Safe Medication Disposal Research Articles

Practice Towards Storage of Unused and Disposal of Expired Medicines among Households in Dharan, Nepal

Introduction: Improper disposal of unused medications has been a public health problem, as unused drug adversely effects on health and environment. Objective: The main objective of this study was to assess the extent of unused medications disposal knowledge, attitude, and practice of among household in Dharan, Province 1, Nepal. Methods: A survey based descriptive study was used. Households were conveniently selected and interviewed using structured questionnaires. Attitudes and practices regarding medicine disposal and storage were asked. The data were analyzed by SPSS version 20.0 software and presented descriptively. Results: Among 380 household surveyed, majority of respondents (82%) reported storing unused medications in their home and only 5% reported returning medication to a pharmacy. Predominant reason for medication non-used was disease or symptoms felt improved (80 %). Less than half of respondents (45%) had check the expiry date of their medicine before purchasing. Most respondents (88%) thought that improper disposal of medicine may cause harmful effects to health and environment. Conclusion: Incorrect practices were found in Dharan families with regard to the storage and disposal of unused medications. Along with a comprehensive media campaign to inform consumers about safe medication disposal techniques, an efficient method for disposing of leftover medications should be offered. This system should be supported by local pharmacist.

Promoting long-lasting changes in student well-being through a pharmacy general education course: A pilot study

Objective Colleges and universities need effective strategies to help students develop medication-use behaviors that positively support their well-being. This pilot study evaluated the utility of Fink’s Taxonomy of Significant Learning (FTSL), an evidence-based instructional strategy, to create long-lasting changes in students’ well-being during a pharmacy general education course. Participants and methods Using a mixed methods survey design, we assessed 84 undergraduate students’ changes in self-reported well-being at three different time points (pre-intervention, post-intervention, and 6-month follow-up) through five variables (safe medication practices, general healthcare behaviors, healthcare self-efficacy, safe medication storage, and safe medication disposal). Results The results of multiple repeated-measures ANCOVAs, four McNemar chi-square tests, and qualitative thematic analysis showed significant positive changes in several variables over time. Conclusions This pilot study demonstrated that intentional integration of FTSL during the course design process helped students develop long-lasting general healthcare and safe medication-use behavior intentions. We discuss holistic approaches for promoting student well-being.

A multisectoral approach to medication safety in Kuwait using the take-back campaign.

The take-back campaign, which focuses on enhancing public awareness, safe medication disposal practices, stakeholder engagement and patient participation was used to promote medication safety in Kuwait. To evaluate the effectiveness of the take-back campaign in promoting medication safety in Kuwait. The campaign was implemented systematically through several stages of planning, communication and coordination among several stakeholders. This social media campaign encouraged individuals from the participating healthy cities to bring unwanted medications to designated collection centres. Returned medications were categorized based on the British National Formulary and data analysis was conducted using Excel. Consultations were held at the collection sites to increase patient confidence in medication compliance and safety. The medications were sorted and disposed safely. The take-back campaign lasted 56 hours over a period of one month. It successfully engaged 405 households and collected 1005 kg of medication, comprising 7648 items, over a period 6 working days. Fifty-seven percent of the medications collected through the campaign originated from the Ministry of Health and 43% from the private sector. Fifty-two percent had expired and 59% were in solid dosage form. Painkillers comprised the largest group (18%) among the returned medications. The take-back campaign effectively raised awareness about medication safety and provided a safe disposal mechanism for unused and expired medications. This campaign has provided a foundation for future initiatives and contributed significantly to improving medication safety and public health outcomes in Kuwait.

Medication Safety Counseling Practices of Pediatric Primary Care Clinicians.

