Disposal Of Medicines Research Articles

An international multidisciplinary consensus statement on the prevention of opioid-related harm in adult surgical patients.

This international multidisciplinary consensus statement was developed to provide balanced guidance on the safe peri-operative use of opioids in adults. An international panel of healthcare professionals evaluated the literature relating to postoperative opioid-related harm, including persistent postoperative opioid use; opioid-induced ventilatory impairment; non-medical opioid use; opioid diversion and dependence; and driving under the influence of prescription opioids. Recommended strategies to reduce harm include pre-operative assessment of the risk of persistent postoperative opioid use; use of an assessment of patient function rather than unidimensional pain scores alone to guide adequacy of analgesia; avoidance of long-acting (modified-release and transdermal patches) opioid formulations and combination analgesics; limiting the number of tablets prescribed at discharge; providing deprescribing advice; avoidance of automatic prescription refills; safe disposal of unused medicines; reducing the risk of opioid diversion; and better education of healthcare professionals, patients and carers. This consensus statement provides a framework for better prescribing practices that could help reduce the risk of postoperative opioid-related harm in adults.

The rational use and disposal of drugs and the environmental and public health risks associated

Abstract The rational use and disposal of medicines is a topic that has been discussed by researchers worldwide, aiming to minimize the consumption and indiscriminate use of these compounds. The objective of this work was to promote the study of rational use, informative and educational action and environmental risks due to inadequate disposal. The proposal for this study was forwarded to the Institution's Ethics Committee, linked to the study, and its realization was approved, CAAE: 91559018.9.0000.5490, Opinion Number: 2,751,853. Data collection was carried out through an interview, through a questionnaire, evaluating aspects, regarding the rational use and disposal of medicines, having been developed in the city of Jaguariuna-SP. The research assessed the level of knowledge of a group, in relation to rational use, disposal of leftovers and expired medicines and knowledge about the potential effects on the environment and public health arising from these actions. It was found that almost all respondents have medicines at home, 50.93% of which are overdue, however the lack of information regarding the correct form of disposal, causes the population to proceed inappropriately. Among the main reported destinations, storage and disposal in common garbage prevails. Regarding awareness and responsibility, with regard to environmental contamination, more than 70% are aware of the problems caused in the environment and public health. Finally, regarding educational and informational actions in relation to the storage and disposal of medicines, 65.22% of the interviewees stated that they had not previously received any type of information on the proper storage and disposal of medicines. The data demonstrate the interviewees: awareness of the environmental and public health problems that may eventually be triggered due to the aspects addressed. However, the lack of information and adequate posts makes it difficult to disseminate information. Key messages The lack of guidance on storage and disposal of medicines, as well as aspects related to rational use, was the main aspect observed. It is necessary to take effective action regarding the inappropriate disposal of drugs in the environment, given the potential risk to public health arising from this practice.

Knowledge, Attitude, and Practice of Unused and Expired Medication Disposal among Patients Visiting Ayder Comprehensive Specialized Hospital.

Background Accumulation of unused and expired medicines at home is a source of environmental hazards and public health problems due to lack of awareness on appropriate medicine disposal methods. Therefore, the study was conducted to assess the knowledge, attitude, and practice of unused and expired medicine disposal among patients visiting Ayder Comprehensive Specialized Hospital. Methods A descriptive cross-sectional study was conducted among 384 patients who visited Ayder Comprehensive Specialized Hospital outpatient pharmacy from April to June 2019. Convenience sampling was used to recruit the participants, and data was collected by a face-to-face interview using a structured questionnaire. The data were entered and analyzed by using SPSS version 21.0. Descriptive statistics on sample characteristics was computed, and results were presented in the form percentage using table and statements. Results Out of the 384 respondents included in the study, 205 (53.4%) of them were males. More than half (199 (51.8%)) of the respondents did not correctly knew about medicine waste, and 233 (60.7%) of them did not have any prior information regarding medicine waste disposal instruction. But 351 (91.4%) of the participants correctly responded that inappropriate unused and expired medicine disposal can cause environmental harm. Above half (218 (56.8%)) of the respondents “agreed” about the potential risks related to having unused/expired medicines at home, and 206 (53.6%) of them “strongly agreed” that children are more vulnerable. One hundred fifty-nine respondents had unused/expired medicines in their homes. The most commonly used disposal practice for unused medicines were throwing them in a household trash as reported by 297 (77.3%) followed by flushing unused medications in toilet/sink 152 (39.6%). Throwing them away in household garbage and flushing them in toilet/sink were also the most commonly preferred disposal practice for expired medicines. Conclusion The majority of the study participants dispose unused and expired medicine in household garbage and toilet/sink. This is against the recommendations of both national and international policies and guidelines on safe and appropriate pharmaceutical waste disposal.

