Medical Disposal Research Articles

Suggested guidelines for emergency treatment of medical waste during COVID-19: Chinese experience.

During the period of COVID-19, the medical waste disposal capacity is seriously inadequate. The main technical process of the municipal solid waste incineration system is the same as that of the medical waste incineration system. Under the conditions of optimizing the technological process, improving the supporting facilities, and controlling the co-processing ratio, the municipal solid waste incinerator (grate furnace) co-processing medical waste is feasible. Some suggested guidelines for emergency treatment of medical waste from COVID-19 have been provided by China.

Effect of lock boxes and education on safe storage of medications

BackgroundSafe medication storage is a proven barrier to ingestions in the pediatric population, but caregivers are often unaware of the importance of safe storage practices or do not have a safe place to store medications. Caregivers may also not be fully aware that the patterns of opioid use and misuse have recently reached crisis levels. The objectives of this study were to define medication storage practices and knowledge of the opioid crisis of participants and to assess the effectiveness of an emergency department intervention on safe medication storage.MethodsThis was a prospective interventional study of caregivers in an urban pediatric emergency department (ED) on safe medication storage and the opioid crisis. Questions assessed the caregivers’ current perceptions and practices related to medication storage and disposal, and opioid crisis awareness. The intervention included verbal instruction about recommended safe storage methods and the opioid crisis, provision of a medication safety handout, and distribution of a medication lock box. A follow-up phone survey conducted 2 weeks later asked participants about use of and satisfaction with the lock box. Frequencies of safe storage behaviors were calculated, and the chi-square statistic was used to compare storage behavior after the intervention.ResultsFifty caregivers of 112 children were enrolled. Only 4% reported they currently stored medications in a locked or latched place. Thirty-eight percent reported their main barrier to storing medications safely was that they did not have a locked or latched storage location. Fifty percent were unaware of the opioid crisis. Ninety-two percent reported they would use a lock box if given one. Twenty-eight participants (56%) responded to the follow-up phone call survey 2 weeks later. At follow up 90% (25/28) reported they placed their medications within the provided lock box (p < 0.00001). Ninety-two percent reported being “very satisfied” with the lock box and how it works.ConclusionsDespite widespread reporting on this issue, many caregivers remain unaware of safe medication storage practices and the opioid crisis. Providing medication lock boxes removes a commonly reported barrier to safely storing medications and improved reported practices.

A Soft-Path Solution to Risk Reduction by Modeling Medical Waste Disposal Center Location-Allocation Optimization.

The risk of medical waste pollution and huge demand of daily medical waste disposal pose great difficulties to medical waste management. Establishing medical waste disposal centers (MWDCs) is considered one of the ways to reduce the environmental and public risk of medical waste pollution. However, how to serve the medical waste disposal demand in optimal MWDCs' locations is a key challenge due to the complexity of the whole system and relationships among stakeholders. This article develops a soft-path solution for reducing risks as well as mitigating the related costs by optimizing the MWDC location-allocation problem. A risk mitigation-oriented bilevel equilibrium optimization model is developed for modeling the Stackelberg game behavior between the local government and the medical institutions. The objectives of the local government are minimizing the total risk of loss, the subsidy costs, and the investment cost of building the MWDCs, while minimizing the disposal and transportation costs are the objectives at the medical institution level. Fuzzy random variables are introduced by combining insufficient historical data with expert knowledge via consulting surveys to describe the coexisting uncertainties in the data. To solve the model, a hybrid approach combined with the interactive fuzzy programming technique and an Entropy-Boltzmann selection-based genetic algorithm are designed and tested. The Chengdu Medical Waste Disposal Centers Planning Project is used as a practical application. The results show that it is possible to achieve a balanced market with higher economic efficiency and significantly reduced risk through an appropriate principle of interactive actions between the bilevel stakeholders.

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.

Proper Disposal of Prescription Opioids in Southwest Virginia: Assessment of Patient, Physician, and Medical Student Beliefs and Practices.

