Drug Wastage Research Articles

Assessing oncology nurses’ knowledge and practices in safe cytotoxic drug handling and waste management in a Moroccan tertiary centre

ABSTRACT Because of the rising burden of cancer worldwide, cytotoxic drugs have become a significant threat to health and the environment. This investigation assessed the level of knowledge of oncology nurses regarding the risks associated with handling cytotoxic drugs and the management of cytotoxic waste and their impact on health and the environment. A qualitative study was conducted among oncology nurses at a Moroccan oncology centre. Most demonstrated a good understanding of cytotoxic drugs and their handling. But, there were notable deficiencies in foundational training. Occasional training sessions were offered, but they were considered insufficient in frequency and depth. The workload was identified as a major obstacle to proper safety protocol implementation. Although all participants recognised the dangers of improper disposal of cytotoxic waste, none had detailed knowledge of the specific environmental impacts. Improved training programmes and a reduced workload are critical to enhancing safety and efficiency in oncology centres.

Revolutionizing Pharmacy Benefit Management: Cost-Reduction through Artificial Intelligence and Data Analytics in Healthcare

Pharmacy Benefit Managers (PBMs) are third party companies that function as intermediaries between insurance providers and pharmaceutical manufacturers. PBMs create formularies, negotiate rebates (discounts paid by a drug manufacturer to a PBM) with manufacturers, process claims, create pharmacy networks, review drug utilization, and occasionally manage mail-order specialty pharmacies. [1] Pharmacy benefit management (PBM) is important for keeping prescription drug costs under control. But the problem is that drug prices keep going up, which makes things tough for the healthcare industry. In this article, we look at how fancy technology like artificial intelligence (AI) and data analysis can help PBM find new ways to save money. By using advanced technology to study a large amount of information, PBMs can find patterns and make educated guesses about how to best use medications. Artificial intelligence makes this even more advanced by helping to quickly find and stop fraud, personalize medication plans, and predict costs more accurately. Remember this: AI and data analytics are being used to make pharmacy benefit programs work better. This helps save money and makes things better for patients. We look at how machine learning models can predict patient adherence, how natural language processing (NLP) can improve medication reviews, and how blockchain technology can keep supply chains transparent and secure. Real-world examples show how these technologies are already making a difference, such as cutting down on administrative work, reducing drug waste, and getting the most out of drug utilization. As more healthcare systems start using these advanced tools, it’s becoming clear that continual innovation and the inclusion of AI and data-driven methods are essential. This article highlights the importance of staying updated with the ever-changing ways of controlling prescription drug expenses by using new technology. For pharmacy benefit managers (PBMs) focused on offering the best value and working effectively despite increasing healthcare costs, adopting these advancements is not just a good choice, it's necessary.

Insights into Drug Donation Practices and Public Perceptions in Saudi Arabia

Background: Effective medication management, disposal, and donation are vital for public health and environmental sustainability. Improper handling of medications can lead to drug misuse, accidental poisoning, and environmental damage. This study examines current practices and challenges in Saudi Arabia, identifying opportunities for improvement. Method: A cross-sectional survey conducted in October and November 2023 targeted the general population in Saudi Arabia. This study employed convenience sampling to explore medication usage, storage, disposal practices, and awareness of donation procedures. Data were analyzed through both descriptive and inferential statistical methods. Results: This study involved 430 respondents. Of these, 73.0% held a university degree, yet 66.3% were unaware of drug donation programs, and 84.2% lacked knowledge about proper medication disposal. Despite this, 71.4% believed that drug donation programs positively impact healthcare, and 87.9% saw them as reducing drug waste and environmental pollution. However, 48.1% expressed concerns about the potential misuse of donated medicines. Awareness and knowledge were significantly higher among participants aged 30 and above. Conclusions: The findings highlight the need for enhanced public awareness, clear medication disposal guidelines, and ethically governed donation practices in Saudi Arabia. These measures can improve healthcare outcomes, protect the environment, and support global health and sustainability goals.

The benefits (or detriments) of adapting to demand disruptions in a hospital pharmacy with supply chain disruptions.

