Unused medications and disposal patterns at home: Findings from a Medicare patient survey and claims data

Maeng, Daniel; Snyder, Ryan C.; Medico, Charles J.; Mold, Winona M.; Maneval, James E.

doi:10.1016/j.japh.2015.11.006

Cited by 22 publications

(25 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Thus, we were particularly concerned to discover that less than 5% of families disposed of leftover medication, and that most families received minimal instruction regarding how to do so. Current practices for discarding unused medications at home often involve putting them in household garbage or flushing them down the toilet, 29 , however, the safety and appropriateness of these recommendations are questionable. 30 Further, suggestions that families return unused opioid to a police station or designated pharmacy are often impractical and not evidence-based in terms of effectiveness.…”

Section: Discussionmentioning

confidence: 99%

Opioid Prescribing for the Treatment of Acute Pain in Children on Hospital Discharge

Monitto

Hsu

Gao

et al. 2017

Anesthesia &Amp; Analgesia

120

View full text Add to dashboard Cite

Introduction The epidemic of nonmedical use of prescription opioids (NMUPO) has been fueled by the availability of legitimately prescribed unconsumed opioids. The aim of this study was to better understand the contribution of prescriptions written for pediatric patients to this problem by quantifying how much opioid is dispensed and consumed to manage pain following hospital discharge, and whether leftover opioid is appropriately disposed of. Our secondary aim was to explore the association of patient factors with opioid dispensing, consumption and medication remaining upon completion of therapy. Methods Using a scripted 10-minute interview, parents of 343 pediatric inpatients (98% post-operative) treated at a university children’s hospital were questioned within 48 hours and 10–14 days after discharge to determine amount of opioid prescribed and consumed, duration of treatment, and disposition of unconsumed opioid. Multivariable linear regression was used to examine predictors of opioid prescribing, consumption, and doses remaining. Results Median number of opioid doses dispensed was 43 (IQR, 30–85 doses), and median duration of therapy was 4 days (IQR, 1–8 days). Children who underwent orthopedic or Nuss surgery consumed 25.42 [95% CI, 19.16–31.68] more doses than those who underwent other types of surgery (p < 0.001), and number of doses consumed was positively associated with higher discharge pain scores (p = 0.032). Overall 58% [95% CI, 54%–63%] of doses dispensed were not consumed, and the strongest predictor of number of doses remaining was doses dispensed (p < 0.001). Nineteen percent of families were informed how to dispose of leftover opioid, but only 4% (8/211) did so. Discussion Pediatric providers frequently prescribed more opioid than needed to treat pain. This unconsumed opioid may contribute to the epidemic of NMUPO. Our findings underscore the need for further research to develop evidence-based opioid prescribing guidelines for physicians treating acute pain in children.

show abstract

Section: Discussionmentioning

confidence: 99%

Opioid Prescribing for the Treatment of Acute Pain in Children on Hospital Discharge

Monitto

Hsu

Gao

et al. 2017

Anesthesia &Amp; Analgesia

120

View full text Add to dashboard Cite

show abstract

“…[8,12,20,21,22] Content validation of the questionnaire was carried out by 5 pharmacists who had experience in running MRP. Questionnaire content was edited according to their feedback.…”

Section: Methodsmentioning

confidence: 99%

Utilization of Ministry of Health Medication Return Programme, Knowledge and Disposal Practice of Unused Medication in Malaysia

Yang¹,

Tan²,

Goh³

et al. 2018

JPPCM

View full text Add to dashboard Cite

Objective: (1) To report the awareness on MRP and its utilization rate. (2) To assess environment awareness with regards to improper disposal. (3) To explore practices toward unused medication. Methods: A cross-sectional study was conducted in 33 out-patient pharmacies in Sabah healthcare facilities. Quota sampling was used to recruit 244 subjects. Data collector from each facility was identified and trained prior to data collection. Self-reporting questionnaire captured data of socio-demographic, awareness on MRP and patient's knowledge and practice towards unused medication. Independent t-test and chi square test were performed to detect differences and association. Result: Subject mean (SD) age was 45.1(15.5) years and almost two-third (60%) of the subjects were female. Majority (73%, 95%CI 67-78%) knew that inappropriate disposal of medication will cause environmental hazard. Only 54% (95% CI 47-60%) had heard of MRP, 26% (95%CI 21-32%) had utilized MRP to return unused medication.Subject's awareness on environmental hazard and MRP were associated with their practice to return unused medication (p=0.001 and p<0.001 respectively). Mean years of education and median family income were significantly different between the aware and unaware group respectively [11.3(6.0) vs 8.9(4.5) yrs, p=0.003; RM2000 vs RM1260, p<0.001]. The most common unused medication were analgesics (27.1%), antihypertensive (24.4%), antiglycemic (14.7%) and supplements (12%). The two predominant methods to "dispose" unused medication at home were through garbage (47.8%) and return to healthcare facilities (30.0%). Conclusion: This study has established the evidence for public awareness on MRP, environment awareness and disposal practice of Malaysian citizen. Creative and innovative recommendations have been made for MRP promotion and to improve public knowledge on safety disposal of unused medication.

