Assessment of Pharmaceuticals Waste Practices Among Private Drug Retail Outlets in Ethiopia

Abstract

Background: Pharmaceuticals waste is a public safety concern, resulting in a possible accidental poisoning, misuse, and environmental pollution. Thus, appropriate disposal of the damaged and expired medicines would save lives and protect the ecological system. Objective: The study was aimed to assess knowledge, attitudes, and disposal practices of pharmaceuticals waste among practitioners in private retail outlets. Method: A facility-based descriptive cross-sectional study was conducted among private practitioners in retail outlets of Jimma city from November 20 to December 19, 2018. All private drug retail outlets and the respective staffs that fulfilled the eligibility criteria were included in the study. The data were collected using self-administrated questionnaires. Results: Of 106 questionnaires distributed to practitioners, 87 completed questionnaires returned, making a response rate of 82.1%. Fifty-nine (67.8%) of the participants reported that at least one type of damaged or expired medicines was present in their store. The main reasons for the damage or expiration include inappropriate storage practices, 32 (29.1%), and receiving medicines with a near expiration date, 42 (38.2%). Concerning knowledge about disposal practices, 70 (41.7%) and 47 (38.2%) of the participants, respectively, reported that safe disposal of damaged or expired medicines would prevent environmental pollution and illegal use. Regarding disposal practice, 47 (38.2%) of the respondents reported burning separately, and 24 (19.5%) of them reported burying underground. Fifty-two (59.8%) of the total participants strongly agreed that they had a responsibility to protect environmental pollution. Conclusions: The majority of the participants knew that the appropriate disposal of pharmaceuticals waste could protect human beings and ecological systems. However, a majority of the respondents disposed of the pharmaceuticals waste at the retail pharmacy.

Towards Medicines Reuse: A Narrative Review of the Different Therapeutic Classes and Dosage Forms of Medication Waste in Different Countries

“…In some of these studies, medication waste was returned by patients to community pharmacies, general practitioners’ clinics, hospitals or sometimes collected via medicine take-back and medicine waste campaigns. However, twenty nine (the majority) studies used a survey to collect information about the therapeutic classes and dosage forms of medication waste by asking participants for information without physically collecting the waste: six studies from Ethiopia [ 36 , 37 , 38 , 39 , 40 , 41 ], three from India [ 42 , 43 , 44 ], two from Malaysia [ 24 , 45 ], two from the USA [ 34 , 46 ], two from Jordan [ 47 , 48 ], two from Egypt [ 26 , 49 ], two from Thailand [ 20 , 50 ], one from Qatar [ 51 ], one from China [ 52 ], one from Iraq [ 53 ], one from Indonesia [ 54 ], one from Nigeria [ 55 ], one from Spain [ 56 ], one from Saudi Arabia [ 27 ], one from Tanzania [ 57 ], one from Malta [ 58 ], and one from Ghana [ 59 ]. The methodologies used and the targeted populations are summarised in Appendix A Table A1 .…”

“…Fifteen studies (36% of the retrieved studies) described the gender of the participants, and it was not apparent that there is a gender difference associated with the presence/reporting of medication waste. For example, more women took part in seven of the studies [ 20 , 38 , 45 , 52 , 54 , 56 , 57 ] and more men took part in eight of the studies [ 36 , 37 , 39 , 40 , 42 , 49 , 55 , 59 ]. In the study from Egypt [ 49 ], the number of people who returned their medication waste happened to be more male than female and one study from Malaysia [ 24 ] recruited female students only.…”

“…Eight studies out of the 42 (19%) reported that CVS medicines were the most common therapeutic category of medication waste [ 6 , 32 , 49 , 60 , 62 , 63 , 64 , 66 ]. Similarly, eight studies out of 42 (19%) reported that anti-infective medicines were the most common therapeutic category of medication waste [ 26 , 36 , 37 , 38 , 39 , 40 , 41 , 57 ]. CNS medicines were reported in five studies out of the 42 (12%) as the most common therapeutic category of medication waste [ 21 , 31 , 47 , 51 , 65 ].…”

“…In addition, the number of studies that investigated medication waste by therapeutic categorisation was more likely to be from a small number of countries. For example, seventeen studies out of forty-two (40%) were from four countries: the UK [ 6 , 13 , 62 , 64 ], Ethiopia [ 36 , 37 , 38 , 39 , 40 , 41 ], New Zealand [ 21 , 31 , 65 , 67 ], and the USA [ 25 , 34 , 46 ]. This makes reporting of the results by the number of studies less representative of the international literature.…”

“…Gudeta and Assefa [39] Jimma city, Ethiopia A cross-sectional study was conducted using semistructured questionnaires, which focussed on knowledge, attitudes, and disposal practices for unused and expired medications were used to collect data from respondents.…”