Medicine Storage, Wastage and Associated Determinants Among Urban Households: A Systematic Review of Household Surveys

Abstract Background: Irrational household storage of medicines is a world-wide problem resulting medicine wastage and associated harms, which imposes an additional burden on the health care system. The study has performed a systematic review of household surveys to provide strong evidences and policy implications through a comprehensive and comparative understanding of available global literatures. The review also maps existing literature on the burden, outcomes and affecting socio-economic factors of medicine storage and wastage.Methods: Five electronic databases were searched (from inception to 2019) for surveys that reviewed in-home medicine storage modality, size, cost and main determinants. The methodological quality of included studies was appraised through an adapted checklist developed by past studies.Results: From the initial 2604 records we identiﬁed, 22 studies met our inclusion criteria. In 16 studies, medicine storage rates were reported for more than 70%. The maximum rate of potential (not in use medicines) and real (expired or without expiration date medicine) wastage were about 70 and 40 percent, respectively. The most common classes of medicines found in households belonged to the nervous system (18%) and anti-infective for systemic use (15%). Income, education, age, presence of chronic illness, female gender and insurance coverage were among the factors influencing medicine storage. The most commonly used method of disposal was throwing them in the garbage.Conclusions: Factors beyond medical needs determined medicine storage in the studied contexts which urges effective strategies in the supply and demand side of the medicine consumption chain. The first necessary step to mitigate home storage is adequate legislation and strict enforcement of regulations on dispensing, prescription and marketing of medicines. Patient pressure on excessive prescription, irrational storage and use of medicines deserve efficient community centered programs for increasing awareness of these issues. Hazardous consequences of inappropriate disposal should be mitigated by different take back programs, particularly in low and middle income countries.

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Medicine storage, wastage, and associated determinants among urban households: a systematic review and meta-analysis of household surveys

BMC Public Health ◽

10.1186/s12889-021-11100-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Adineh Jafarzadeh ◽

Alireza Mahboub-Ahari ◽

Moslem Najafi ◽

Mahmood Yousefi ◽

Koustuv Dalal

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Supply And Demand ◽

Random Effect ◽

Effect Sizes ◽

Household Surveys ◽

Affective Factors ◽

Urban Households ◽

Medical Needs ◽

Geographical Regions

Abstract Background Irrational household storage of medicines is a world-wide problem, which triggers medicine wastage as well as its associated harms. This study aimed to include all available evidences from literature to perform a focused examination of the prevalence and factors associated with medicine storage and wastage among urban households. This systematic review and meta-analysis mapped the existing literature on the burden, outcomes, and affective socio-economic factors of medicine storage among urban households. In addition, this study estimated pooled effect sizes for storage and wastage rates. Methods Household surveys evaluating modality, size, costs, and affective factors of medicines storage at home were searched in PubMed, EMBASE, OVID, SCOPUS, ProQuest, and Google scholar databases in 2019. Random effect meta-analysis and subgroup analysis were used to pool effect sizes for medicine storage and wastage prevalence among different geographical regions. Results From the 2604 initial records, 20 studies were selected for systematic review and 16 articles were selected for meta-analysis. An overall pooled-prevalence of medicine storage and real wastage rate was 77 and 15%, respectively. In this regard, some significant differences were observed between geographical regions. Southwest Asia region had the highest storage and wastage rates. The most common classes of medicines found in households belonged to the Infective agents for systemic (17.4%) and the Nervous system (16.4%). Moreover, income, education, age, the presence of chronic illness, female gender, and insurance coverage were found to be associated with higher home storage. The most commonly used method of disposal was throwing them in the garbage. Conclusions Factors beyond medical needs were also found to be associated with medicine storage, which urges effective strategies in the supply and demand side of the medicine consumption chain. The first necessary step to mitigate home storage is establishing an adequate legislation and strict enforcement of regulations on dispensing, prescription, and marketing of medicines. Patient’s pressure on excessive prescription, irrational storage, and use of medicines deserve efficient community-centered programs, in order to increase awareness on these issues. So, hazardous consequences of inappropriate disposal should be mitigated by different take back programs, particularly in low and middle income countries.

