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

Abstract

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.

Knowledge, attitude and disposing practice of unused and expired medicines among the general public in Malaysia

“…On the contrary, respondents who were not aware of appropriate disposal methods tend to dispose of unused medicines in the rubbish bin, flushing down the toilet or pouring down the sink. The study finding is consistent with the other studies which showed that knowledge and environmental awareness play an important role in the practice of disposing of unwanted or unused medicines.…”

“…In fact, in the year 2010, Medication Return Program (MRP) has been introduced by the Pharmaceutical Service Division, Ministry of Health Malaysia as an effort to provide a safe place for the public to dispose of unused medicines . Apparently, the service is not well known to the public as the recent study in Sabah, Malaysia, also showed that only half of the respondents had heard about MRP service provided by the pharmacy department and therefore the low utilization rate of the service . The study suggested that, if the public is more aware of the MRP, they would be more likely to opt for this method of disposing of unwanted medicines as there was a significant association between awareness and use of MRP .…”

“…Dispose of unwanted medicines in the rubbish bin is the most popular method used for liquid, tablets/capsules and ointments/creams medicines in the current study. This was also the top choice in other studies conducted in Malaysia and other countries such as Indonesia, Thailand, India, Afghanistan, Pakistan, Saudi Arabia, Kuwait and Qatar . This may be due to rubbish bin disposal is the most convenient and easiest way for the public.…”

“…Contrary to the growing number of data on disposal patterns of unwanted medicines in developed countries, there is still a lack of research into Malaysians' knowledge of and understanding of the environmental issues arising from improper disposal of unused medicines, as well as their attitude and disposal practices of household medicines. While some previous studies gave some insight, these studies also restricted the collection of data to particular university, group or state with instruments not previously validated in the population of Malaysia . The aim of this study was therefore to obtain a more comprehensive picture from the public across Malaysia with a pre‐validated questionnaire in order to understand their knowledge, attitude and practice of disposing of unwanted medications.…”

Investigation and Analysis of Medication Disposal in Hospitals and Community Pharmacies in Taiwan

“…Aware of these environmental issues, a number of countries have developed waste drug recycling mechanisms. For example, community pharmacies in the United States, Sweden, France, Italy, and Malaysia are responsible for the collection of discarded drugs [18][19][20][21], and pharmacists also provide information about safe disposal of medications. In 2010, the U.S. Drug Enforcement Administration (DEA) even initiated a National Prescription Drug Take-Back Day, in response to growing public concern over improper disposal of unused, unwanted, or expired (UUE) medications [18].…”