Peningkatan Pengetahuan Siswi MTS Al-Huda tentang Penggunaan, Penyimpanan dan Pembuangan Obat Hewan melalui Seminar Edukasi dan Demonstrasi

Currently, there are many pet shops, animal clinics, and animal lover communities in Malang. Data from UB's animal education hospitals showed an increasing number of patients visiting there. This reflects that the owner had considered his favorite animal as part of his family that must be treated if they are sick. Drugs medicine plays an important role in the treatment of animal diseases. Therefore, pet owners must know how to use and store drugs properly so that the efficacy of the drug does not change, and the results of treatment are achieved. When the drug is not used anymore, the owner must know how to properly dispose of the drug to prevent the drug from being mixed, polluting the environment, or even being used by irresponsible people. The aim of this community service was to provide additional knowledge about how to use, store and dispose of veterinary medicines. The theme we took was "Increasing Knowledge of Al-Huda MTS Students on the Use, Storage and Disposal of Animal Medicine through Educational Seminars and Demonstration". Community service methods used were counseling and seminars on the use, storage and disposal of veterinary medicines and demonstrations on how to give medicines to cats. The evaluation tools used were pretest and posttest. The pretest and posttest results showed an increase in the knowledge of MTS Al-Huda students about how to give medicines to pets - especially cats -, how to store and dispose of drugs that are not used. While the results of the questionnaire showed a very good response related to community service.

A survey on the knowledge, perceptions and practices regarding unwanted medicine disposal among pharmacists in Sri Lanka

Background: Unwanted medicines are defined as expired, unused, damaged or contaminated pharmaceutical products. Improper disposal of unwanted medicines leads to many health and environmental hazards. The World Health Organisation recommends that unwanted medicines should always be disposed properly. The main objective of this study was to assess the knowledge, practices and perceptions on the disposal of unwanted medicines among pharmacists in Sri Lanka.Methods: A cross-sectional study was carried out among pharmacists in 40 private retail pharmacies in the Northern, Eastern and the Western provinces within a period of three months. The pharmacies were selected via stratified randomised sampling in each district. The most experienced pharmacist in each pharmacy was recruited for data collection. A pre-tested, self-administered questionnaire was used. The ethics approval was obtained (Ref: EC-12-190). The data was represented using simple descriptive statistics.Results: The data was collected from 40 pharmacies. Among the pharmacists, 65% were males. The majority answered that burning and landfill as the most appropriate methods of disposal for most of the types of medicinal waste. A significant number of pharmacists were not aware about the method of disposal for anti-infective agents and anti-neoplastic agents. The majority perceived the seriousness of environmental damage caused by disposal via trash or sink. A majority was not agreeing to have pharmacies as collecting centers for unwanted medicines. A discrepancy between the pharmacists’ perceptions and the practices was observed.Conclusions: The level of knowledge, practices and perceptions among pharmacists on unwanted medicines disposal was substandard and needs attention.

Developing a health communication campaign for disposal of unused opioid medications