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Stress, anxiety, depression and burnout in frontline health care workers during COVID-19 pandemic: a brief systematic review and new data from Russia

10.31234/osf.io/je3ch ◽

2021 ◽

Author(s):

Ekaterina Mosolova ◽

Dmitry Sosin ◽

Sergey Mosolov

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Female Gender ◽

Assessment Tools ◽

Care Workers ◽

Younger Age ◽

Wide Range ◽

Associated Risk Factors ◽

Anxiety Depression ◽

The Impact

During the COVID-19 pandemic, healthcare workers (HCWs) have been subject to increased workload while also exposed to many psychosocial stressors. In a systematic review we analyze the impact that the pandemic has had on HCWs mental state and associated risk factors. Most studies reported high levels of depression and anxiety among HCWs worldwide, however, due to a wide range of assessment tools, cut-off scores, and number of frontline participants in the studies, results were difficult to compare. Our study is based on two online surveys of 2195 HCWs from different regions of Russia during spring and autumn epidemic outbreaks revealed the rates of anxiety, stress, depression, emotional exhaustion and depersonalization and perceived stress as 32.3%, 31.1%, 45.5%, 74.2%, 37.7% ,67.8%, respectively. Moreover, 2.4% of HCWs reported suicidal thoughts. The most common risk factors include: female gender, nurse as an occupation, younger age, working for over 6 months, chronic diseases, smoking, high working demands, lack of personal protective equipment, low salary, lack of social support, isolation from families, the fear of relatives getting infected. These results demonstrate the need for urgent supportive programs for HCWs fighting COVID-19 that fall into higher risk factors groups.

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Interventions to Reduce Alcohol Harms in Low and Middle Income Countries: a Systematic Review and Meta Analysis

10.31234/osf.io/mg5s4 ◽

2018 ◽

Author(s):

Joao Ricardo Nickenig Vissoci

Keyword(s):

Systematic Review ◽

Alcohol Use ◽

Randomized Controlled Trials ◽

Brain Stimulation ◽

Meta Analysis ◽

World Health ◽

Controlled Trials ◽

Middle Income ◽

Brief Motivational Intervention ◽

Randomized Controlled

BackgroundHarmful alcohol use leads to a large burden of disease and disability which disportionately impacts LMICs. The World Health Organization and the Lancet have issued calls for this burden to be addressed, but issues remain, primarily due to gaps in information. While a variety of interventions have been shown to be effective at reducing alcohol use in HICs, their efficacy in LMICs have yet to be assessed. This systematic review describes the current published literature on alcohol interventions in LMICs and conducts a meta analysis of clinical trials evaluating interventions to reduce alcohol use and harms in LMICs.MethodsIn accordance with PRISMA guidelines we searched the electronic databases Pubmed, EMBASE, Scopus,Web of Science, Cochrane, and Psych Info. Articles were eligible if they evaluated an intervention targeting alcohol-related harm in LMICs. After a reference and citation analysis, we conducted a quality assessment per PRISMA protocol. A meta-analysis was performed on the 39 randomized controlled trials that evaluated an alcohol-related outcome.ResultsOf the 3,801 articles from the literature search, 87 articles from 25 LMICs fit the eligibility and inclusion criteria. Of these studies, 39 randomized controlled trials were included in the meta-analysis. Nine of these studies focused specifically on medication, while the others focused on brief motivational intervention, brain stimulation, AUDIT-based brief interventions, WHO ASSIST-based interventions, group based education, basic screening and interventions, brief psychological or counseling, dyadic relapse prevention, group counseling, CBT, motivational + PTSD based interview, and health promotion/awareness. Conclusion Issues in determining feasible options specific to LMICs arise from unstandardized interventions, unequal geographic distribution of intervention implementation, and uncertain effectiveness over time. Current research shows that brain stimulation, psychotherapy, and brief motivational interviews have the potential to be effective in LMIC settings, but further feasibility testing and efforts to standardize results are necessary to accurately assess their effectiveness.

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