show abstract

“…However, despite the recent increase in and reported efficacy of drug take-back programs, recent studies suggest that the mere presence of such programs is not sufficient. Many individuals continue to employ incorrect drug disposal methods, which can largely be attributed to a lack of education on safe disposal practices [44][45][46]. Overall, we propose that reduced prescription and OTC drug abuse hinges on a combined effort that integrates education, growth and expansion of drug disposal programs, and elimination of environmental stressors (refer to and OTC drugs as well as safe methods of drug disposal.…”

Section: Discussionmentioning

confidence: 96%

“…Silvestre et al [45] also surveyed patients receiving opioids and found that only 13% had received education on safe opioid disposal and 77% indicated the presence and improper storage of unused opioids at home. Maeng et al [46] conducted a telephone survey of 721 Medicare adults in central Pennsylvania on their unused medication disposal patterns. While 11% of unused medication was disposed of through drug take-back programs, 14% of unused medication was disposed of in the trash, 9% was flushed down the toilet and 55% remained in a household cabinet.…”

Section: Proper Drug Disposal As a Mechanism For Changementioning

confidence: 99%

Proper Drug Disposal: Studying a Solution to Household Prescription and Over-the- Counter Drug Abuse

Kinrys¹,

Gold²,

Nierenberg³

2016

J Drug Abuse (edi(n))

View full text Add to dashboard Cite

For the average American, prescription and over-the-counter drugs are a standard component of a daily health regimen with 35% of American adults consuming over-the-counter (OTC) medicines on a daily basis [1] and 48.7% of Americans reporting use of at least one prescription drug in a 30 day period [2]. Data indicate that OTC medications serve a crucial role in helping treat a host of common health problems such as pains, aches, sprains, and rashes [1,3] with 81% of adults utilizing OTC medications as a first response treatment for common medical symptoms [4]. With OTC sales at approximately 31 billion dollars in 2014, OTC drugs importantly provide low-cost treatments to individuals in underserved communities [4].In a thirteen-year span from 1999 to 2012, prescription drug use in the United States demonstrated a notable increase [5]. Using data from the National Health and Nutrition Examination Survey, Kantor et al. [5]. found that 51% of US adults reported use of any prescription drug from 1999 to 2000 while 59% reported use of any prescription drug from 2011-2012. A recent Mayo Clinic study estimated that 70% of Americans are on at least one prescription drug [6].Widespread prescription and OTC medication use in the United States has produced an environment in which drugs are highly present and, thus, readily accessible to any given individual [7]. This ease of access is reflected in many areas. First, OTC drugs can be easily purchased in pharmacies and drug stores. Further, many individuals have access to expired or unused drugs in their home cabinets [8,9]. These avenues create opportunities for individuals to share excess drugs with friends and family members or to consume the drugs themselves. In many cases, these medications are not consumed as prescribed -specifically, they are consumed at higher doses or by non-intended recipients [10,11]. Thus, high accessibility can, in turn, contribute to misuse and abuse of prescription and OTC drugs [12]. Proper Drug Disposal: Studying a Solution to Household Prescription and Over-theCounter Drug Abuse AbstractWith 6.5 million Americans misusing a prescription drug in 2014 and 12% of American teenagers indicating lifetime use of over-the-counter cold medicine or cough syrup for getting high, misuse and abuse of prescription and over-thecounter drugs remains a major problem in the United States. Prescription and over-the-counter drug abuse often results from unused or unwanted medications remaining in the household cabinet. A potential solution to this problem lies in drug take-back programs which allow individuals to bring unused medications back to designated facilities for safe and proper disposal. In this commentary, we discuss the current state of drug take-back programs and their relevance to prescription and over-the-counter drug abuse. We conclude with suggestions on future directions in drug disposal that can help fight against prescription and overthe-counter drug abuse.

show abstract

Unused medications and disposal patterns at home: Findings from a Medicare patient survey and claims data

Cited by 22 publications

References 14 publications

Opioid Prescribing for the Treatment of Acute Pain in Children on Hospital Discharge

Opioid Prescribing for the Treatment of Acute Pain in Children on Hospital Discharge

Utilization of Ministry of Health Medication Return Programme, Knowledge and Disposal Practice of Unused Medication in Malaysia

Proper Drug Disposal: Studying a Solution to Household Prescription and Over-the- Counter Drug Abuse

Contact Info

Product

Resources

About