IntroductionCommunities throughout the United States have implemented medicine disposal programs to prevent diversion of unused opioid analgesics from homes but a general lack of awareness may contribute to low rates of utilization. The objective of this study was to develop and test community-based campaign messages promoting appropriate disposal of unused opioids at disposal programs. MethodsIn Fall 2019, 491 residents (79% female, 97% White, mean age: 40 years) of five rural, Appalachian counties (3 in Kentucky and 2 in North Carolina) completed a web-based, experimental survey. Participants were randomly exposed to two of four messages and rated each message separately. A pretest–posttest design was utilized to assess change in beliefs about retaining unused prescription opioids in the home following exposure to message sets. ResultsAll messages favorably influenced participants’ perceptions related to concerns and risks of retaining unused prescription opioids and importance of - and self-efficacy in disposing of unused opioid medications. After controlling for social and demographic characteristics and baseline beliefs in generalized linear mixed models, Message 1 outperformed other messages in increasing participants’ concern about retaining unused prescription opioids in the home and Message 3 was most effective in increasing self-efficacy to dispose of unused prescription opioids. ConclusionsMessages including young children and pictorially demonstrate how to dispose of medications may have the greatest impact on behavioral actions related to medication disposal. The findings from this study can be used to inform community-based campaigns to facilitate disposal of unused prescription opioids.

\u201cKnowledge and practices of HIV infected patients regarding medicine disposal among patients attending public ARV clinics in KwaZulu Natal, South Africa\u201d

BackgroundRecent analysis of drinking water in South Africa found the presence of ARVs, other pharmaceutical and personal care products. The environmental and human health risk that this presents is daunting. The increased use of ARVs with poor disposal practices could be the reason for these substances being present in drinking water. Therefore, this study aimed to determine the knowledge and practices of HIV infected patients, regarding medicine disposal.MethodA descriptive, cross sectional, quantitative study that utilised a structured, self-administered, questionnaire was undertaken at 3 different public ARV clinics in the eThekwini Metro of KwaZulu Natal, SA. The variables included questions on demographics, knowledge and practices of medicine disposal of ARV and other medications. Data was captured using excel spreadsheets and analysed using SPSS version 25. Chi square tests were used to compare factors between correct and incorrect knowledge and practice groups.ResultsFour hundred and eighty four participants agreed to participate in this study, of which the majority (71.1%) were females. Over 87% of the participants knew that improper disposal of medicines were harmful to the environment with only 28.3% knowing that there were laws governing the way medicines should be disposed. Majority of participants that had unused and expired ARVs at home disposed of these medicines. The most common route of medicine disposal for ARVs was by throwing these medicines into the bin (56.4%). Only 24.2% of participants were informed by healthcare professionals about the proper method of medicine disposal. Participants who had secondary and tertiary level of education (p = 0.043) and the ability to speak English (p = 0.001) had appropriate knowledge on medicine disposal.ConclusionThis study identified that poor medicine disposal practices and lack of adequate information about the proper methods of medicine disposal were evident among the participant population. There is a need for patient education and healthcare professional intervention to ensure patients are aware of standard proper medicine disposal practices.

Outdated and unused medicines disposal practice among the undergraduate paramedical students – a pharmacist's intervention