Supply chain disruptions and demand disruptions make it challenging for hospital pharmacy managers to determine how much inventory to have on-hand. Having insufficient inventory leads to drug shortages, while having excess inventory leads to drug waste. To mitigate drug shortages and waste, hospital pharmacy managers can implement inventory policies that account for supply chain disruptions and adapt these inventory policies over time to respond to demand disruptions. Demand disruptions were prevalent during the Covid-19 pandemic. However, it remains unclear how a drug's shortage-waste weighting (i.e., concern for shortages versus concern for waste) as well as the duration of and time between supply chain disruptions influence the benefits (or detriments) of adapting to demand disruptions. We develop an adaptive inventory system (i.e., inventory policies change over time) and conduct an extensive numerical analysis using real-world demand data from the University of Michigan's Central Pharmacy to address this research question. For a fixed mean duration of and mean time between supply chain disruptions, we find a drug's shortage-waste weighting dictates the magnitude of the benefits (or detriments) of adaptive inventory policies. We create a ranking procedure that provides a way of discerning which drugs are of most concern and illustrates which policies to update given that a limited number of inventory policies can be updated. When applying our framework to over 300 drugs, we find a decision-maker needs to update a very small proportion of drugs (e.g., ) at any point in time to get the greatest benefits of adaptive inventory policies.

Medication stewardship in the operating theatre in Malaysia: A quality improvement project.

A quality improvement project ('Safe Anaesthesia for ALL-SEAL') was implemented to reduce preventable medication errors and drug wastage in the operating theatre (OT) of a tertiary hospital. The primary objective of this quality improvement project was to prevent the incidence of medication errors, and the secondary objective was to reduce the wastage of unused drugs. A pre-intervention questionnaire and an audit survey were performed, and multidirectional interventions were designed post-survey. A post-intervention survey was conducted to evaluate effectiveness. The incidence of medication errors, including near misses, was assessed for root causes. Unused drugs drawn or diluted in syringes were recorded daily in each OT. The weekly drug orders and mid-week reordering frequency were also monitored. The data were reported as simple means and percentages. Ninety-eight anaesthesia care providers participated in the survey (72.4% doctors and 27.6% anaesthetic nurses). Pre-intervention, 76.1% of respondents had experienced medication errors during their practice. Common errors included misidentification of ampoules or vials (65.2%), miscalculation of dosages (65.2%), improper syringe labelling (56.5%), accidental drug omission (54.3%) and wrong prescriptions (39.1%). The main sources of errors were fatigue/overwork (80.4%) and a hectic OT environment (71.7%). Post-intervention, no incidents of medication errors were reported. In addition, there was a significant reduction in drug wastage. The SEAL project positively prevented medication errors and reduced drug wastage, which should be further validated in other clinical settings.

Reducing Cancer Drug Cost: 3-Year Analysis of Automated Dose Rounding in Electronic Health Records.

Globally, cancer drug expenditure exceeds $185 in US dollars (USD) billion, with the United States contributing $75 (USD) billion. Many cancer drug doses are calculated on the basis of body weight or body surface area, which often results in leftover drug in partially used single-dose vials (SDVs). The cost of wasted drug is a huge financial burden on the US health care system. We evaluated the cost savings resulting from the reduction of SDV wastage, achieved through the implementation of automated dose rounding rules in electronic health records (EHRs). Mayo Clinic implemented automated dose rounding rules within the EHR. These rules were designed to round calculated doses to the nearest SDV if the vial size closely matched the original calculated dose, within a 10% threshold. We assessed doses administered between January 2019 and December 2021, and computed cost-savings, waste reduction, and cost of waste for chemotherapy drugs. In 3 years, 36.1% of doses were rounded down, 35.8% were rounded up, and 28.1% were exact doses. By rounding doses down to a vial size, we achieved cost-savings of $39.75 (USD) million and prevented 62,065 SDV of cancer drugs from going to waste. By rounding doses up, we avoided wasting $9.95 (USD) million worth of drugs. However, there were still instances where the rounding fell outside of the 10%, resulting in wasted drugs worth $25 (USD) million. The substantial burden imposed on patients and the US health care system because of cancer drug wastage is of significant concern. Although the automated dose rounding system represents a partial solution for this issue, a comprehensive approach involves the imperative development of policy and legislative solutions to effectively mitigate the challenges associated with cancer drug waste.

Leftover of Amoxicillin Suspension After Use by Children in the Netherlands.