Medication exposures and poisonings are a major cause of pediatric morbidity and mortality. Unsafe patient practices are well documented despite the American Academy of Pediatrics recommending that pediatric primary care clinicians discuss medication safety with patients. Current clinician counseling practices for pediatric patients are unknown. Studies of adult patients suggest that physician counseling practices often focus on administration but not storage or disposal. To address this gap, we administered a web-based survey to clinically active pediatric primary care clinicians in two mid-Atlantic health care systems. Survey content focused on characteristics of medication safety counseling practices by age group, including safe medication storage, administration, and disposal. Of 151 clinicians emailed, 40 (26.5%) responded. The majority were physicians (93.5%), female (87.1%), and completed residency/clinical training in pediatrics >15 years ago (58.1%). Most (82.5%) reported having >1 pediatric patient (aged < 19 years) in their practice who experienced an unintentional or intentional medication exposure or poisoning event. Reported practices for medication safety counseling often varied by patient age but safe disposal was rarely addressed for any age group. Respondents generally felt less knowledgeable and less comfortable with providing counseling on safe disposal in comparison to safe storage and safe administration. Nearly all respondents (97%) would like to provide more counseling about medication safety, and the majority (81.3%) wanted additional educational resources. In this survey, we identified several modifiable deficits in pediatric medical counseling practices and a need for additional clinician training and resources, most notably in the content area of safe disposal.

Pathways to opioid use and implications for prevention: voices of young adults in recovery

BackgroundOpioid use remains a major public health issue, especially among young adults. Despite investment in harm reduction and supply-side strategies such as reducing overprescribing and safe medication disposal, little is known about demand-side issues, such as reasons for use and pathways to opioid use. Adolescents and young adults who struggle with opioid use disorder (OUD) are multifaceted individuals with varied individual histories, experiences, challenges, skills, relationships, and lives.MethodsTo inform the development of prevention strategies that hold promise for addressing opioid use, this study employs brief structured surveys and semi-structured in-depth interviews with 30 young adults (ages 18–29; 19 female, 23 White, 16 from Suburban areas) in recovery from OUD. For survey data, we used descriptive statistics to summarize the means and variance of retrospectively reported risk and protective factors associated with opioid use. For in-depth interview data, we used a combination of thematic analysis and codebook approaches to generate common themes and experiences shared by participants.ResultsSurveys revealed that the most endorsed risk factors pertained to emotions (emotional neglect and emotional abuse) followed by sexual abuse, physical abuse, and physical neglect. Themes generated from qualitative analyses reveal challenging experiences during adolescence, such as unaddressed mental health, social, and emotional needs, which were often reported as reasons for opioid initiation and use. Through surveys and interviews, we also identified positive assets, such as skills and social relationships that were present for many participants during adolescence.ConclusionImplications include the need for universal prevention strategies that include emotion-focused interventions and supports alongside current harm reduction and environmental strategies to regulate prescriptions; the potential utility of more emotion-focused items being included on screening tools; and more voices of young people in recovery.

Drug take-back program: assessment of knowledge, practices, and barriers to safe disposal of unused medication among healthcare students in a Nigerian university

BackgroundThe 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.MethodsA 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.ResultsA 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).ConclusionA 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.

Assessment of practices and awareness regarding the disposal of unwanted pharmaceutical products among community pharmacies: a cross-sectional study in Palestine

BackgroundThe 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.MethodsA 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.ResultsOf 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.ConclusionsMost 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.

Assessing a Medication Safety and Disposal Educational Program using the Health Belief Model.

Background: Self-medication practices continue to grow due to reclassification of prescription to OTC status and self-care information on the internet, however unintended injuries and inappropriate use of medications continue to challenge healthcare providers during the provision of patient care. Pharmacists have an integral role in pharmacovigilance and patient education activities to ensure safe medication use, storage, and disposal practices. Objectives: The objective of this medication safety and disposal educational program was to provide comprehensive informational support to the community coupled with an assessment using the Health Belief Model (HBM) to gauge participants' perceived behavior change. Methods: The HBM was selected to assess the understanding of the community members' benefits and barriers to safe medication practices. The HBM posits that health behaviors are influenced by perceptions of a diseases' severity, perceived susceptibility, perceived barriers to health practices, perceived benefits of health practices, self-efficacy, and cues to action. An 8 item pre/post survey following the HBM constructs was developed which used a 5 point Likert scale. Results: A total of 25 senior participants attended the educational program. Twenty-three pre/post surveys were completed (RR=92%). Five items revealed a statistically significant change from pre to post-educational content including understanding risk of herbal/OTC products (p=0.021), improved awareness of medication disposal methods (p=0.044), comprehension of OTC 'Drug Facts' information (p=0.004), understanding OTC label information to prevent medication interactions and side effects (p=0.008), and routinely reviewing expiration dates on medications and disposing of these properly (p=0.019). Conclusion: This study suggests a comprehensive approach which covers a wide range of medication safety topics and disposal practices can successfully improve the knowledge and skill of community participants and potentially improve medication harm reduction practices.