The majority of the patients remain unaware of the disposal of unused and outdated medicines. This study was conducted to assess the disposal practice of unused and outdated medicines among undergraduate paramedical students in Butwal (Nepal), and to assess the impact of pharmacist's intervention. A multi-stage random sampling technique was done and an interventional study was conducted in undergraduate paramedical students through a self-administered questionnaire regarding knowledge and drug disposal practice. The pre- and post-test analyses were done using the Statistical Package for Social Science (SPSS version 22), and the results were compared. A total of 150 valid and complete responses were received, in which 43.3% male and 56.7% female participated. Among the disposal practice of unused medicines, 33.3% gave to their friends or relatives, whereas about 28.0% percent of the respondents kept unused till expiry, and for the disposal practice of expired medicines 32.7% disposed of the expired medicines through flush whereas 32.0% threw away in household garbage. After the intervention, 46% returned unused medicine to medical stores, whereas about 20.0% of the respondents kept unused medicines at home until it is expired. In total, 44.0% returned unused medicine to medical stores. A total of 35.3% disposed of expired medicines through flush recklessly. Mc Nemar's test was implied for the comparison of pre- and post-intervention study, which showed a 31% improvement in proper disposal practice of unused and expired medicines after an intervention. Thus, the intervention resulted in positive change in the disposal practice of unused and expired medicine among the respondents. La majorité des patients ne sont pas informés des modalités d’élimination des médicaments inutilisés et/ou périmés. Cette étude a été menée pour évaluer la pratique d’élimination des médicaments non utilisés et périmés parmi les étudiants paramédicaux de premier cycle à Butwal (Népal), et pour évaluer l’impact de l’intervention éducative du pharmacien. Une technique d’échantillonnage aléatoire en plusieurs étapes a été réalisée et une étude interventionnelle a été menée auprès d’étudiants paramédicaux de premier cycle au moyen d’un questionnaire concernant les connaissances et les pratiques d’élimination des médicaments. Les analyses pré- et post-interventionnelles ont été effectuées à l’aide du progiciel statistique pour les sciences sociales (SPSS version 22) et les résultats ont été comparés. Au total, 150 réponses valides et complètes ont été reçues, auxquelles 43,3 % d’hommes et 56,7 % de femmes ont participé. Parmi les pratiques d’élimination des médicaments inutilisés, 33,3 % des répondeurs donnent des médicaments à leurs amis ou à leurs proches, tandis qu’environ 28,0 % pour cent des répondants les conservent jusqu’à leur expiration. Pour la pratique d’élimination des médicaments périmés, 32,7 % ont éliminé les médicaments périmés dans les toilettes alors que 32,0 % les ont jetés dans les ordures ménagères. Après l’intervention, 46 % ont rendu les médicaments inutilisés dans les pharmacies, tandis qu’environ 20,0 % des répondants ont conservé les médicaments inutilisés à la maison jusqu’à leur expiration. Au total, 44,0 % ont jeté les médicaments périmés dans une filière de recyclage, tandis que 35,3 % ont éliminé les médicaments périmés dans les toilettes. Le test de Mc Nemar était implicite pour la comparaison des études pré- et post-intervention qui ont montré une amélioration de 31 % des bonnes pratiques d’élimination des médicaments inutilisés et périmés après une intervention. Ainsi, l’intervention a entraîné un changement positif dans la pratique d’élimination des médicaments inutilisés et périmés parmi les répondants.

Practice of storage, reuse and disposal of unused medications among semi-urban households of Northern Tamil Nadu – A Community Based Cross-Sectional Study

Medicine is a science of uncertainty and an art of probability. Inappropriate disposal of medicines may be harmful to the environment as well as mankind, at the same time improper storage is detrimental. Hence assessment of the ways of Storage, reuse and disposal of unused medications plays a key role. The objective of the study is to investigate the storage and reuse practices of unused medications and to gain insight on knowledge and attitude of proper disposal practices of unused medicines among semi-urban households in urban field practice area of Tertiary medical college hospital of northern Tamil Nadu. This study is a community based cross sectional study. A total of 243 study participants were enrolled using multistage random sampling method. Pretested semi-structured questionnaire is used for conducting face to face interviews. Procurement of medicines is mainly through pharmacy without prescriptions (40.32%), most of the families (42.8%) stored used and unused medications together. On inspection of drugs, 29.6% of expired medicines and 22.23% of medicines without labels were found. The predominant way of disposing medicines is disposal through garbage (51.4%). Addiction level is not much noted and negligible amount of people are aware of drug take back program (0.82%). Awareness must be created about wrongful procurement of drugs, and improper storage of drugs. Drug take back program must be initiated to reduce the improper disposal of drugs.

Understanding the behavioural intention to dispose of unused medicines: an extension of the theory of planned behaviour.

This study examined behavioural intention to dispose of unused medicines using a comprehensive model integrating the theory of planned behaviour (TPB), with knowledge as a driver of personal norms; attitudes, personal norms, and perceived busyness as additional drivers of behavioural intention; and perceived convenience as a moderator. The model was tested with data collected from 204 respondents using the partial least squares technique. Knowledge about the proper disposal of unused medicines was recognized as a strong predictor of personal norms and attitudes towards proper disposal of waste medications. The results showed that attitudes, personal norms, perceived busyness, and perceived behavioural control have significant effects on intention to dispose of unused medicines. Furthermore, perceived convenience moderates the impacts of attitude, personal norms, and perceived behavioural control on intention to dispose of unused medicines. The extended TPB explained 55.7% of the variance of intention to dispose of unused medicines properly. Our results indicate the importance of integrating additional variables into the TPB to enhance its explanatory power in predicting behavioural intention. The results suggest to governments that in order to implement planned programs for proper collection and destruction of waste medication, a plan is needed to enhance public knowledge on the impacts of improper medication waste disposal on the environment, and also that collection points should become accessible for anyone.

