Special Issue "Medication Wastage"

A special issue of Pharmacy (ISSN 2226-4787).

Deadline for manuscript submissions: closed (31 March 2019).

Special Issue Editors

Prof. Dr. Derek Stewart
Website
Guest Editor
School of Pharmacy and Life Sciences, Robert Gordon University, Garthdee Road, Aberdeen AB10 7GJ, Scotland, UK
Interests: research focuses on developing, implementing and evaluating models of care and the safe and effective use of medicines; specific areas of interest are around: non-medical prescribing; use of medicines in older people; medication safety; and medication wastage
Dr. Lorna Marie West

Guest Editor
Department of Clinical Pharmacology and Therapeutics, University of Malta, Msida, Malta
Interests: beliefs about medicines; health beliefs; medication adherence; medication education; medication wastage; quality improvement measures in relation to enhanced value and wastage minimization in pharmacy processes

Special Issue Information

Dear Colleagues,

The scope of this Special Issue is to consider medication wastage, not only as the stockpiling, by patients, of unused medication which will eventually expire, but also as a problem which goes beyond simply stockpiling. The issue of medication wastage pertains, not only to patients within households, but can even be prompted by healthcare professionals and is encountered in many settings, including community and hospital pharmacies, doctor clinics, as well as hospital wards, amongst others. Therefore, medication wastage should not be considered a problem of the individual, but should be regarded as an issue which effects the healthcare system and society as a whole. The repercussions of medication wastage are multiple and can include financial, environmental, and safety issues. Medication wastage reduction approaches should be adopted whenever possible to ensure sustainability of important but limited resources. However, such approaches face multiple challenges, and at times could be counterproductive if not thought out adequately.

We encourage you to present, within this Special Issue, your research, including reviews, in relation to behavior and practices leading to medication wastage and highlight successful medication wastage reduction approaches. Opinion papers are also welcome. It is our wish that this Special Issue instigates awareness about medication wastage amongst healthcare professionals, especially pharmacists, in all settings. Successful interventions could also be replicated or adapted by healthcare professionals to mitigate medication wastage whenever possible.

Prof. Dr. Derek Stewart
Dr. Lorna Marie West
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Pharmacy is an international peer-reviewed open access quarterly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1000 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • expired medication
  • interventions
  • medication wastage
  • strategies
  • unused medication
  • wastage reduction
  • wastage minimization

Published Papers (4 papers)