In clinical practice, a discrepancy may exist between the prescribed amount of a drug and the commercially available pack sizes in the pharmacy, potentially contributing to drug waste. This study aimed-as an example of this phenomena-to quantify leftover of amoxicillin suspension prescribed to children, due to discrepancies between physician-prescribed and pharmacy-dispensed amounts. We performed a retrospective cohort study including amoxicillin suspension dispensations for patients aged 0-12 years between 2017 and 2019 utilizing the Dutch PHARMO database. Leftover amount of amoxicillin was estimated by assessing the discrepancy between the prescribed and dispensed amounts. Extrapolated amoxicillin weight and economic spillage estimates for the Netherlands were determined. The impact of two theoretical interventions on leftover amount was assessed: (1) introducing vials with half the volume of the current 100 and 30 mL vials and (2) a combination of the first intervention with a maximum of 10% round-down by the dispensing pharmacy of the prescribed dose. We included 79 512 amoxicillin suspension dispensations for 62 252 patients. The mean leftover amount of amoxicillin suspension per dispensing was 27%. The yearly amount of amoxicillin leftover was 49.8 kg in the study cohort, equivalent to yearly 633 kg and €621 000 when extrapolated to the Netherlands. Employing the first theoretical intervention reduced the mean leftover per dispensing to 20%, reducing the yearly leftover to 31.6 kg amoxicillin in the study cohort, and to 400 kg and €400 000 extrapolated. The second theoretical intervention further reduced leftover to 17%, reducing the yearly leftover to 24.3 kg amoxicillin in the study cohort, and to 300 kg and €300 000 extrapolated. Approximately a quarter of amoxicillin suspension remains as leftover per dispensing. Applying different theoretical intervention shows the potential for a significant reduction of amoxicillin leftover.

Anesthetics drug wastage and preventive strategies: Systematic review.

Surgical Patients and hospitals are now facing financial strain due to direct anesthetic demand as a result of the development of new anesthetic drugs, equipment, and techniques. Up to 15% of a hospital's pharmacy budget is currently allocated to anesthetic drug expenses. Drug wastage during anesthesia practice is a widespread hidden source of healthcare waste that leads to anesthetic drug shortages as well as poor operating room efficiency. On the other hand, despite the fact that it is preventable in the vast majority of cases, it is well described that drug wastage is routinely observed, including in developing countries where the consequences significantly affect both hospitals and patients. This review aims to review the prevalence of anesthetic drug waste across the world and systematically formulate and describe preventive strategies. Relevant publications were identified using systematic searches on databases including Google Scholar, Medline (PubMed), the Cochrane Library, and Embase. In addition, papers were detected and then selected through the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria guidelines and the inclusion and exclusion criteria. Using the predetermined terms and dates from the searching databases, a total of 504 articles were identified. Based on the screening criteria, 16 papers were considered eligible and included in the final review. In addition, the Joanna Briggs Institute (JBI) Manual for Evidence Synthesis was used for evaluating the quality of selected articles. This study is registered on PROSPERO, number CRD42024497044. Of the sixteen publications from eleven different nations that were considered suitable for inclusion, only two of them addressed the waste of inhalational anesthetics. In more than half of eligible articles, propofol was the frequently wasted drug that contributed to increased financial loss through drug waste. The first most significant factor contributing to the waste of intravenous and inhalational anesthetics was the disposal of multidrug vials following their use for a single patient and high fresh gas flow, respectively. Anesthetic medication waste is a common occurrence worldwide, despite the fact that it is expensive and has a significant negative impact on operating room efficiency. Because the majority of drug waste is avoidable, preventive measures may lower drug waste and improve patient and hospital efficiency.

INVESTIGATION OF THE PREVALENCE OF EXPIRED AND UNUSED PHARMACEUTICALS IN THE ANKARA REGION

Objective: Due to the increase in the market share of pharmaceuticals and the unconscious use of medicines, unused or expired medicines are being discarded in a way that harms the environment. This study aims to examine which medicines are brought to collection points as household waste in order to reduce waste medicines from the source. Material and Method: The medicines collected in 12 spontaneously selected pharmacies operating in low and high income levels in the Ankara region were recorded at different periods during one year and the results were statistically evaluated. 4852 waste medicines were sorted and classified according to pharmaceutical dosage form and indication Result and Discussion: Unopened 521 medicines were discarded. In addition, it was seen which drug groups create waste in socio-economic terms. In addition to the damage to the environment, it has created a foresight to prevent drug waste that creates a deficit in the budget.