Efeitos do descarte de medicamentos no meio ambiente

Medicamentos são produtos químicos manipulados a fim de trazer afeitos terapêuticos as pessoas. Todos os dias é possível observar sua importância na sociedade, seja auxiliando no tratamento de alguma patologia ou favorecendo uma melhor qualidade de vida. O presente estudo teve como objetivo avaliar os efeitos provocados pelo descarte de medicamentos no meio ambiente. Para realização do presente estudo foi realizado um levantamento bibliográfico nas bases de dados Medline, BVS e Pubmed, no período de 2014 a 2020, nos idiomas inglês e português que se adequassem aos critérios de inclusão e exclusão, foram selecionados 10 artigos. Em todos os estudos avaliados, os autores concluem de forma unânime, que a maioria da população desconhece os meios de descarte correto de medicamentos e os impactos maléficos que os mesmos causam no meio ambiente. Portanto, essa revisão demonstrou que apesar de se ter vários estudos sobre essa problemática ainda há muita falta de informação quanto à população.

Prevalence and Predictors of Storage of Unused Medicines among Households in Northwestern Ethiopia.

Background Unused medicines are those that are expired, discontinued, deteriorated, and/or not intended for any future use. The aim of this study was to assess the prevalence of unused medicines and predicting factors in households of Awi zone, Amhara regional state, Northwestern Ethiopia. Methods A community-based cross-sectional study was conducted. A survey of unused medicines was conducted through interviews with representatives of households. The collected data were entered with Epi Data version 3.1 and exported to SPSS version 21 for analysis. Predictors of storage of unused medicines were assessed through binary and multivariable logistic regression methods. A confidence interval of 95% and a P-value of <0.05 were considered to declare statistical significance. Results Of the total of 507 households surveyed, 70 (13.8%) were found to have unused medicines. These constituted twenty-eight types of unused medicines. Anti-infective medicines were the most commonly unused medicines, 58.9%. People who pay for medicines by themselves, those who lacked knowledge about medicines, and those who did not receive enough counseling about medicines they took were found to be 2.6, 4.8, and 3 times more likely to have unused medicines, respectively. Conclusion A significant amount of unused medicines was present in the community. Strategies aimed at educating the public regarding the safe disposal of unused medicines and an organized method of collection and disposal of unused medicines in the community need to be introduced.

A study on awareness and disposal practices of unused and expired medicines by consumers

Background: Hazards to the environment due to improper drug disposal practices is an issue of concern. The prescription drugs, disposed into trash /sewage, consequently enter into surface waters and contaminate even drinking water. In view of the potential hazards posed due to improper storage and disposal of medicines, evaluation of the awareness of the consumers and educating them about proper disposal methods is required. The aim of present study was to evaluate the awareness and practice of drug disposal among the population.Methods: A cross sectional, observational study was conducted at Rural Health Centre (RHTC) of Kamineni Academy of Medical Sciences and Research Centre with the patients visiting the RHTC as the study subjects. A predesigned questionnaire was used to evaluate the awareness and disposal practices of unused and expired medicines by the respondents.Results: On analysis it was observed that 80 (57%) of the respondents procure medicines from health care centre. A total of 97 (69%) respondents possess unused/leftover medicines at home, 54 (39%) of the respondents mentioned the reason to be due to self discontinuation. Among the class of drugs left unused antibiotics constituted 13%, antipyretics 6%, analgesics 6%. 49% of the respondents dispose unused medicines in domestic trash, 24% flush down toilet/sink. A majority of 121 (86%) opined that awareness must be made created.Conclusions: In present study it was observed that many of the respondents possessed leftover medicines and were unaware of the hazards of improper disposal of medicines. Thus, there is a need for proper educational and regulatory interventions.

Knowledge and Disposal Practice of Leftover and Expired Medicine: A Cross-Sectional Study from Nursing and Pharmacy Students' Perspectives.