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Research

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Open AccessArticle
Pharmacists’ Knowledge Regarding Drug Disposal in Karbala
Pharmacy 2019, 7(2), 57; https://doi.org/10.3390/pharmacy7020057 - 10 Jun 2019
Cited by 1
Abstract
Background: Consumers and caregivers should remove expired, or unwanted, medications to minimize the chance for misuse or accidentally using those medicines. This study investigated pharmacists’ knowledge regarding drug disposal in Karbala, Iraq. Methods: This study was a cross-sectional survey among pharmacists [...] Read more.
Background: Consumers and caregivers should remove expired, or unwanted, medications to minimize the chance for misuse or accidentally using those medicines. This study investigated pharmacists’ knowledge regarding drug disposal in Karbala, Iraq. Methods: This study was a cross-sectional survey among pharmacists in Karbala. It was performed from December 2018 until January 2019. A standardized, 12-item, self-administered questionnaire was designed, developed and validated to assess pharmacists’ knowledge when generating pharmaceutical waste in pharmacies. Results: One hundred twenty-nine participants enrolled in the study. The mean age of participants was 33 ± 9.3 years—more than two-thirds (65.9%)—agreed that the return of medications to the source would be appropriate drug disposal. A good proportion of participants agreed with disposing of drugs in the trash. Further, 63.6% believe that education is the main barrier opposing the implementation of a medicine–take–back program in Iraq. Conclusion: Pharmacists had relatively poor knowledge regarding drug disposal methods. Health care providers (not only pharmacists) need educational courses and workshops to improve their knowledge regarding medication disposal in Iraq. Full article
(This article belongs to the Special Issue Medication Wastage)
Open AccessArticle
Analysis of Disposed Unused Medications at a Village Community Pharmacy
Pharmacy 2019, 7(2), 45; https://doi.org/10.3390/pharmacy7020045 - 12 May 2019
Abstract
Background: The aim of this study was to determine the type, quantity, and cost of medications being disposed of by clients in a specifically-set pharmaceutical disposal bin at a village community pharmacy. Methods: Medicines placed in a medication disposal bin by clients were [...] Read more.
Background: The aim of this study was to determine the type, quantity, and cost of medications being disposed of by clients in a specifically-set pharmaceutical disposal bin at a village community pharmacy. Methods: Medicines placed in a medication disposal bin by clients were examined during a nine-month period from April to December 2018. The data recorded included the active ingredient, trade name, dose, dosage form, disposed quantity, and the actual expiry date on the pack. The medications were classified according to ATC (Anatomical Therapeutic Chemical Classification System) code, and the cost of the amount wasted was calculated using the pharmacy’s price list. Descriptive statistics were used to analyze the data. Results: A total of 411 medications were collected, amounting to a total cost of approximately €2600. The largest group of medications belonged to the alimentary group, and this also represented the group with the highest monetary value. The number of months that medicinal products were retained by patients beyond the expiry date ranged from 1 to 232. Conclusion: This small study provides a glimpse of what clients dispose of in a medication bin when this is readily available in their community pharmacy, a simple measure which, if adopted on a national level, could aid in ensuring the appropriate disposal of wasted medication. Full article
(This article belongs to the Special Issue Medication Wastage)
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Open AccessArticle
Pharmacists’ Activities to Reduce Medication Waste: An International Survey
Pharmacy 2018, 6(3), 94; https://doi.org/10.3390/pharmacy6030094 - 29 Aug 2018
Cited by 6
Abstract
Aim: To identify activities that pharmacists undertake to reduce medication waste, and to assess the extent to which these activities are implemented, their importance for waste-reduction and feasibility for broad implementation. Methods: A two-phase survey was conducted among community and hospital pharmacists working [...] Read more.
Aim: To identify activities that pharmacists undertake to reduce medication waste, and to assess the extent to which these activities are implemented, their importance for waste-reduction and feasibility for broad implementation. Methods: A two-phase survey was conducted among community and hospital pharmacists working in different developed countries. Phase one used an open-ended questionnaire to identify activities undertaken by pharmacists. Answers were thematically analysed to construct a list of medication waste-reducing activities. In phase two, a questionnaire was disseminated among pharmacists from different countries, to assess if these activities are implemented (yes/no), their importance and feasibility (1 to 5 ranking scale). Results: In phase one, 53 pharmacists participated and 14 activities were identified. These were categorized into the pharmaceutical supply chain: prescribing, dispensing (pharmacy/patient-related) and leftover stage. In phase two, 89 pharmacists participated. Most activities were implemented by a minority of pharmacists. Reducing medication amounts in stock was most frequently implemented (dispensing stage pharmacy-related; 86%), followed by collecting unused medications (leftover stage; 77%) and performing a medication review (dispensing stage; 68%). Waste-reducing activities in the dispensing stage activities were both considered most important and feasible (ranked 4). Overall, most activities scored higher on importance than on feasibility. Conclusions: Pharmacists have various opportunities to reduce medication waste throughout the pharmaceutical supply chain, however, not all are broadly implemented. Pharmacists consider waste-reducing activities important, but they are less certain about the feasibility for implementation in practice. Full article
(This article belongs to the Special Issue Medication Wastage)
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Review

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Open AccessReview
The Prevalence of Unused Medications in Homes
Pharmacy 2019, 7(2), 61; https://doi.org/10.3390/pharmacy7020061 - 13 Jun 2019
Abstract
The prevalence of unused medications in homes has dramatically increased in recent decades, which has resulted in medication wastage. The aim of this study is to review the prevalence of unused medications in homes and to determine the reasons behind this disuse, so [...] Read more.
The prevalence of unused medications in homes has dramatically increased in recent decades, which has resulted in medication wastage. The aim of this study is to review the prevalence of unused medications in homes and to determine the reasons behind this disuse, so as to help reduce such wastage. The review also sheds light on current methods of disposal of unwanted medications. Here, using a narrative review, we provide an overview of the issues of unused medications, medication wastage, and methods of disposal. We conducted an extensive literature search focusing on subject-related keywords, as given in the methods section below. A search was undertaken through indexing services available in the library of the authors’ institution. Full-text papers concerned with the prevalence of unused medications in homes, written in English language between 1992 and 2018, were retrieved and reviewed. Twenty-five related studies performed in different world regions were reviewed and included. The public, healthcare providers, and governments are all accused of promoting medication wastage in different ways, and thus, they need to be targeted to solve the problem. It was also noticed that the prevalence of unused medications is high in many countries. Non-steroidal anti-inflammatory drugs are among the most frequently wasted medications, and most of the public just dispose of their expired medications in the trash or toilet. Non-adherence, death, and medication change are among the main causes of medication accumulation and consequent wastage. A lack of policies to return unwanted medications in some countries, as well as public unawareness, carelessness, or illiteracy, are reasons for improper disposal of unused medications that may lead to adverse economic and environmental impacts. Various mitigation strategies (e.g., smart medicine cabinet) have emerged to reduce medication wastage. Joint work among the public, healthcare providers, and various governmental and private organizations is needed to adequately address the issue of medication wastage. Full article
(This article belongs to the Special Issue Medication Wastage)
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