Southwestern Virginia demonstrates the highest regional mortality rate from prescription opioid overdoses. Nationally, 65% of patients misusing opioid medications received them from friends and family, underscoring the need for effective disposal of unused narcotics. (1) To understand patient, provider, and medical student beliefs and misconceptions regarding proper methods of opioid disposal; (2) to characterize discrepancies that exist between patient self-reported habits and medical student/provider perceptions of opioid usage, disposal, and diversion. Descriptive, cross-sectional, observational study. Large, nonprofit health care organization and allopathic medical school in Southwestern Virginia. All ambulatory patients 18 years or older presenting for elective consultation at health system orthopedics department; all institutionally employed physicians with active system e-mail addresses; and all current students at the associated medical school. Patients: The number who had received information regarding proper methods of opioid disposal, intended disposal method, methods of disposal considered appropriate, comfort level with opioid disposal, and demographic data. Physicians and Medical Students: The number who had received instruction regarding proper methods of opioid disposal, acceptable means of opioid disposal, most appropriate disposal method, disposal method most likely to be employed by patients, practice profile/prescribing data, and medical school year. In total, 64% of patients (n = 255/750) had never received instruction from a physician regarding opioid disposal; 56% of physicians (n = 212/732) and 78% (n = 80/171) of medical students indicated that they never received formal instruction regarding methods of disposal. The majority of physicians believed that their patients are most likely to use in-home methods of disposal or store prescription medications for future use; 61% of patients indicated a preference for accessible disposal facilities. The discrepancy between patient and physician responses highlights a lack of communication regarding disposal of unused opioid medications and is a target for future intervention.

Spinal surgery and related management on patients with COVID-19: experience of a regional medical centre in Wuhan.

During the pandemic of COVID-19, some patients with COVID-19 may need emergency surgeries. As spine surgeons, it is our responsibility to ensure appropriate treatment to the patients with COVID-19 and spinal diseases. A protocol for spinal surgery and related management on patients with COVID-19 has been reviewed. Patient preparation for emergency surgeries, indications, and contraindications of emergency surgeries, operating room preparation, infection control precautions and personal protective equipments (PPE), anesthesia management, intraoperative procedures, postoperative management, medical waste disposal, and surveillance of healthcare workers were reviewed. It should be safe for surgeons with PPE of protection level 2 to perform spinal surgeries on patients with COVID-19. Standardized and careful surgical procedures should be necessary to reduce the exposure to COVID-19.

Spinal surgery and related management on patients with COVID-19: experience of a regional medical centre in Wuhan

During the pandemic of COVID-19, some patients with COVID-19 may need emergency surgeries. As spine surgeons, it is our responsibility to ensure appropriate treatment to the patients with COVID-19 and spinal diseases. A protocol for spinal surgery and related management on patients with COVID-19 has been reviewed. Patient preparation for emergency surgeries, indications, and contraindications of emergency surgeries, operating room preparation, infection control precautions and personal protective equipments (PPE), anesthesia management, intraoperative procedures, postoperative management, medical waste disposal, and surveillance of healthcare workers were reviewed. It should be safe for surgeons with PPE of protection level 2 to perform spinal surgeries on patients with COVID-19. Standardized and careful surgical procedures should be necessary to reduce the exposure to COVID-19.

Characteristics of the antibiotic resistance genes in the soil of medical waste disposal sites

The inappropriate disposal of medical waste allows bacteria to acquire antibiotic resistance, which results in a threat to public health. Antibiotic resistance gene (ARG) profiles were determined for 45 different soil samples containing medical waste and 15 nearby soil samples as controls. Besides physical and chemical analyses (i.e., dry matter content, pH value, and metal content), the genomes of microorganisms from the soil samples were extracted for high-throughput sequencing. ARG abundances of these samples were obtained by searching the metagenomic sequences against the antibiotic resistance gene database and the copies of ARGs per copy of the 16S rRNA gene at different levels were assessed. The results showed medical waste accumulation significantly enriched the contents of Cu, Cr, Pb, and As in the tested soil samples. Compared to the controls, the samples collected from areas containing medical waste were significantly enriched (p < 0.05, t-test) with ARGs annotated as sulfonamide and multidrug resistance genes, and in particular, the subtypes sul1 and sul2 (sulfonamide resistance genes), and multidrug_transporter (multidrug resistance gene). Moreover, the ARGs of the samples from the polluted areas were more diverse than those of the control samples (p < 0.05, t-test). The comparatively higher abundance and diversity of ARGs in contaminated soil pose a potential risk to human health.