An Overview of Floating Drug Delivery System

The goal of Floating Drug Delivery Systems (FDDS) is to arrange the current emphasis on the basic flotation mechanism to attain stomach retention time. The most current advancements in FDDS are thoroughly discussed, including the formulation and physiological factors influencing stomach retention, methods for designing floating systems, and the characteristics of their classification and formulation. Since dosage forms stay in the stomach longer than conventional dosage forms, the capacity to extend and control the gastric emptying time is a major asset. Gastric emptying of dosage forms is a highly variable process. Drugs with gastroretentive systems have a much longer residence time in the stomach area, improving bioavailability, decreasing drug waste, and increasing solubility for medications that are less soluble in high pH environments. These benefits are achieved over a period of many hours. This review provides a brief overview of floating medication delivery devices

Ophthalmic Drop Waste Due to Self-imposed Use Cessation Dates

Self-imposed use cessation dates for multi-use eye drop bottles lead to significant drug waste and increased costs. We quantified the residual medication in eye drop bottles across three clinics in an academic ambulatory setting.

An audit on the amount of drug wastage and the cost related to the disposal of unused intravenous agents in the operating theatres in a tertiary care hospital

: This manuscript presents an audit focused on assessing the extent of drug wastage and associated costs linked to the disposal of unused intravenous agents within the operating theatres of a tertiary care hospital. The study aims to carefully look at drug wastage, figure out why it happens, and propose strategies for optimizing resource utilization and cost-efficiency in clinical settings. : This audit is a prospective observational study carried out in a tertiary care hospital. The amount of drug loaded preoperatively, the amount of drug utilized, the amount of drug unutilized and discarded, the total quantity of drug wasted, and the cost related to the wastage were calculated in percentage. The maximum wastage of loaded drugs was seen with atropine (100%), followed by ephedrine (93.6%), propofol (52.5%), phenylephrine (35.2%), atracurium (28.6%), dexmedetomidine (27.8%), fentanyl (16.8%), vecuronium (16.2%) and morphine (6.4%). The cost analysis revealed that 36.3% of the total loaded drugs were wasted amounting to Rs.46903.54. The cost of wastage of propofol was maximum with Rs.14006 which is 29.8% of total cost wastage followed by atracurium 21%(Rs.9856), dexmedetomidine 18.4%(Rs.8687.5), ephedrine 14.7%(Rs.6919), phenylephrine 10.4%(Rs.4910), fentanyl 3.7%(Rs.1780), atropine 1.9% (Rs.906), vecuronium 1.2% (Rs.563.76), Morphine 0.18% (Rs.85.28).: In our audit, the maximum drug wastage was observed with atropine (100%) amounting to Rs.906, and the cost of wastage was maximum with propofol amounting to Rs.14006 which was 29.8% of the total cost of wastage. Our audit underscores the importance of proactive management of drug wastage and disposal costs in healthcare settings, particularly within operating theatres where intravenous agents play a crucial role in patient treatment. By conducting a comprehensive audit and proposing targeted interventions, healthcare institutions can optimize resource utilization, enhance sustainability, and ultimately improve patient outcomes.

Evaluating the carbon footprint of sedation practices in intensive care.

Healthcare's carbon footprint contributes to 4.4% of global net emissions and intensive care units (ICUs) are very resource intensive. Existing studies on environmental sustainability in ICUs focused on carbon footprint generated from energy and electricity consumption, use of medical consumables and equipment, but few studies quantified carbon footprint generated from pharmaceuticals used in ICUs. To evaluate carbon footprint arising from sedation practices in the ICUs. A pilot, prospective observational study was conducted in two ICUs from 1 August to 22 September 2022 in Singapore General Hospital. Adult patients who were consecutively sedated, intubated and expected to be mechanically ventilated for at least 24 h were included. Total amount of analgesia and sedatives used and wasted in eligible patients were collected. Carbon emission from ICU sedation practices were then quantified using available life cycle assessment data. A total of 31 patients were recruited. Top analgesia and sedative used in both ICUs were fentanyl and propofol, respectively. Carbon footprint from sedative usage and wastage across 7 weeks in both ICUs were 2.206 kg CO2-e and 0.286 g CO2-e, respectively. In total, this equates to driving 15.8 km by car. Proportion of drug wasted ranged from 5.1% to 25.0%, with the top reason for wastage being the drug was no longer clinically indicated. Recommendations to reduce carbon footprint include choosing sedatives with lower carbon emissions where possible and having effective communication among doctors and nurses regarding management plans to minimize unnecessary wastage. Our study quantified carbon footprint arising from sedation practices, mainly drug usage and wastage in two ICUs in Singpore General Hospital. Adopting a holistic approach to environmental sustainability in the ICU, sedation practices also contribute to generating greenhouse gases, albeit small, and can be targeted to reduce unnecessary carbon footprint.

