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

Abstract

Background: Medicines are formulations for the prevention and treatment of diseases and symptoms. Pharmaceutical wastes are products of unused, damaged, and expired medicines (UEMs) which pose a disposal challenge globally. Previous studies have shown that environmental disposal of medicines has health and environmental consequences. Hence, this study aims to determine and compare the management of household UEMs in a heterogeneous municipality in southwest Nigeria.Methods: The study was comparative, cross-sectional in design. Multi-stage sampling identified respondents, who are females, experienced in the handling and safekeeping of medicines. The study sample was 404 and recorded a 93% response rate. Data were analysed by IBM-SPSS, version 20. Continuous and categorical variables were presented in tables as mean(±SD), proportions (%) while bar charts highlight salient findings. Differences between LDS and HDS values were determined by 𝝌2(Pα>0.05).Results: 53.4% and 71.2% of respondents respectively had good knowledge and positive attitudes to safe disposal of UEMs. At least 31.5% households do not stock medicines in homes while 1-2 sachets of antimalarial (57.3%), analgesics (52.7%) and antibiotics (49.7%) medicines were inventoried in households and significantly different between low-density (LD) and high-density (HD) settlements. 72.9% and 67.8%; 47.9% and 55.6% respondents in LD and HD settlements respectively disposed of household solid and liquid UEMs in thrash-bins, though 34.9% (LDS) and 16.7% (HDS) disposed of liquid UEMs in the toilet/sink. There were significant differences in medicines abundance and disposal practices between LD and HD settlements for solid and liquid medications. 37.1% of respondents perceived consequences for the current methods of disposing of UEMs, which include accidental ingestion (76.6% vs 26.7%) and land pollution (69.6% vs 36.7%) and water pollution (72.4% vs 32.8%) and drugs toxicity (58.3% vs 32.8%), respectively in LD and HD settlements.Conclusions: Respondents good knowledge and positive attitudes contrasted the poor UEMs disposal practice. Most of the households’ medicines were antimalaria and analgesics and there were disparities in the disposal of solid and liquid medicines, between LD and HD settlements, respectively. Appropriate legislation, compliance monitoring and enforcement are drivers to incentive-driven, sound recovery systems for UEMs to alleviate the consequences of current disposal practices in Nigeria.