Cleaning up China’s Medical Cabinet—An Antibiotic Take-Back Programme to Reduce Household Antibiotic Storage for Unsupervised Use in Rural China: A Mixed-Methods Feasibility Study

Background: Antibiotic misuse and unsafe disposal harm the environment and human health and contribute to the global threat of antimicrobial resistance. Household storage of antibiotics for unsupervised use and careless disposal of medications is a common practice in China and most low- and middle-income countries. Currently, few interventions are available to address this challenge. Objective: This study assesses the feasibility and acceptability of an evidence-based, theory-informed, community-based take-back programme for disposing household’s expired, unwanted, or unused antibiotics in rural China. Methods: We adopted the RE-AIM framework and the community-based participatory research principles in the development, implementation, and evaluation of the intervention. The RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) and Medical Research Council’s frameworks were employed in analysing and reporting evaluation results. A mixed-methods, controlled pre-and post-test design was used for (1) quantitative surveying of a representative community panel of 50 households, and (2) qualitative semi-structured stakeholders’ interviews to explore intervention and study design feasibility and acceptability at three phases: pre-intervention, intervention, and post-intervention. Quantitative and qualitative data from a similar village—serving as a control—were also collected. Results: All a priori feasibility objectives were met: Conversion to consent was 100.0% (100 screened, approached, recruited, and consented). All participants completed the pre-intervention assessment, and 44/50 households in the intervention village completed the post-intervention assessment. The programme, embedded in existing social and physical infrastructure for dissemination, directly reached over 68.2% (30/44) of its target audience. Stakeholders reported the intervention and study design as feasible and acceptable. Conclusions: This study illustrates the feasibility, acceptability, and potential efficacy of community-based antibiotic take-back programmes in China to encourage safe disposal and decrease the availability of expired, unwanted, or unused antibiotics in the household for unsupervised use.

Proportion of Ophthalmic Self-Medication and Associated Factors among Adult Ophthalmic Patients Attending Borumeda Hospital, Dessie, Northeast Ethiopia

Purpose The aim of this study was to determine the proportion of ophthalmic self-medication and associated factors among adult ophthalmic patients attending Borumeda Hospital, Northeast Ethiopia, 2019. Methods An institution-based cross-sectional study design was conducted on 402 participants at Borumeda Hospital from April 29 to May 24, 2019. Systematic random sampling technique was used to get study participants. Data were collected with a face-to-face interview by using a semistructured questionnaire. Data were entered into Epi Info 7 and analyzed by SPSS 20. Descriptive statistics and binary logistic regression analysis were employed. P values of less than 0.05 were considered statistically significant. Results The proportion of ophthalmic self-medication was 28.6% (95% CI; 24.6–33.3). Age-group 29–42 years (AOR: 2.19, 95% CI: 1.06–4.52), absence of health insurance (AOR: 4.29; 2.35–7.84), more than 10 kilometer traveling distance to get eye services (AOR: 3.11; 1.58–6.12), previous experience of ocular illness (AOR: 2.62, 95% CI: 1.53–4.48), family or friend experience of ocular illness (AOR: 2.65, 95%CI: 1.43–4.92), availability of ophthalmic medicine bottle/tube at home (AOR: 4.59, 95% CI: 2.36–8.92), and poor knowledge about hazards of self-medication (AOR: 6.22; 3.26–11.85) were significantly associated with ophthalmic self-medication. Conclusion and Recommendations. The proportion of ophthalmic self-medication was high, which needs stakeholders' attention. The policymakers and regulatory body better to scale-up health insurance coverage, nearby accessible eye care services, improve knowledge of patients regarding the effect of ophthalmic self-medication, and proper disposal of leftover eye medication from the house. It is better to take regulatory actions on those who dispense ophthalmic medications without prescription.

Pain Management for Pediatric Burns in the Outpatient Setting: A Changing Paradigm?