The objective of the present study was to investigate the knowledge and practices concerning unused and expired medicine among pharmacy and nursing students at King Saud University, Riyadh, Saudi Arabia. A cross-sectional study design was used. The study used a validated paper-based, self-administered questionnaire. Statistical analyses were performed using SPSS, Version 24. The response rate was 70.4% (n = 352). The results indicated that 57.4% of pharmacy students and 53.4% of nursing students check the expiry date of medicine before procuring, and 37.6% of pharmacy students and 52.5% of nursing students keep unused medicine until it expires. With regard to disposal, 78.9% of pharmacy students and 80.5% of nursing students reported discarding expired medicine in household garbage or flushing it down a sink or toilet. Only a small percentage returns leftover medicine to a medical store. There was a statistically significant difference between pharmacy and nursing students in regard to checking the expiry date of medicine before procuring (p = 0.01), and keeping unused medicine until it expires (p = 0.03). The study concluded that the majority of respondents dispose of medicine unsafely. The findings suggest that creating awareness regarding proper medicine disposal procedures among university health care students in Saudi Arabia is needed.

Penyuluhan Penggunaan Obat Rasional (POR) dalam Swamedikasi Kepada Masyarakat RW 18 Desa Cijengkol Kecamatan Setu Kabupaten Bekasi

Self-medication is an attempt to self-medication by the community to overcome the symptoms of the disease, without the help of health workers. Irrational management can result in various disadvantages such as medication errors due to inaccurate self-diagnosis; drug use is not appropriate because of the acquisition of incorrect information from the media; waste of time and costs; can cause unwanted drug reactions such as sensitivity, allergies, side effects or resistance. This activity was carried out with the aim to increase the understanding and knowledge of the community in RW 18 Cijengkol Village, Bekasi Regency, especially mothers about rational medicine and the provision of Dagusibu information (Get Use to Save and Dispose of medicines) in the household environment. Counseling is given by the interactive talk method. The effectiveness of counseling was tested with quasi experimental designs pre and post design. Participants were given a pre-test questionnaire, then given counseling intervention and finally given a post-test questionnaire. The observations of the activities showed that the participants were very enthusiastic about participating in the activity and the results of the data analysis showed that there was an effect of counseling in increasing knowledge about the use of rational drugs (POR) in self-medication based on the results of the paired t-test and Wilcoxon test.

Storage and disposal of expired medicines in home pharmacies: emerging public health problems

ABSTRACTObjective To characterize storage and disposal practices associated with expired medicines in home pharmacies of Primary Care users.Methods Cross-sectional study based on data collected from 423 users of 15 Primary Care units located in a Brazilian city, between August 2014 and July 2016. Data were collected via face-to-face interviews. Categorical (demographic and socioeconomic characteristics) and continuous variables were expressed as proportions and means and standard deviations, respectively . Storage behaviors and disposal practices associated with unused and expired medicines were described as frequencies.Results Most (83%) interviewees were female and approximately 70% had completed high school. The kitchen was the most common medicine storage place (58.6%). Approximately 75% of participants reported inappropriate medicine disposal practices.Conclusion This study revealed high rates of inappropriate medicine disposal practices with direct impacts on pharmacological treatment and the environment. Continuing education of healthcare professionals and the general public is required to raise awareness about proper medicine use and disposal.

Current Disposal Practices of Unused and Expired Medicines Among General Public in Delhi and National Capital Region, India.

Stocking unused or expired medicines or donating these to others can lead to accidental or inappropriate ingestion, increasing the risk of adverse drug reaction(s) and even lead to antibiotic resistance. Further improper disposal of expired or unused medicines is associated with environmental pollution, health hazards and damage to ecosystem. Ecopharmacovigilance is an important area in this context. To explore the awareness and disposal practices of unused/expired in the general public. The current study is an observational, cross-sectional, questionnaire-based study conducted in 956 medicine consumers in New Delhi and National Capital Region, India. The knowledge, attitude, and practice of consumers regarding the disposal of unused medicines were evaluated. The majority (89.9%) of consumers opined that expiry of medicine(s) meant for completion of shelf life, production of toxic chemical and loss of or decreasing of beneficial effects of medicines. Majority (87%) of the consumers stored medicines at home. Almost all (92.6%) of the consumers threw away the expired medicines after storing for few days. Consumers discarded the expired medicines mainly in household trash (73%). The majority (93%) of consumers were in favour of a government program to collect unused or expired medicines from their home. The knowledge and practices of consumers towards disposal of unused and expired medicines needs to be improved. Health care professionals, government and policy makers should offer training to educate and guide the general public on safe and proper disposal practices of expired or unused medicines.

