Logistics performance: critical factors in the implementation of end-of-life management practices in the pharmaceutical care process

Abstract

The management of healthcare waste and end-of-life medication coming from different sources are primary challenges faced by public health leaders. Several factors may be considered critical and inhibitive to reverse logistics within the context of waste management processes. If those factors are not addressed, they may become obstacles to reverse logistics implementation. The purpose of this study is to evaluate the effect that critical factors play in the adoption of end-of-life management practices for medication and its influence on logistics performance. Literature provided some critical factors: management factor, collaboration factor, information technology factor, infrastructure factor, politics factor, financial and economic factor, end-of-life management practices, and logistics performance factor. A sample of 67 professionals from the public pharmaceutical care process answered a structured questionnaire. The collected data was analyzed using partial least square-structural equation modeling. The theoretical structural test confirmed eleven out of the fifteen hypotheses considered. The results have indicated that end-of-life management practices exert a direct influence on logistics performance. The analysis confirmed a direct effect of the information technology factor on end-of-life management practices, but not a moderation effect. Findings have contributed to the literature by providing deeper insights into the relationship between end-of-life management practices for medicines and logistics performance. Moreover, it supports health managers’ decision-making in the pharmaceutical care process improvement and engagement with solid waste management policies. Supplementary Information The online version contains supplementary material available at 10.1007/s11356-022-24035-z.

Sustainability Assessment of Medicines Reverse Logistics in Brazil: Outcomes from the National and Local Systems

“…Finally, with respect to collection campaigns as a principle of the federal MRLS, it is noteworthy that they are mainly delivered by the retailers through the drugstore pharmacists, thus are limited in extent, which confirms gaps of information and collaboration in this RL system [17,37]. The municipal MRLS does not have campaigns as a principle, but local communities are mobilized to deliver the medicine schemes and integrate other public and private agents in task forces [68][69][70][71].…”

“…The majority of the studies in this field have been focused on understanding the factors that drive and constrain the reverse flows, and the optimization of reverse operations' efficiencies in supply chains [1][2][3]. Recently, approaches to RL have focused on the possibilities of circularity in the return of products and/or parts of products in diverse types of business sectors [24,25] including electronics [26][27][28], clothing [29,30], domestic solid wastes [31,32], packaging [33,34], and medicines [4,17,[35][36][37], amongst others. The main principles of RL have recently been clearly aligned with circular economy thinking that stimulates awareness of the supply chain stakeholders and the advantages of avoiding, reducing, reusing, refurbishing, and sharing products, and, where possible, optimizing the design stage of developing goods to facilitate more circularity during the use stage [25,38].…”

“…Recent research highlights that medicine reuse can be framed under the lenses of circular and sharing economies [14], although circularity is still far from reality in the MRLSs. Medicine sharing receives little attention in the academic literature [15,16]; although, a tendency to rethink this issue has been gradually detected in recent years, giving the consumers opportunities to express their opinions and needs [11,17,18]. Consumers have a decisive role in boosting circularity and sharing.…”

“…Brazil is one of the countries in which MRLSs are most studied [4][5][6], and in which the investigations keep showing recurring problems such as poor management, poor collaboration, political interference, and financial and economic constraints, amongst others [5,17,18]. Nonetheless, to the extent of our knowledge, there are no studies examining both national and local MRLSs in Brazil.…”