Evaluating the feasibility of implementing a prescription drug misuse prevention intervention in the community: a mixed methods study

BackgroundThis study is part of a state-wide effort to promote the safe disposal of prescription medications and mitigate prescription drug misuse. The objective of this study was to evaluate the implementation of a two-component prevention intervention through Community Prevention Organizations (CPOs) in Texas. The first component involved the distribution of in-home disposal products (IHDP) and the second focused on providing education of the risks of prescription drug misuse.MethodsThis study followed a mixed methods sequential explanatory study design. In the quantitative phase, the extent to which CPOs carried out the intervention was determined by the distribution rate – a proportion representing the number of IHDP distributed to end users from the amount of IHDP the CPO was shipped. This measure was used to organize the CPOs in to one of three performance categories. In the qualitative arm of the study, stratified random sampling was used to select five CPOs from each performance strata to participate in an in-depth, semi-structured interview about their distribution activity. The interview guide and the data analysis were guided by Bowen’s Feasibility Framework. The interviews were transcribed and analyzed using a content analysis approach by two research team members. All qualitative analyses were conducted in ATLAS.ti© V7.ResultsThere was a total of 47 CPOs contacted and asked to be part of this study. Of them, 44 CPOs participated in the quantitative phase of the study. This phase revealed that all CPOs had existing relationships with organizations throughout the community such as pharmacies and schools that could act as points of distribution. Following the quantitative phase, 15 CPOs were selected for more in-depth interviews about their distribution practices. In the qualitative phase, this finding was reinforced through the theme “partnerships with local institutions and ability to implement the intervention at community events”. Similarly, education promotion efforts were unanimously emphasized as a strategy to increase utilization of IHDP among end users. All CPOs indicated that the intervention was supplemental to their overall goals.ConclusionCPOs have unparalleled access to community events, local institutions, and the general population they serve, thus, they have the potential to be active facilitators in implementing prevention interventions.

Evaluation of medication disposal behaviors after counseling by a community pharmacist and provision of a home medication disposal kit

ObjectivesTo evaluate providing an at-home medication disposal kit on opioid disposal behaviors. Self-report of prior disposal behaviors also was assessed to describe the sample. DesignPilot study with randomization. Surgery outpatients were counseled on medication disposal by a pharmacist from the outpatient community pharmacy at the bedside and given an informational pamphlet detailing recommended disposal methods. Patients on even-numbered dates also received an at-home medication disposal system, creating a quasi-randomized assignment. SettingHospital outpatient surgery center. ParticipantsAmbulatory surgery outpatients filling an opioid prescription. Outcome measuresPatients were called one month after discharge to answer a structured interview about their disposal behaviors. Responses were recorded. Descriptive statistics were calculated to describe disposal behaviors, and chi-squared and t-tests were used to assess group differences. ResultsA total of 45 patients participated, with 24 receiving a disposal packet. Of the 23 patients that had left-over tablets, 8 patients disposed of them. Seven (30.4%) of patients with leftovers disposed of their medication safely as recommended by the pharmacist during counseling. Rates of appropriate disposal were statistically similar. Of the 14 patients who had left-over opioids and received a disposal packet, 5 (35.7%) patients used the provided packet. Of the 9 patients with left-over opioids who did not receive the disposal packet, 2 (22.2%) patients disposed of their left-over opioids appropriately. ConclusionThis pilot provides insight into the implementation of medication disposal services in the ambulatory surgery setting and the potential impact that a community pharmacist can have in promoting safe medication disposal. While the study demonstrated similar rates of disposal, those with the disposal packet exclusively reported using the packet as their method of disposal, suggesting having the packet on-hand simplified decision-making.

