Knowledge, Attitude, and Practices of Unused Medications Disposal among Patients Visiting Public Health Centers in Gondar Town, Ethiopia: A Cross-Sectional Study

Background. The improvement of healthcare systems has brought the subsequent increase in people access to medications. The consumers are not able to use all the dispensed medications because of various reasons. The improper disposal of these unused medicines has led to environmental contamination to an alarming extent. Therefore, the study was conducted to assess the knowledge, attitude, and practice of unused medications disposal among patients visiting public health centers in Gondar town, Ethiopia. Methods. A descriptive cross-sectional study was conducted among 404 patients visiting public health centers in Gondar town, Ethiopia, from August to September 2021, by using standardized and a locally translated semistructured questionnaire. The data were entered and analyzed by using the SPSS version of 21.0. The variable of interest was described in the form of statements and tables. Result. Out of 404 respondents included in the study, 221 (54.7%) of them were female. More than half (226 (55.9%)) of the respondents had unused medicine at home. The common methods of disposal practice were throwing into a household garbage (150 (31.4%)), followed by flushed into toilet/sinks (88 (21.8%)). More than half (286 (70.8%)) of the respondents knew about medication waste and 239 (59.2%) of them checked their medication expiry date. More than half (215 (53.5%)) of the participants strongly agreed that unused medicine can cause potential risk at home and 279 (69.1%) of study participants strongly agreed that children are more vulnerable to the potential risk of unused medicine at home. Conclusion. There was a high practice of keeping medication at home, and most disposal approach indicated by the participants was not recommended methods. Awareness about the proper disposal of unused medicines among the public should be created. Guidelines on safe disposal are required, and an organized method of collecting unused and expired pharmaceuticals needs to be introduced.

Examining Success Factors in Deprescribing Proposals from Community Pharmacists

Background: Polypharmacy is a critical issue that affects elderly people in particular. In Japan, fees to support deprescription are calculated bycommunity pharmacists who propose deprescribing 2 or more medications for patients prescribed 6 or more. However, the fees are rarely calculated.The objective of this study is toexamine success factors in deprescribing proposals submitted bycommunity pharmacists to prescribing doctors.Methods: Tracing reports submitted from Aug 2017 to Mar 2020 were investigated retrospectively to uncover factors that influenced the success of deprescribing using statisticalanalyses.Results:One hundred and twenty-three unique tracing reports were submitted to the prescribing doctors. Of these, 67 reports were successful in deprescribing and 56 failed; the success rate was 54.5%. Deprescribing proposals with existingunused medications significantly increased the deprescribing success rate. Possible adverse events, potentially inappropriate medications, and overlapping medications with the same effecttended to increase the success rate, but not significantly. Whether the pharmacist experienced face-to-face communication with the prescribing doctors did not significantly influence the outcome.Conclusions:Tracing reports with deprescribing proposals submitted by community pharmacists may help resolve problems arising frompolypharmacy. Mentioning unused medications could increase the deprescribing success rate.Trial registration: This study did not registered due to purely observational study.

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 < 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.

Lack of Awareness of the Impact of Improperly Disposed Of Medications and Associated Factors: A Cross-Sectional Survey in Indonesian Households

Introduction: Disposal of unused medications through environmentally unsafe routes is common in Indonesia. The lack of awareness of the impact of improperly disposed of medications is a significant contributing factor. The objectives of this study were to identify factors associated with lack of awareness of the impact of improperly disposed of unused medications and to assess the associations of awareness with medication disposal practices among the general population in Indonesia.Patients and methods: An observational cross-sectional survey was conducted using nonprobability sampling in Bandung, Indonesia, from November 2017 to January 2018 among respondents who were older than 18 years, had used any medication in the past, were literate, and had signed an informed consent document. Disposal practices and awareness regarding the impact of improperly disposed of unused medications were collected using an online- and a paper-based pre-validated questionnaire. The paper-based questionnaires were distributed to respondents in public places such as city center, markets, and religious places. Binary logistic regression was performed to assess associations of sociodemographic and other related factors with a lack of awareness. Odds ratios (ORs) with 95% confidence intervals (CIs) are reported.Results: Of 497 participating respondents, 433 and 64 respondents filled an online- or a paper-based questionnaire, respectively. Most respondents were female, aged between 18 and 30 years, and students/university students. Of 497 respondents, more than half (53.1%) were not aware that improper medication disposal could harm the environment and population health. Most respondents (79.5%) had never received information about proper medication disposal practices. The education level, the number of stored medications at home, and previous education about medication disposal practices were significantly associated with awareness of proper practices. In the multivariate analysis, only those with previous education about medication disposal practices were less likely to report a lack of awareness (OR: 0.043; 95% CI: 0.02–0.09). Respondents with a lack of awareness tended to dispose of their unused medications in the garbage or shared them with friends or relatives.Conclusion: There is a clear need to increase awareness of the importance of proper medication disposal practices, in particular among the student population of Bandung city, Indonesia. Healthcare providers can play an important role by educating this specific population on the proper disposal of unused medications.