Storage and disposal of pharmaceuticals at home: a systematic review.

This study's objective was to analyze Brazilian and international scientific evidence on the reasons people store medication at home and the disposal methods used. This systematic literature review includes studies published from 2001 to 2016 and indexed in PubMed, Lilacs and Elsevier's Scopus Database, using the following key words: Disposal of medicines in household, Disposal of drugs expired, Residential expired drugs, Management of expired medications in household. Thirty-three studies were selected after applying inclusion and exclusion criteria. The studies reveal that the main reasons people keep a stock of medicines at home include the possibility of future use, leftovers from previous treatments, and self-medication. Inappropriate disposal methods prevail, such as throwing medicines in the household trash or flushing them into the sewer. Some countries have adopted programs to educate on proper storage and disposal of medicines, though only one study describes a national program guiding these practices that is free of charge. Evidence shows there is a need to implement public policies intended to provide guidance on the proper storage and disposal of medicines at home.

Consumer willingness to pay for a pharmaceutical disposal program in Serbia: A double hurdle modeling approach

Proper collection and disposal of pharmaceutical waste from households can reduce the negative influence of medicines on the environment. The aim of this paper is to examine the current methods of disposal of unused medicines from households, as well as the willingness of Serbian residents to participate and bear the costs of an organized collection program. Moreover, this research aims to define factors contributing to an individual's willingness to participate and pay for a medicine collection program. The survey included randomly selected patients older than 18 years visiting private pharmacies in the four largest Serbian cities. The questionnaire included information regarding the presence of unwanted medicines within the household, general medicine disposal practices, the likelihood to participate in a medicine take-back program, willingness to pay for a medicine disposal program (per prescription and per visit), importance to the environment, and demographic variables from participants. Approximately 80% of surveyed respondents are very or somewhat likely to participate, however less than half of the respondents are willing to pay for the collection of their unused medicines. The factors that influenced willingness to participate are environmental awareness and income, while the factors affecting willingness to pay, are previously received advice about proper disposal, education level, number of unwanted medicines in the household and gender. The majority of Serbian people dispose unused medicines improperly, mostly into household garbage. Well-organized and easily accessible collection programs are essential in order to enable the general public to return unused medicines for proper disposal.

O descarte de insumos farmacêuticos em estabelecimentos de saúde

The disposal of medicines by health establishments, such as pharmacies and drugstores, for the most part, is not based on a health service waste management plan. Thus, the incorrect disposal of waste from health services by these establishments becomes a feasible reality and increasingly common to observe. The present study was constructed through a literature review shows a theoretical, explanatory and exploratory character with a qualitative approach regarding the proposed theme, in addition to presenting solutions to the problems pointed out. The article addresses, as a central axis, the problem of incorrect waste disposal in health establishments, in addition, it explains the consequences that improper disposal of this waste can bring to human and environmental health, highlights the rational use of medicines and the importance of the clinical pharmacist in stimulating this conduct, describes innovative policies adopted in American and European countries, discusses from the classification of each health service waste how it should be properly disposed of, after its term of use, and mentions policies adopted by some Brazilian states that aim for sustainable development and mitigate the impacts that these residues can bring to human health and the environment. The incorrect disposal of waste from health establishments can cause digestive changes in human health, such as gastrointestinal disorders, liver and kidney failure, episodes that affect the central nervous system such as: agitation, anxiety, respiratory depression, coma. Many of these residues, when disposed of incorrectly, favor bacterial resistance, mutagenesis and carcinogenesis. Policies such as reverse logistics and campaigns for the proper disposal of drug residues are some actions that have been successful in the correct disposal of healthcare waste in Brazil. The clinical pharmacist for having a range of knowledge about medicines and adverse effects has become a professional increasingly required in health establishments not only to ensure adequate management of waste from health services, but also to encourage the rational use of medicines by the population.