Screening for Antinociceptive Action of Gastroretentive Drug delivery System of Tramadol hydrochloride in Mice

The floating drug delivery system is to avoid the problem of drug waste and to limit the frequency of administration. Here the drug Tramadol is being centrally acting opioid analgesic can be formulated as sustained release formulation by adopting the method gastroretentive drug delivery system through effervescent floating drug delivery system with different grades of polymer Hyperomellose. The Pharmacological activity on Mice by both Hot Plate and Tail Flick Methods also suggest that when the Tramadol Hcl increased with its dosage form shows significant Analgesic Activity in animals which shows a spontaneous dose dependent increase in Analgesic activity was found it shows that the dosage form deserve for designed method of gastroretentive drug delivery system.

Pelatihan Pengelolaan dan Pemusnahan Limbah Obat Rusak dan Kadaluarsa di Desa Kotapulu Kabupaten Sigi

The widespread circulation of illegal drugs poses a serious threat to society as it can have negative impacts on health. In 2019, BPOM Palu confiscated illegal drugs and cosmetics from various areas in Central Sulawesi. A law enforcement operation in Sigi Regency on September 23, 2020, together with the Central Sulawesi Regional Police, successfully seized Class G prescription drugs, traditional medicines, and illegal cosmetics (BPOM Palu, 2022). The main cause of illegal drug circulation is the improper reuse of household drug waste, exploited by irresponsible parties. The use of illegal drugs, which may consist of counterfeit, damaged, or expired items, can endanger health and even lives. One crucial step to prevent this is by managing drug waste properly. Since 2019, BPOM has been conducting awareness campaigns such as "Beware of Illegal Drugs, Dispose of Drug Waste Properly" to educate the public on proper drug disposal (BPOM, 2019). Many people still don't understand the correct way to manage and dispose of expired drugs. Most of them throw these drugs into the trash, potentially fueling illegal drug reuse by irresponsible parties. Training and awareness efforts, such as those conducted in Kotapulu Village, Dolo District, Sigi Regency, are highly relevant. With better knowledge of proper drug management and disposal, it is hoped that communities can independently address drug waste issues, ultimately reducing the circulation of illegal drugs in the region. These activities are crucial for educating the public about the dangers of illegal drugs and the importance of proper drug waste management. The goal is to help reduce the circulation of illegal drugs, especially in Central Sulawesi, thereby safeguarding the overall health and safety of the community.

Propranolol Hydrochloride Psychiatric Effectiveness and Oxidative Stress: An Update

In this review, in addition to the potential cardiovascular applications of β-blockers and, more specifically, propranolol, we wanted to list the more recent applications in psychiatry as well as current knowledge on the impact of oxidative stress on propranolol hydrochloride and the oxidative stress that could be limited by the latter. In fact, a number of studies show that this molecule is modified by oxidative stress but is also able to limit it. Mention is also made to studies on the increasingly important problem of eliminating drug waste and its impact on the environment, particularly the marine environment. Given the increase in the consumption of medicines, more rigorous waste management is needed to avoid impacting biodiversity.

Intentions to Create Green Start-Ups for Collection of Unwanted Drugs: An Empirical Study

Drug waste poses a real threat to human health and the environment. Therefore, recycling and sustainability scholars have recently sought practical solutions to the drug waste problem. Furthermore, several governments have made significant efforts to reduce the negative effects of waste, such as establishing programs to take back unwanted drugs (expired and unused) for recycling (i.e., drug reuse or drug redispersing). However, many of these programs have failed to achieve their goals. In this context, it is expected that creating green start-ups to collect unwanted drugs will contribute to solving this problem. Accordingly, this study aims to investigate the antecedents of intentions to create green start-ups for collecting unwanted drugs. To this end, the authors integrate start-up self-efficacy and drug waste collection-related knowledge constructs into the theory of planned behavior (TPB). Using a self-administered paper questionnaire and relying on a convenience sample, data were collected from 328 students in six Algerian universities. A hierarchical multiple regression was conducted to test the proposed study model. Theresults revealed that perceived behavioral control (PBC) (β = 0.187, p < 0.001), attitudes (β = 0.182, p = 0.002), start-up self-efficacy (β = 0.169, p = 0.001), drug waste collection-related knowledge (β = 0.161, p < 0.001), and subjective norms (β = 0.088, p < 0.05) have a positive significant effect on the intention to create a start-up to collect unwanted drugs. In conclusion, this paper contributes to reducing drug waste by investigating the drivers of intention to create green start-ups for collecting unwanted drugs. Therefore, our study is expected to provide valuable insights for hospitals, pharmacies, pharmaceutical manufacturers, environmental protection associations, and stakeholders interested in reverse logistics.