Knowledge, attitude and practice of community pharmacists towards household pharmaceutical waste disposal.

To assess the knowledge, attitude and practice of community pharmacists (CP) towards household pharmaceutical waste disposal. All pharmacists attending the Malaysian Community Pharmacy Guild event held in-person were invited to self-administer a web-based survey. The response rate was 61% (168/276). Overall, community pharmacists have mixed knowledge (mean ± SD: 5.89 ± 1.38) and positive attitude (mean ± SD: 9.58 ± 0.81) towards household pharmaceutical waste disposal. However, few community pharmacists (18/168, 10.7%) have promotional materials encouraging safe medication disposal in their pharmacies. Community pharmacists do not proactively promote safe household pharmaceutical waste disposal to mitigate pharmaceutical pollutants entering the environment although they have satisfactory knowledge and attitude.

Assessment of knowledge and awareness of safe disposal of unused or expired medication in Saudi Arabia: A cross-sectional study

BackgroundPoor waste management of unused or expired medications jeopardizes healthcare staff, employees who oversee medical waste, patients and their families, the neighboring population, and environmental contamination. In addition, the inappropriate treatment or disposal of that waste leads to. In addition, medical waste disposal exerts an intolerable burden on the economy of health care facilities. Currently, there is a lack of data in community settings regarding adequate methods of medication disposal in Saudi Arabia. Aim of the StudyThe current study aimed to evaluate current knowledge and awareness of the safe disposal of unused or expired medicines in the Saudi Arabia. MethodA survey study was conducted in Saudi Arabia within 5 months from October 2021–February 2022. The survey was distributed to participants via social media channels. The questionnaire was constituted of 16 items divided into three sections: demographic information, quantification, and characterization of unused and expired medication at home, and practice and attitude regarding the disposal of unused or expired medication. ResultsThe survey was taken by 1105 participants and 1100 (99.54%) participants completed the survey. The study found that (49.1%) of participants stored medicines at home and these medicines were mainly stored in the refrigerator (64.4%). Household trash was the most frequent method of disposal (79.5%). Non-prescribed medicines (67%) were mainly stored as unused or expiry medicines at home followed by prescribed medicines (51.9%). The main reason for the storage of unused/expired medicines at home was stopped medication after recovery (68.5%). Only 8.4% of participants had received appropriate education or training related to the correct disposal of medication. The best-practiced method to increase community awareness regarding the disposal of unused or expiry medicine was awareness through social networking (70.3%). In conclusion, patients’ education regarding safe medication disposal and availability of medication disposal program is necessary to improve appropriate medication waste methods and decrease possible environmental harm.

Examining adolescents' opioid knowledge and likelihood to utilize an educational game to promote medication safety.

Adolescents' knowledge on opioids is seldom studied, despite the fact young people are one of the groups most affected by the opioid crisis within the United States. There is a need to understand adolescents' perceptions about opioid misuse and safety to create the necessary tools to educate adolescents on safe opioid use. This study sought to understand adolescents' knowledge and perceptions of opioid use and safety as well as their receptiveness to using an educational game for improving medication safety knowledge. A 67-item survey was developed to assess adolescents' opioid perceptions, knowledge, and the likelihood of an educational game to enhance their opioid medication safety. A nationally representative sample of US adolescents aged 12 to 18 were recruited via a Qualtrics participant panel to complete the online survey from October through November 2020. Survey questions were grouped into 10 categories to represent key concepts and summarized into concept scores. Concepts were described through means, median, and range as well as percent correct for individual questions. Differences between groups were assessed using Kruskal-Wallis tests. Concept scores and their relation to the participant's age were described by the Pearson's correlation coefficient and the linear model coefficient. A total of 592 responses were analyzed. Male and older participants reported greater perceived opioid knowledge than females. White participants reported higher rates of perceived opioid knowledge, behavioral intent, and knowledge of safe medication disposal than any other racial group. About 80% of participants were receptive to the use of an educational game to increase their opioid safety knowledge. There are discrepancies in adolescents' knowledge on opioid safety and harm amongst genders, race, and age. Study findings support the use of an educational game to increase adolescents' opioid knowledge. Future studies should design an educational game intended for a diverse audience.

