Medication Wastage and its Disposal Amongst Patients at Suri Seri Begawan Hospital in Brunei Darussalam

Nowadays, the contamination caused by emerging pollutants is a global concern due to the lack of scientific evidence to demonstrate the risk or toxicity to humans due to the presence of pharmaceutical residues in the environment. This study aimed to identify and describe the disposal practices of unused and unwanted medications, as well as to analyze and identify the most frequent drugs determined on water bodies adjacent to the biggest urban population in Mexico. A two-phase study with an epidemiological and an ecological assessment was performed. The epidemiological phase was carried out with a descriptive cross-sectional study among citizens from Mexico City and the metropolitan area using an electronic survey applied to 719 subjects aimed to assess practices in which pharmaceutical products are disposed. The ecological phase included a review of scientific reports. The results show that nearly 83.5% of those surveyed use inappropriate practices for disposal medicines, the main ones are through the municipal dump or directly in the drain. The ecological approach was carried out by a systematic literature review of original reports published between 2013 to 2023; information about the class of drugs, active substance, environmental compartments, location, and concentration was extracted and presented. Fifty-one different types of pharmaceutical residues were detected in wastewater in Mexico City in the last decade. The results of this study can contribute to the application of public policies for waste management authorities to mitigate the socio-environmental risks due to the inappropriate disposal of medicines.

Section: Discussionsupporting

confidence: 88%

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

Benitez-Rico

Pérez-Martínez

Muñóz-López

et al. 2023

“…Brunei Darussalam is a small country with a population of 453,600, according to 2020 estimates [ 23 ]. The country offers a single-payer system of universal healthcare, with its health services and funding mainly financed by the central government [ 24 ]. Even though free medical treatment and medication are provided, the general public sometimes practices self-medication for minor ailments, primarily with leftover medicines at home or medicines bought directly from pharmacies or grocery stores [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Over-the-Counter Medicine Attitudes and Knowledge among University and College Students in Brunei Darussalam: Findings from the First National Survey

Abdullah

Chaw

Koh

et al. 2022

Over-the-counter (OTC) medicine is defined as safe and effective for the general public to use, without seeking therapy from a health professional. As primary social media and internet users, university and college students are more likely to be exposed to unverified sources of health information. This study aims to assess the knowledge, attitudes, and behaviour of students at institutions of higher learning in Brunei with regard to the safe use of OTC medicines. A cross-sectional study was performed using a self-administered online questionnaire, adapted from the literature with additional information from the United States Food and Drug Administration (FDA) on the educational resources in understanding OTC medicine for consumers. The questionnaire consisted of 4 sections: demographic information, knowledge of OTC medicines, attitudes, and practice. Descriptive and inferential statistics were used for data analysis. A total of 335 students returned a completed questionnaire. The students had a mean knowledge score of 7.1 out of 9, with more than half (53.4%) having good knowledge (knowledge score > 7), and only a small percentage (5.7%) with poor knowledge. Almost all of the students (99.7%) had a positive attitude toward OTC medicine use. Few of the students practiced improper habits in terms of OTC medicine use, such as not reading the instructions or taking more than the recommended dose. Awareness of proper OTC medicine use among students in institutions of higher learning is necessary to prevent the rise of inappropriate user practices.

“…There is a full ten-year record (2006–2016) of returned medicines from hospital wards and inpatient pharmacies from the main tertiary hospital in Brunei. Out of the total USD 2.7 million worth of returned medications, 53.8% were eventually reused; hence approximately USD 127k of medication is wasted per year [ 1 , 2 ]. As a matter of fact, the Ministry of Health of Brunei Darussalam’s annual expenditure has reached USD 176k for medical and pharmaceutical products, as stated in the recent database of 2020 [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

“…Medication wastage has been an issue that has been increasing over the years and is widely reported in the literature, exposing the need to address this issue [ 1 , 2 ]. It was accentuated by the World Health Organization (WHO) that fifty percent of the medications supplied were neglected and wasted [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Economic Analysis of Patient’s Own Medication, Unit-Use and Ward Stock Utilization: Results of the First Pilot Study

Nasir

Goh

Wee

et al. 2022

Background: Medication wastage is causing a cost burden to the healthcare system that is worth millions of dollars. An economic and ecological friendly intervention such as using a patient’s own medications (POM) has proven to reduce wastage and save the cost spent by the hospital. The potential benefits of using POM in inpatient settings have yet to be explored in a country with universal health coverage. This study aimed to pilot test the POM intervention in an adult ward setting and to perform the economic analysis of using POM and ward stock during hospitalization. Methods: A prospective cross-sectional observational study was conducted among the patients admitted to the medical and surgical wards in a public hospital located in Brunei Darussalam between February 2022 and April 2022. Hospitalized adults above 18 years old with regular medications with a minimum length of stay of 48 h and a maximum length of stay of 21 days were included in the study. These eligible patients were divided into a POM group and a non-POM group. The economic analysis of using POM was performed by calculating the direct cost per unit of medication used during admission (from unit-use, ward stock and POM) and comparing the cost spent for both groups. Expired ward stock deemed as medication wastage was determined. Medical research ethics were approved, and all participating patients had given their written informed consent before enrolling in this study. Results: A total of 112 patients aged 63.2 ± 15.8 years participated in this study. The average cost of medication supplied by the inpatient pharmacy for the non-POM group was USD 21.60 ± 34.20 per patient, whereas, for the POM group, it was approximately USD 13.00 ± 18.30 per patient, with a mean difference of USD 8.60 ± 5.17 per patient (95% CI: −3.95, 27.47, p ≥ 0.05). The use of POM minimized 54.03% (USD 625.04) of the total cost spent by the hospital for the POM group within the period of the study. Conclusion: The pilot study showed that the supplied medication cost per patient was not significantly different between the POM and non-POM groups. Nevertheless, the utilization of POM during hospitalization is capable of reducing at least 50% of the total cost spent on inpatient medications by the hospital. The use of POM during hospitalization also helped in reducing the total time spent on the medication process per patient.