Unused medications and disposal patterns at home: Findings from a Medicare patient survey and claims data

Abstract

ObjectiveTo examine what medications are most frequently left unused by patients, how much is left unused, and how these medications are disposed of among Medicare beneficiaries. DesignSecondary data analysis combining insurance claims and telephone survey data of Medicare Advantage members. SettingRegional health plan in Central Pennsylvania. ParticipantsSeven hundred twenty-one Medicare Advantage members who had Part D coverage through the plan as of December 31, 2013, and completed the telephone survey in May 2014. InterventionTelephone survey conducted by a survey research center. Main outcome measureMember survey response. ResultsOf the 2,994 medications in the dataset, 247 (8%) were reported being left unused by patients. Of the 247, the most common medications were those for pain (15%), hypertension (14%), antibiotics (11%), and psychiatric disorders (9%). Approximately 15% of unused medications were controlled substances. The reasons for being unused varied by drug type. For example, for pain medications, adverse effects and overprescribing were the most commonly cited reasons; for hypertension medications, “dosage changed by doctor” was the most common reason. Most commonly, unused portions accounted for approximately 25% to 50% of the unused medications identified by patients. Approximately 11% of unused medication was disposed of via drug take-back programs, whereas the majority was kept in a cabinet (55%), thrown in the trash (14%), or flushed down the toilet (9%). ConclusionA lack of patient adherence alone does not explain unused medications and their improper disposal. Community-level interventions designed to improve prescription efficiency and patient awareness of appropriate disposal methods—particularly of controlled substances—are necessary to reduce the potentially harmful effects of improper disposal of unused medications.