Childhood burns are common and distressing for children and their parents. Pain is the most common complaint and often thought to be undertreated, which can negatively influence the child's care and increase the risk of posttraumatic stress disorder. There is limited literature on the role of opioids and multimodal therapy in the treatment of pediatric outpatient burns. We sought to evaluate the current use of opioids (including the use of multimodal therapies), storage, and disposal of opioids in this patient population. Parents of burn-injured children 8 months to 18 years old, who were seen in an outpatient setting within 2 weeks of their burn injury, were queried from April to December 2019 regarding their child's pain control, opioid medication use, over-the-counter pain medication use, opioid storage, and disposal. A total of 142 parents of burn-injured children and their parents were surveyed. The median age of the burn-injured children was 2.7 years old and the majority (54.2%; 77/142) were male. The mean total body surface area (TBSA) was 1.8% and half sustained burn injuries to one or both hands. The most frequently used regimens for constant and/or breakthrough pain control were acetaminophen (62.7%) and nonsteroidal anti-inflammatory drugs (NSAIDs; 68.3%). Less than one fifth (26/142;18%) of patients were prescribed opioids and 88% filled their prescription. The median number of doses of opioids prescribed was eight doses, with a median of four doses of opioids unused. Only three patients used all of their prescribed opioids and no patient ≥12 years old used their entire prescription. Burns greater than 3% TBSA, irrespective of burn injury location, were associated with opioid prescription (P = .003). Approximately 40% (10/26) of parents who filled their child's opioid prescription stored the opioid in a locked area. Fewer than one third (7/26) of patients were educated on how to dispose of excess opioid pain medication. Overall, most pediatric outpatient burn injuries can be successfully managed with over-the-counter medications. Providers, who care for burn-injured children ≤ 12 years old with burns that cover ≥3% TBSA in the outpatient setting, should consider no more than four opioid doses for initial pain control. This guideline, coupled with family and provider-centered education on multimodal therapy at the time of initial presentation and safe use of opioids, are important first steps to minimizing the use of opioids in the management of small area burns in children.

The Standardization of Outpatient Procedure (STOP) Narcotics after anorectal surgery: a prospective non-inferiority study to reduce opioid use.

Prescription of opioid medication after ambulatory anorectal surgery may be excessive and lead to opioid misuse. The purpose of this study was to evaluate the efficacy of a multi-modality opioid-sparing approach to control postoperative pain and reduce opioid prescriptions after outpatient anorectal surgery. A prospective non-inferiority pre- and post-intervention study was completed at three academic hospitals. Patients included were 18-75years of age who had outpatient anorectal surgeries. The Standardization of Outpatient Procedure (STOP) Narcotics intervention was implemented, which is a multi-pronged analgesia bundle integrating patient education, health care provider education, and intra-/postoperative analgesia focused on multi-modal pain control strategies and opioid-reduced prescriptions. The primary outcome was patient-reported average pain in the first 7 postoperative days. Secondary outcomes included patient-reported quality of pain management, medication utilization, prescription refills and medication disposal. Ninety-three patients had outpatient anorectal surgery (42 pre-intervention and 51 post-intervention). No difference was seen in average postoperative pain in the pre- vs. post-intervention groups (2.8 vs. 2.6 on an 11-point scale, p = 0.33) or patient-reported quality of pain control (good/very good in 57% vs. 63%, p = 0.58). The median oral morphine equivalents (OME) prescribed was significantly less [112.5 (IQR 50-150) pre-intervention vs. 50 (IQR 50-50) post-intervention, p < 0.001]. In the post-intervention group, only 45% of patients filled their opioid prescription and median opioid use was 12.5 OME (2.5 pills). While pain control after anorectal surgery must consider the individual patient's needs, a standardized pain care bundle significantly decreased opioid prescribing without an increase in patient-reported postoperative pain.

How to Properly Dispose of Unwanted Medications

Properly disposing of expired or unused medications can help reduce the prevalence of prescription drug abuse in Florida. It also helps prevent accidental ingestion by children or pets, helps prevent accidentally taking the wrong medication, and prevents medications from entering water sources. This new 3-page publication of the UF/IFAS Department of Soil and Water Sciences provides some dos and don’ts for disposing of your medications. Written by Alexander J. Reisinger.https://edis.ifas.ufl.edu/ss680

HUBUNGAN MOTIVASI PERAWAT DAN GAYA KEPEMIMPINAN DENGAN PERILAKU PERAWAT DALAM PEMBUANGAN SAMPAH MEDIS BENDA TAJAM DI RSUD DR.A.DADI TJOKRODIPO KOTA BANDAR LAMPUNG

