Abstract
Objective To examine the types, quantities, and monetary value of drugs which are disposed of by patients of outreach pharmacists, and to describe the role of outreach pharmacists in promoting the safe disposal of drug waste and reducing medication cost. Setting An Outreach Medication Review service at a major public hospital in Melbourne, Australia. Methods Part of the service offered by outreach pharmacists in OMR at St Vincent’s Hospital Melbourne is to collect the medications that have expired, or are no longer needed by patients. This audit looked at all the items collected over a period of 2 months, July and August of 2008. We recorded the types of medication groups and the number of items in each of these groups. An estimate of the value of this medicinal waste was also made. Main outcome measure Measurable parameters were the number of medications collected in the various therapeutic groups, and an estimate of their monetary value. This served to provide an estimate of the total value of wasted medications. Results Medications collected fell into 11 therapeutic groups, with a total of 293 items collected. The largest number of medications belonged to the cardiovascular group. The number of patients seen was 40 patients, with each patient having an average of 7.3 items that are either expired or unnecessary. The estimated value of medicinal waste per patient is about AU$1308 annually. Conclusion Outreach pharmacists are in a good position to collect unnecessary medications, and to educate patients on the prudent use of government subsidy of medications. The economic ramification of medication disposal is significant, in terms of the cost of medications that end up not being used. Cardiovascular medications are the main group that end up being wasted, and is among the most expensive to subsidize. Further studies are needed to examine ways of minimising medication waste and reducing the cost of such wastage.
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References
Bound JP, Voulvoulis N. Household disposal of pharmaceuticals as a pathway for aquatic contamination in the United Kingdom. Environ Health Perspect. 2005;113:1705–11.
Kummerer K. Drugs, diagnostic agents and disinfectants in wastewater and water—a review. Series of the Association for Water, Soil, Air and Hygiene. 2000;105:59–71.
Bound JP, Kitsou K, Voulvoulis N. Household disposal of pharmaceuticals and perception of risk to the environment. Environ Toxicol Pharmacol. 2006;21:301–7.
Musson SE, Townsend T, Seaburg K, Mousa J. A continuous collection system for household pharmaceutical wastes: a pilot project. J Air Waste Manag Assoc. 2007;57:828–35.
Sorensen L, Stokes JA, Purdie DM, Woodward M, Roberts MS. Medication management at home: medication risk factor prevalence and inter-relationships. J Clin Pharm Ther. 2006;J31:485–91.
Kuspis DA, Krenzelok EP. What happens to expired medications? A survey of community medication disposal. Vet Hum Toxicol. 1996;38:48–9.
Butler CC, Rollnick S, Pill R, Maggs-Rapport F, Stott N. Understanding the culture of prescribing: qualitative study of general practitioners’ and patients’ perceptions of antibiotics for sore throats. BMJ. 1998;317:637–42.
Cockburn J. Pit S Prescribing behaviour in clinical practice: patients’ expectations and doctors’ perceptions of patients’ expectations—a questionnaire study. BMJ. 1997;315:520–3.
Expenditure and prescriptions twelve month to 30 June 2007. Data and modelling Section: Pharmaceutical Policy and analysis Branch, PBS. http://www.health.gov.au/internet/wcms/publishing.nsf/Content/pbs_expenditure_prescriptions-copy1. Accessed 17th July 2009.
Media Release “Vintage RUM!”. The national Return and Disposal of Unwanted medicines Limited; 2008. Accessed July 2009.
Guiding principles for medication management in the community—July 2006. Australian Government: Department of Health and Ageing. http://www.health.gov.au/internet/main/publishing.nsf/Content/nmp-guide-medmgt-jul06-contents~nmp-guide-medmgt-jul06-guidepr9. Accessed 17th July 2009.
Seehusen DA, Edwards J. Patient practices and beliefs concerning disposal of medications. J Am Board Fam Med. 2006;19:542–7.
Mackridge AJ, Marriott JF. Returned medicines: waste or a wasted opportunity? J Public Health. 2007;29:258–62.
Jorgensen T, Johansson S, Kennerfalk A, Wallander M, Svardsudd K. Prescription drug use, diagnoses, and healthcare utilization among the elderly. Ann Pharmacother. 2001;35:1004–9.
Collins M, Johnston A. Project Medicollect: an analysis of the drugs collected. Aust Prescr. 1992;11:341–4.
Isacson D, Olofsson C. Drugs up in smoke: a study of caseated drugs in Sweden. Pharm World Sci. 1999;21:96–9.
Hanlon JT, Fillenbaum GG, Ruby CM, Gray S, Bohannon A. Epidemiology of over-the-counter drug use in community dwelling elderly: United States perspective. Drugs Aging. 2001;18:123–31.
Mills E, Ernst E, Singh R, Ross C, Wilson K. Health food store recommendations: implications for breast cancer patients. Breast Cancer Res. 2003;5:R170–4.
Hawksworth GM, Wright DJ, Chrystyn H. A day to day analysis of the unwanted medicinal products returned to community pharmacies for disposal. J Soc Adm Pharm. 1996;13:215–22.
Sorensen L, Stokes JA, Purdie DM, Woodward M, Roberts MS. Medication management at home: medication-related risk factors associated with poor health outcomes. Age Ageing. 2005;34:626–32.
Balassa J. Brand confusion with digoxin. Aust Prescr. 2006;29:153.
Acknowledgement
The author wishes to acknowledge Nigel Ng, an OMR pharmacist, for his help in collecting, counting, and allocating medications into therapeutic groups.
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Guirguis, K. Medications collected for disposal by outreach pharmacists in Australia. Pharm World Sci 32, 52–58 (2010). https://doi.org/10.1007/s11096-009-9340-x
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DOI: https://doi.org/10.1007/s11096-009-9340-x