17.4%) and the Nervous system (16.4%). Moreover, income, education, age, the presence of chronic illness, female gender, and insurance coverage were found to be associated with higher home storage. The most commonly used method of disposal was throwing them in the garbage.ConclusionsFactors beyond medical needs were also found to be associated with medicine storage, which urges effective strategies in the supply and demand side of the medicine consumption chain. The first necessary step to mitigate home storage is establishing an adequate legislation and strict enforcement of regulations on dispensing, prescription, and marketing of medicines. Patient’s pressure on excessive prescription, irrational storage, and use of medicines deserve efficient community-centered programs, in order to increase awareness on these issues. So, hazardous consequences of inappropriate disposal should be mitigated by different take back programs, particularly in low and middle income countries.
Highlights
Irrational household storage of medicines is a world-wide problem, which triggers medicine wastage as well as its associated harms
Factors beyond medical needs were found to be associated with medicine storage, which urges effective strategies in the supply and demand side of the medicine consumption chain
This study aimed to include all available evidences obtained from literature for performing a focused examination of the prevalence and the associated factors affecting medicine storage among households
Summary
Irrational household storage of medicines is a world-wide problem, which triggers medicine wastage as well as its associated harms. This study aimed to include all available evidences from literature to perform a focused examination of the prevalence and factors associated with medicine storage and wastage among urban households. Home storage of medicine is a public health problem worldwide, which occurs because of improper utilization of medicines and/or non-adherence with drug therapy that affects health, environment, and healthcare services [1,2,3,4,5,6]. In China, the share of medicine expenses from GDP has raised more than up to 320 times since 1980 [18] Such observations only indicated the immediate consequences of inappropriate supply and demand of medicines, whereas further concerns would be attached to the risk of inappropriate storage and disposal. Accidental intoxication, inappropriate self-medication, the presence of pharmaceutical ingredients in waterways as environmental pollutants, accidental poisoning of wildlife, and risk of antibacterial resistance can be named in this regard [8,9,10, 19,20,21]
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