Improper disposal practice of unused and expired pharmaceutical products in Indonesian households

Abstract

Background Improperly disposed medicines could adversely affect the environment and increase the risk of drug misuse or accidental poisoning. Objective To evaluate the disposal practices of unused and expired medicines among the general population in Bandung, Indonesia. Method This was a descriptive cross-sectional survey conducted among 497 respondents in Bandung, Indonesia. Data were collected through interviews using a prevalidated structured questionnaire. Descriptive statistics were calculated using the Statistical Package for Social Science (SPSS) version 23. Ethics approval was obtained. Main outcome measure General public knowledge and attitude regarding unused and expired medication disposal practice. Results Approximately 95% of the respondents had unused medicines stored in their homes, with nonsteroidal anti-inflammatory drugs (NSAIDs), vitamins/nutritional supplements, and antibiotics were the most common types of medicines left unused. The majority of the respondents checked the expiration date of the drugs before purchasing (72.8%). The most common disposal method of unwanted medicines was throwing away in household garbage (82.1%). A significant percentage of them never received information about proper medication disposal practice (79.5%). Furthermore, more than half of the respondents were unaware that unsafe medication disposal practices could harm the environment and population health (53.1%). Conclusion Disposal of unwanted pharmaceutical products through environmentally unsafe route was prevalent among the respondents. There is also a lack of awareness of the impact of improperly disposed of medicines for the ecosystem. These findings call upon the strategies to strengthen the pharmaceutical waste management program.

The Perception and Disposal Practices of Unused And Expired Medicines By Households In an Urban Municipality, Southwest Nigeria: A Comparative Cross-Sectional Study.

“…This also agrees with ndings in Brazil [49] and Ethiopia [26,27]. [26,28]. Also, antimalarial, analgesics and antibiotics were predominantly stored by households.…”

“…Medicines expiry is the date provided on them that guarantees their full potency and safety under good manufacturing practices and several of them, such as vaccine vials, insulin and nitro-glycerin degenerate on expiry [47,48]. Our study revealed that many households con rmed medicines expiry on prescription and OTC drugs, as previously reported [7,9,25,28]. This could be attributed to the awareness created over the years on the need to ensure that medicines are still within the expiry dates before use.…”

“…This may be responsible for the observations by Barnett-Itzhaki et al that large amounts of expired and unused medications accumulate in households [4]. It can, therefore, be hypothesized that people use, and complied with, a drug regimen, in most cases when prescribed as part of treatment by healthcare professionals with the tendency of those acquired through self-medication largely responsible for UEMs at the household level, as observed in Indonesia [28]. The abundance of UEMs in homes was due to non-compliance (56.8%) with the prescribed drug use regimen, due to feeling of recovery and the emergence of side effects [28][29][30].…”

“…It can, therefore, be hypothesized that people use, and complied with, a drug regimen, in most cases when prescribed as part of treatment by healthcare professionals with the tendency of those acquired through self-medication largely responsible for UEMs at the household level, as observed in Indonesia [28]. The abundance of UEMs in homes was due to non-compliance (56.8%) with the prescribed drug use regimen, due to feeling of recovery and the emergence of side effects [28][29][30]. This observation was consistent with the study ndings in Ethiopia where mostly due to recovery/disappearance of disease symptoms in most cases [27].…”

“…A few respondents have seen advertorials on the safe management of damaged and expired medicines through the news and electronic media, indicting a poor public awareness on disposal guidelines for unused, damaged and expired medicines [26,27,53]. In another study, respondents attested to paucity of information on disposal of UEMs [28,54]. Just as the management of healthcare wastes are not regulated in many countries at the household level [55], there is no protocol either by NAFDAC or NESREA to guide home management of damaged and expired medications in Nigeria, and thus, contributing to the ignorance of households in LDS and HDSs in the study area.…”