Prescription for Success

Introduction It was noted that caregivers of pediatric surgical patients are often not able to speak to the correct disposal of leftover narcotic pain medication. The purpose of this process improvement project was to increase the knowledge and use of activated-carbon-based deactivation kits during the discharge process to increase safe medication disposal. Methods A team was formed to increase safe disposal. The team developed a plan for the pharmacy to provide quick facts when dispensing narcotic pain medication, giving instructions to the parents about how to obtain an activated-carbon-based deactivation kit if they had unused narcotic medication. In addition, the dangers of incorrect disposal of narcotics were included. The nurses provided verbal education to the parents on the safe disposal at discharge to home. Furthermore, parents were reminded of the opportunity to utilize an activated-carbon-based deactivation kit provided from the hospital pharmacy to dispose of the narcotics during postsurgical follow-up call. Results The hospital pharmacy saw a sixfold increase in the dispensing of activated-carbon-based deactivation kits since the education was initiated. Caregivers noted a 68% increase in reporting of proper disposal of narcotics. Discussion Implementation of a standardized educational practice for the families of patients being discharged with narcotic medication resulted in an increased awareness of safe disposal of narcotics and an increase in dispensing of activated-carbon-based deactivation kits. Ultimately, this resulted in the families having a greater confidence in caring for their children at discharge as reported on patient satisfaction surveys.

Knowledge, attitude, and practice of unused and expired medication disposal among second year medical students

Background: Medications are not only used for disease treatment, but also for diagnosis and prevention of the disease. Not all the prescribed drugs are used by the patients, due to lack of adherence to therapy, there are chances of stocking up the unused or expired drugs at home. It is important to provide practical and scientific guidelines for the safe disposal of expired, unused, and leftover medications. Most developing countries lack standard guidelines for the safe disposal of expired, unused, and leftover medications. There are very few studies conducted in this region to assess the knowledge of the safe disposal of unused drugs. Aims and Objectives: The present study was undertaken to assess the knowledge, attitude, and practice of disposal of unused or expired medications. Materials and Methods: This was cross-sectional, questionnaire-based study conducted among 2nd year undergraduate medical students at a Medical College in South India. The questionnaire included three parts: Part I includes demographic details of the students and questions on knowledge of safe disposal of expire/unused drugs, Part II includes questions on attitude towards the safe disposal of expired/unused drugs, and Part III includes questions on practices toward the safe disposal of expired/unused drugs. The responses received from the participant was analyzed using Microsoft Excel (2019 version), and the results are explained in frequency and percentage. Results: A total of 118 2nd year medical undergraduate students participated in the present study. Out of 118, 62 (52.5%) were female students and 56 (47.4%) were male students. Among all the participants, 98 (83%) of students said that they are aware of medicinal waste. In the present study, 73 (61.8%) students knew about the safe disposal of unused, expired, and leftover medications. Most of the students (93.2%), agreed that unsafe disposal of unused, expired, and leftover medications would adversely affect the environmental, animal as well as human health. And 50% of the students, strongly agreed that educational activities like drug take-back programs should be introduced among the public people. When the students were asked about their practice of keeping expired, unused, or left-over drugs at home, 66.1% (78) of the students said yes and 47.2% (40) of the students said they do not keep the leftover medicine at home. Topical formulations (63.5%) were the most common group of drugs that were stored. The majority of students (73%) reported that they would throw unused/expired medications in dust bins at home. Self-discontinuation is most the common reason for storing drugs in the majority of the study participants (39%). Conclusion: In the present study, the 2nd-year medical undergraduate students had awareness regarding the harmful events associated with improper disposal of unused or expired drugs. But due to lack of information or knowledge of safer methods available, majority of the students were following inappropriate methods for disposing leftover or expired medication at home. Indian Government should provide national level guidelines and conduct awareness programs, mediated through healthcare professionals to bring significant changes about the disposal of unused or expired medications.