Effects of solution chemistry on dielectric barrier atmospheric non-thermal plasma for operative degradation of antiretroviral drug nevirapine

The global prevalence of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) has been an environmental menace. Tons of drug wastes from antiretroviral therapy are released into the environment annually. We, for the first time, employed the novel dielectric barrier atmospheric non-thermal plasma (DBANP) discharge, to mitigate the inadvertent pollution arising from the antiretroviral therapy. A 40-min treatment of nevirapine achieved >94 % (0.075 min−1) removal efficiency at discharge power of 63.5 W and plasma working gas of atmospheric air. Chemical probes confirmed •OH, ONOO− and eaq− as the dominant reactive species whilst further revealing the reaction acceleration role of NaNO3 and CCl4 which are known reaction terminators. The commonly coexisting inorganic anions potentiated nevirapine removal with over 98 % efficiency, achieving the highest rate constant of 0.148 min−1 in this study. Moreover, the initial solution pH (1.5–11.1) was no limiting factor either. The insensitivity of the DBANP discharge to actual water matrices was an eminent inference of its potential applicability in practical conditions. With reference to data obtained from the liquid chromatography-mass spectrometer analysis, nevirapine degradation pathway was proposed. A nucleophilic attack by ONOO− at the cyclopropyl group and •OH attack at the carbonyl carbon of the amide group, respectively, initiated nevirapine degradation process. It is anticipated that the findings herein, will provide new insights into antiretroviral drug waste management in environmental waters using the innovative and green non-thermal plasma process.

Cost-effectiveness and drug wastage of bevacizumab biosimilar with or without chemotherapy for platinum-resistant recurrent ovarian cancer

ABSTRACT Introduction The cost-effectiveness of adding bevacizumab biosimilar with or without chemotherapy (CT) and drug wastage in treating platinum-resistant recurrent ovarian cancer (PRrOC) was assessed. Methods A three-state partitioned-survival model to compare the clinical and economic outcomes in the treatment of patients with PRrOC from a Taiwan healthcare prospective, extrapolated to two years based on data obtained from the JGOG3023 clinical trial. The primary outcomes of the model were incremental cost-effectiveness ratios (ICERs). Results In the base-case scenario, using vials of bevacizumab biosimilar (Bevbiol) plus chemotherapy, the ICER was (new Taiwan dollar) NT$ 4,555,878 per QALY gained. The incremental cost savings of an incremental 2.02 QALYs were NT$ 1,605,828 if weight-based Bevbiol plus chemotherapy were used, but the ICER remained high at the willingness-to-pay (WTP) threshold. If the cost of Bevbiol were reduced to 50% per vial, adding it to CT would be cost-effective at an acceptable WTP threshold of NTD 2,994,200, with an ICER of NT$ 2,975,484. Conclusions Bevacizumab biosimilars in mg/kg dosage form with chemotherapy are still not cost-effective in Taiwan, but using weight-based dosing will reduce drug waste and save treatment costs.

How the chitosan structure can affect the adsorption of pharmaceuticals from wastewaters: An overview

The disposal of pharmaceutical compounds in wastewater is a significant environmental and health challenge. These drug residues can have adverse effects on aquatic ecosystems and human health. Chitosan, a natural polysaccharide derived from chitin, is promising as an effective material for adsorbing pharmaceutical waste due to its unique chemical structure containing amino and hydroxy functional groups that facilitate interactions with organic molecules in wastewater. Chitosan can adopt various structural forms, such as hydrogels, nanoparticles, beads, membranes, fibers, and aerogels, which offer opportunities to optimize its performance in adsorbing drug waste. In this review, which includes articles published in the last 5 years, the influence of chitosan's structural forms, particularly on the adsorption of pharmaceutical compounds in wastewater is explored. Furthermore, the different synthesis and fabrication methods for each chitosan form and highlight their characteristics, advantages, and specific applications, are discussed. Additionally, this review delves into the adsorption mechanisms involved in each form.