Introduction: sharp medical waste is not only able to cause scratch and stab wounds but also to infect wounds when they are contaminated by pathogen. A pre-survey result done by the researcher in wards of dr. A. Dadi Tjokrodipo at 20 January 2019 to 10 nurses concerning activities of nursing care and medicla waste management including needle, syringe, and bandage that were disposed without sorting.Objective: the objective of this research was to find out the correlations of nurse’s motivation and leadership style to nurse’s behavior in sharp medical waste disposal in dr. A. Dadi Tjokrodipo public hospital in Bandar Lampung. Method: this was a quantitative analytic survey research by using cross sectional approach and it was conducted in dr. A. Dadi Tjokrodipo public hospital from March to April 2019. Population was all nurses and samples were of total sampling. Data were collected by using questionnaires and analyzed by using univariate (frequency distribution) and bivariate (chi square test) analyses.Result: there were 31 respondents (54.4%) with poor medical waste littering behavior, 34 respondents (59.6%) with low motivation, and 29 respondents (50.9%) with bad leadership style. There were correlations of nurse’s behavior (p-value 0.000; OR 11.70) and leadership style (p-value 0.012: OR 4.725) to sharp medical waste disposal in dr. A. Dadi Tjokrodipo public hospital in Bandar Lampung in 2019. Conclusion: there were correlations of nurse’s motivation and leadership style to nurse’s behavior in littering sharp medical waste in dr. A. Dadi Tjokrodipo public hospital in Bandar Lampung in 2019. The researcher expects nurse’s motivation improvement concerning medical waste disposal by joining training about effects of improper sharp medical waste disposal.Introduction: sharp medical waste is not only able to cause scratch and stab wounds but also to infect wounds when they are contaminated by pathogen. A pre-survey result done by the researcher in wards of dr. A. Dadi Tjokrodipo at 20 January 2019 to 10 nurses concerning activities of nursing care and medicla waste management including needle, syringe, and bandage that were disposed without sorting.Objective: the objective of this research was to find out the correlations of nurse’s motivation and leadership style to nurse’s behavior in sharp medical waste disposal in dr. A. Dadi Tjokrodipo public hospital in Bandar Lampung. Method: this was a quantitative analytic survey research by using cross sectional approach and it was conducted in dr. A. Dadi Tjokrodipo public hospital from March to April 2019. Population was all nurses and samples were of total sampling. Data were collected by using questionnaires and analyzed by using univariate (frequency distribution) and bivariate (chi square test) analyses.Result: there were 31 respondents (54.4%) with poor medical waste littering behavior, 34 respondents (59.6%) with low motivation, and 29 respondents (50.9%) with bad leadership style. There were correlations of nurse’s behavior (p-value 0.000; OR 11.70) and leadership style (p-value 0.012: OR 4.725) to sharp medical waste disposal in dr. A. Dadi Tjokrodipo public hospital in Bandar Lampung in 2019. Conclusion: there were correlations of nurse’s motivation and leadership style to nurse’s behavior in littering sharp medical waste in dr. A. Dadi Tjokrodipo public hospital in Bandar Lampung in 2019. The researcher expects nurse’s motivation improvement concerning medical waste disposal by joining training about effects of improper sharp medical waste disposal.