Review on Drug Waste Management

Drug waste management is the alarming issue nowadays so provide more awareness from healthcare professionals and drug receiver. The pharmacist are in the admirable position to aware people about safe medication disposal. The safe medication disposal awareness in society leads to the sufficient good differences in public health and surroundings. the knowledge of the safe drug disposal is equally important that consumption of the medicines. The easiest solution to the drug pollution is to disposal of medicines properly. The aim of this review is the government have to maintain the drug disposal methods on the label of drugs and dosage forms. The collection of the drug is easier and they can authorize the collection in the take back program. The Indian government have to authorized the drug collection sites and registered business or various authorization for the collection of the drug safely, they also have to organize the various types of events like drug take back awareness events, awareness programs on the need of proper drug disposal and its conditions. The drug waste contains the expired and non-expired drugs.

At your disposal: A pilot for safely discarding medication in postoperative patients

BackgroundThe improper storage of and unsafe disposal methods for leftover and expired prescription medication represent a risk for diversion, misuse, and other public health issues. Health care providers are well positioned to offer education and resources for the safe disposal of medication. ObjectivesA quality improvement pilot was constructed to provide education and a medication disposal packet to patients who received a prescription for an opioid on discharge from Emory University Orthopaedics and Spine Hospital after surgery. Objectives were to assess the packet’s utility and to determine whether proximity of existing community takeback bins had any effect on packet usage. MethodsFive weeks after discharge, patients received an automated phone call to evaluate their use of the disposal packet. Call responses were the primary data point for determining success, with a goal of greater than 50% packet use. Demographic data were collected retrospectively to assess the count of medication disposal bins within the patient’s ZIP Code. ResultsOf a total of 532 unique patients, 239 responded to the automated survey, indicating how they planned to use the disposal packet provided to them on discharge. Of the 239 responses, 150 (63%) patients either used or planned to use the packet. In addition, a chi-square test of independence and a z test for the difference in proportion of packets used showed that the existence of 2 or more community takeback bins per ZIP Code was associated with packet nonuse (P < 0.05). ConclusionPublic health resources can help address medication disposal issues that contribute to environmental contamination, opioid misuse, overdose, and death. Emory University Orthopaedics and Spine Hospital outpatients have a need for safe medication disposal initiatives and education, especially in communities with fewer existing means.

Perianesthesia Nurses’ Knowledge, Attitude, and Intention to Promote Safe Use, Storage, and Disposal of Opioids

<h3>Introduction</h3> Opioid overdose deaths and opioid use disorders are a crisis in the United States. Perianesthesia nurses have an excellent opportunity to educate patients and families who are discharged to home after surgery. <h3>Identification of the problem</h3> In a prior study, the authors found that nurses and other providers do not routinely discuss safe use, storage, or disposal of medications; perianesthesia nurses are more likely to discuss side effects of opioids. <h3>Purpose of the Study</h3> The purpose of this study is to determine if a web-based educational intervention increases knowledge, attitude, and intention of perianesthesia nurses to promote safe use, storage and disposal of opioids. <h3>Methodology</h3> A one group pre-test, post-test interventional study was conducted using a survey of ASPAN nurses. The intervention was a web-based voiceover module with patient education scenarios focused on information for patients before discharge. Responses to the pre-survey and 2 post surveys were collected. Data analysis included descriptive summary and evaluation of changes in knowledge and domains of Theory of Planned Behavior using repeated measures mixed modeling. <h3>Results</h3> The participants included pre-test survey (n = 678), the immediate post-test (n = 247), and the 4-week post-test (n = 171). The analysis presented is limited to 247 who completed at least the first post-survey. For all outcomes, there was an immediate increase in the measure following the intervention; this pairwise difference (between pretest and the immediate post-test) was significant in each model. The immediate and 4-week post-test scores exceeded the corresponding pre-test score, though for perceived behavioral control, attitude, and intention, the difference between baseline and week 4 was not significant. <h3>Discussion</h3> These findings suggest a more intensive intervention with possibly the inclusion of booster sessions, particularly for the outcomes of perceived behavioral control and subjective norms may be needed. <h3>Conclusion</h3> This educational intervention can be implemented at the national level for optimum impact. <h3>Implications for perianesthesia nurses and future research</h3> Perianesthesia nurses are well-positioned to teach patients about the risks of diversion, nonmedical use, and proper disposal of opioids. Research to develop safe postdischarge prescription practices and encourage safe opioid practices after surgery is needed.

