Medication Disposal; Household Practices in Karachi, Pakistan. Need for a Medication Take-Back Program

Abstract

ABSTRACT… Introduction: Due to irresponsible and unsafe methods of drug disposal employed by consumers pharmaceutical waste enters the ecosystem, ultimately having a detrimental effect on both human health and environment. Objectives: The purpose of the study is to measure attitude and practice of local community in Karachi, Pakistan regarding safe disposal of unwanted medicines and assess willingness of participants to take part in a medicationtake-back program. Study Design: A two-phase observational study was conducted using convenience sampling. Period: January to February, 2016. Methodology: In Phase I (n = 200) students enrolled in various health sciences institutions in the study were asked to take part in the survey. In Phase II(n = 300) household consumers were contacted by telephone and social media. Results: Participants (response rate 84.4%) were given a questionnaire to explore their attitudes towards medicine disposal. More than half of the consumers surveyed reported storing unused/expired medications in their homes, and majority threw away unwanted medicine in the garbage. The most common reason was unawareness of expiry date (32.7%). Only 12.32% reported returning medication to a pharmacy for disposal. Majority of the consumers had never received advice about medication disposal by a health care provider but were aware of the possible negative consequences and were willing to participate in national pharmacy take-back programs if implemented by the government. Conclusions: Our findings suggest that effective communication and established protocols will promote appropriate disposal practices. Public services in Pakistan, and especially pharmacies, must play a more proactive role in this regard.

Medical Household Waste as a Potential Environmental Hazard: An Ecological and Epidemiological Approach

“…The results show that nearly 83.5% of those surveyed disposed of their pharmaceutical products in an incorrect way. The main method used to dispose of them is in the municipal dump, directly in the drain, or burning them, which is in accordance with some other reports [ 34 , 35 , 36 , 37 , 38 ], with very low awareness (10.5%) of them knowing how the medical drugs can be properly disposed, as reported previously [ 38 , 39 ].…”

Pharmacy Services beyond the Basics: A Qualitative Study to Explore Perspectives of Pharmacists towards Basic and Enhanced Pharmacy Services in Pakistan

“…Pakistan is struggling with a number of threats to the optimal use of medicines, including high prevalence of medication errors (causing deaths of 0.5 million people annually [13]) and adverse drug reactions (detected in 60% adults and 40% children [14]), misuse of controlled substances (by 6.7 million individuals [15]), and excessive self-medication [16]. There is also a growing list of medicine-related issues that demand immediate participation of pharmacists in the patient's welfare, including over-the-counter (OTC) availability of prescription medicines, inappropriate use of medicines, formulation issues, unsafe storage and disposal of medicines, and poor availability of medicines [16][17][18][19][20][21]. Additionally, poor health in the female population, elderly, and medically underserved rural populations in Pakistan need scalable and affordable community pharmacy services, such as health screening (e.g., diabetes, cholesterol, osteoporosis), timely immunizations, pain control, and home-based care delivery and family planning services [22,23].…”