Disposal practices of expired and unused medications among households in Mwanza, Tanzania

Background The community practice towards disposal of expired and unused medications in spite of its adverse impact have been widely neglected in many developing countries. The available guidelines in Tanzania focus on the disposal of expired medications and cosmetics in hospitals and community pharmacies only. Aim The aim of this study was to assess the disposal practice of expired and unused medications at household level in Mwanza city, north-western Tanzania. Methodology The household based cross-sectional study was conducted among 359 randomly selected household members. Semi-structured questionnaires were used for interview during data collection and while STATA® version 13 was used for analysis. Results Out 359 households visited, 252 (70.19%) had medications kept in their houses at the time of data collection. Among them, 10 (4.0%) households had kept medications at their houses because they were still continuing with treatment while 242 (96.0%) kept unused medications which were supposed to be discarded. The main reason for keeping unused or expired medications at home was uncompleted course of treatment (199 (82.20%) after feeling that they had recovered from illness. The main reason for discarding medications were recovering from illness (141(48.7%) and expiry (136 (46.9%). The major discarding practices for medications were disposing into domestic trashes (219 (75.5%) and pit latrines (45 (15.5%). Majority of respondents (273 (76%) were aware that improper disposal of expired medications are detrimental to human health and environment in general. Conclusion Improper disposal of unused and expired medications at household level was a common practice in the study area. Tailor-made interventions by the Food and Drugs Authority (FDA) and other national as well as local stake holders are urgently needed to address the situation.

Searching for Success Factors in Deprescribing Proposals from Community Pharmacists

BackgroundPolypharmacy is one of the most critical issues worldwide, especially in elderly people. In Japan, fees to support deprescription were established in 2018 which are calculated as the community pharmacists propose deprescribing in patients prescribed 6 or more medications regularly by submitting documents to the prescribing doctor, who may withdraw 2 or more medications. However, these are hardly calculated though many deprescribing proposals submitted.ObjectiveThe objective in this study, success factors in deprescribing proposals from the community pharmacists to prescribing doctors were searched for.MethodsTracing reports submitted from Aug 2017 to Mar 2020 were investigated retrospectively and factors that influenced the success of deprescribing were searched for.ResultsOne hundred and twenty-three tracing reports (67 reports of successful deprescribing and 56 reports of failure, success rate was 54.5%) were submitted to the prescribing doctors. Deprescribing proposals with existing unused medications or an assessment of possible adverse events significantly increased the deprescribing success rate. Whether the pharmacist experienced face-to-face communication with the prescribing doctors was not significant.ConclusionTracing reports with deprescribing proposals submitted by the community pharmacists may resolve polypharmacy. Mentioning unused medications or possible adverse events could increase the deprescribing success rate.

Effectiveness of an intervention to increase the knowledge, attitude, and practice regarding the return and disposal of unused medications

This study aimed to evaluate the effectiveness of an educational intervention (Safe D.U.M.P) to improve the knowledge, attitude, and practice regarding the return and disposal of unused medications. Community-dwelling adults in Malaysia who could understand English were recruited from two healthcare events. Participants were asked to fill out the validated Return and Disposal of Unused Medications (ReDiUM) questionnaire (pre-intervention), view six educational intervention posters on how to dispose of unused medications (Safe D.U.M.P), then answer the ReDiUM questionnaire immediately after viewing the posters (post-intervention). A total of 390 out of 456 participants participated (response rate=85.5%). Most were female (71%) with a median age of 42 years. The overall knowledge of participants significantly increased from 60% to 80% (p<0.001). However, no improvement was seen regarding their overall attitude and practice. This outcome was as expected as it may be more difficult to improve attitude and practice (when compared to knowledge) with a single educational session.

Prevalence and Practice of Unused and Expired Medicine—A Community-Based Study among Saudi Adults in Riyadh, Saudi Arabia

Purpose. The objective of the current study was to determine the prevalence and practice of unused and expired medicine among Saudi adults. Subjects and Methods. The study used cross-sectional web-based design to collect the data, over a period of 4 months among people who are living in Riyadh, Saudi Arabia. Results. A total of 337 questionnaires were obtained during the study period. The majority of respondents were university graduates n=251 (74.7%). The prevalence of unused medicine was n=301 (89.3%). The most commonly used drugs were nonsteroidal anti-inflammatory drugs n=272 (80.7%) and antibiotics n=164 (48.7%). Of the participants, 186 (55.2%) checked the expiry date of the medicine before they purchase. Most of them n=305 (90.5%) obtained medicine through prescription. About n=219 (65%) of them keep the medicine until it expired; 48.1% throw away in the household garbage while only 18 (5.4%) of the respondents said to give it back to the medical store. Conclusion. The study revealed a high prevalence of unused medications among Saudi community. However, the disposable practice among the Saudi community was inadequate. Increasing awareness through education programs about proper disposable guidelines is necessary for controlling the medication wastage.