ASSESSMENT ON KNOWLEDGE, ATTITUDE AND PRACTICE OF PATIENTS IN HOSPITAL TAPAH REGARDING DISPOSAL OF UNUSED AND EXPIRED MEDICINES

According to the World Health Organization (WHO), more than half of dispensed medications were inappropriately prescribed, which causes a build-up of unused medications and increasing medication disposal. The aim of this study is to assess the level of knowledge, attitude and current practice of patients in Hospital Tapah, Perak, Malaysia towards this issue. A cross-sectional study was conducted by using a self- administered questionnaire adapted from Su Lan et al. (2018). Patients aged more than 17 years old who visited outpatient pharmacy and who admitted into medical ward; the caregivers of children who admitted into paediatric ward, Hospital Tapah were enrolled in this study, selected through convenience sampling. Logistic regression analysis was performed to determine significant association between independent and dependent parameters. The significance level was set at p &lt; 0.1. Total of 344 valid questionnaires were returned in which 34.9% (n = 120) men and 65.1% (n = 224) women participated. The majority of the participants has general knowledge of the correct way of disposing medicines. Although 57.3% of the participants have heard about ‘Return Your Medicines Programme’ (RMP) implemented by the Ministry of Health Malaysia, only 38.1% returned their unused or expired medication to the nearby hospital/clinic. Most of them were found to have a positive attitude regarding this issue, nevertheless only 24.7% practiced a proper medication disposal. The utilisation of RMP could be improved by increasing the awareness of safe medication disposal, as significant association has been found between the level of knowledge and attitude with current disposal practice of patients in Hospital Tapah.

A National Survey of Challenges Faced by Hospices During the Opioid Crisis: Estimates of Pain Medication Shortages, Missing Medications, and Opioids Left in the Home Post-Death

ContextNo national data exist on hospice medication shortages, the frequency that opioid medications go missing, and drug disposal practices. ObjectivesTo provide national estimates for hospices on: drug shortages; frequency of missing medications; and opioids left in the home post-death. MethodsA national survey of 600 randomly selected hospices stratified by state and profit status (data collection 2018). Sample weights were applied to adjust for non-response. Respondents were hospice representatives knowledgeable about agency policies and practices. Participants reported their knowledge and perceptions about medication shortages, frequency that opioid medications go missing, and the proportion of hospice deaths in which opioids are left in the home. Findings were stratified by agency size. Results371 hospices completed surveys (response rate = 62%), half (50%) of which were mid-sized (26-100 patients), and not-for-profit. Respondents had 7.5 years (SD = 7.7) of agency experience. 42% of hospices – and 61% of large hospices – reported medication shortages. Among the full sample, 28% of agencies indicated shortages of morphine; 20% reported shortages of hydromorphone. Nearly half (43%) of hospice representatives reported that missing opioid medications occurred within the last 90 days. 52% of representatives reported employees are not allowed to dispose of medications after a home death; and, among home deaths, unused opioids were left in the home 32% of the time. This suggests opioid medications are frequently left in U.S. households after a hospice home death. ConclusionHospices face numerous challenges during the national opioid crisis. Interventions are needed to ensure access to needed treatments, mitigation of diversion, and safe medication disposal.