869 Opioid Utilization in Pediatric Burn Patients

Abstract Introduction Childhood burns are extremely common and distressing for children and their parents. Pain is the most common complaint and often thought to be undertreated, disrupting care and increasing the risk of post-traumatic stress disorder. There is limited literature on the role of opioids and multimodal therapy in the treatment of burns in pediatric patients. We sought to evaluate the current use of multimodal therapy as well as the use, storage, and disposal of opioids in this patient population. Methods We prospectively surveyed parents of pediatric burn patients (0–18 years old) who presented to the burn clinic within two weeks of burn injury. Parents were surveyed regarding over-the-counter pain medication use and opioid medication use, storage, and disposal in the treatment of their child. Medians and interquartile ranges were used to describe continuous variables and frequencies and percentages were used for categorical variables. Results A total of 92 parents of burn-injured children were surveyed at a single institution in the outpatient burn clinic. The median age of burn-injured children was 3.1 years old, and 50% of patients were male. The majority had a TBSA of 1%. The hand was the most frequently burned location (45.7%). Acetaminophen (58.7%) and ibuprofen (69.6%) were the most common treatments for both constant and breakthrough pain. Approximately 28% (26/92) of patients were prescribed opioids, of which 18.5% (17/92) filled their prescription. Only 29% of patients (5/17) consumed their entire prescription, and a median of 3 doses of opioids remained for those who did not finish the entire prescription. Parents most commonly decided to give their children opioid pain medications because “my child is in severe pain” or “I give my child pain medications as scheduled (written on prescription).” Approximately 40% (7/17) of patients who filled opioid prescriptions stored them in a locked area, and only 35.3% (6/17) were educated on how to dispose of excess opioid pain medication. Conclusions Presently, multimodal therapy with over-the-counter pain medications is used to treat the majority of pediatric burns. This study demonstrates an increased need for education on opioid administration, storage, and disposal for parents of burn-injured children. Applicability of Research to Practice We aimed to evaluate what current trends in opioid use are in pediatric burn patients and areas for improvement in parent education for over-the-counter pain medication use, opioid use, opioid storage, and disposal. From the study, we were able to glean that the majority of patients are successfully managed with over-the-counter pain medications. However, parents and patients managed with opioids need additional education on appropriate administration of opioid pain medications, safe locked storage of opioids, and opioid disposal. This demonstrates an area for quality improvement inpatient and outpatient.

Educating Patients Regarding Pain Management and Safe Opioid Use After Surgery: A Narrative Review.

In recent years, there have been escalating concerns related to the opioid epidemic. With a steadily increasing opioid supply, it is critical to provide proper education to patients who are prescribed these medications. Education should be emphasized as a means of ensuring safe use and potentially as a strategy for curbing the opioid supply. Patients who undergo surgery are frequently prescribed opioids for postoperative pain; however, the content and delivery of information related to usage is inconsistent and often inadequate. Lack of education on postoperative pain management and opioid use places patients at risk for poor compliance and worse pain control. Furthermore, patients are often not properly educated on opioid-related side effects and risks or about safe behaviors when taking medications. The majority of patients are also not informed about how to store and dispose of leftover medications. Patients who are prescribed opioids require education preoperatively to cover the topics of pain management, opioid-related side effects, and risks, storage, and disposal. Evidence from various studies demonstrates that educational interventions improve knowledge and potentially lead to safer behaviors and reduced opioid use. Education can be provided in various formats with each having unique advantages and limitations.

Medication Use in Schools.

This article serves as a Position Statement of the Pediatric Pharmacy Association (PPA), which supports safe and effective medication use in schools. PPA recommends that schools develop comprehensive medication use policies to support safe and appropriate administration of both chronic and emergency medication in schools. These policies must address issues specific to pediatric patients, including off-label and over-the-counter medication use, various pediatric dosage forms, as well as appropriate medication storage, administration, and disposal practices. PPA also advocates for continued staff development and education regarding laws, regulations, and policies surrounding medication use in school to ensure safe and effective care of children and adolescents in the school setting.

Disposal Practices of Unused Medications Among Patients in Public Health Centers of Dessie Town, Northeast Ethiopia: A Cross Sectional Survey.

BackgroundDisposal 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.MethodsA 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.ResultsThe 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.ConclusionIn 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.

Evaluation of an activated carbon disposal system for safe disposal of model prescription sedative medications

Lack of a safe and convenient disposal method for expired and unused medications may lead to many problems such as accidental exposure, intentional misuse, and food and water contamination. Activated carbon can offer safe disposal of medications due to its highly porous structure, which exerts strong physical adsorption forces with chemicals. This study aimed to evaluate the efficiency of an activated carbon-based drug disposal system for deactivating three model sedative prescription medications. Deactivation was performed by mixing the medication, activated carbon, and tap water. Desorption was evaluated by exposing the deactivation system to wash-out solutions. Rapid, precise, accurate, and sensitive HPLC-UV method for each drug was successfully developed, validated and employed. Results of the 28-day deactivation study showed that on average, more than 94.00% of drugs were rapidly deactivated within 8 hours. All drugs reached more than 99.00% deactivation by the end of 28-day period. Desorption study demonstrated that all medications were retained by the system, with insignificant amount of drug (0.25%) leached into the washout solutions within 24 hours. In conclusion, activated carbon rapidly and successfully deactivated the medications tested, suggesting activated carbon-based drug disposal system provides a convenient, secure, and effective method for unused medication.