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      Knowledge and Disposal Practice of Leftover and Expired Medicine: A Cross-Sectional Study from Nursing and Pharmacy Students’ Perspectives

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          Abstract

          The objective of the present study was to investigate the knowledge and practices concerning unused and expired medicine among pharmacy and nursing students at King Saud University, Riyadh, Saudi Arabia. A cross-sectional study design was used. The study used a validated paper-based, self-administered questionnaire. Statistical analyses were performed using SPSS, Version 24. The response rate was 70.4% (n = 352). The results indicated that 57.4% of pharmacy students and 53.4% of nursing students check the expiry date of medicine before procuring, and 37.6% of pharmacy students and 52.5% of nursing students keep unused medicine until it expires. With regard to disposal, 78.9% of pharmacy students and 80.5% of nursing students reported discarding expired medicine in household garbage or flushing it down a sink or toilet. Only a small percentage returns leftover medicine to a medical store. There was a statistically significant difference between pharmacy and nursing students in regard to checking the expiry date of medicine before procuring ( p = 0.01), and keeping unused medicine until it expires ( p = 0.03). The study concluded that the majority of respondents dispose of medicine unsafely. The findings suggest that creating awareness regarding proper medicine disposal procedures among university health care students in Saudi Arabia is needed.

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          Disposal practices of unused and expired pharmaceuticals among general public in Kabul

          Background Most of the medicine users remain unaware about the disposal of unused or expired medicines. The aim of this study was to know the disposal practices of unused and expired medicines among the general public in Kabul. Methods This was a descriptive, cross-sectional survey, conducted through face-to-face interviews using prevalidated structured questionnaire. Returned questionnaires were double-checked for accuracy. Statistical Package for Social Science (SPSS) version 23 was used for statistical analysis. Results Total of 301 valid questionnaires were returned with a response rate of 100% in which 73.4% men and 26.6% women participated. More than half of the respondents were university graduates. Interestingly, 83.4% of the interviewees purchased medicines on the prescription of which 47.2% were university graduates, while 14.6% purchased medicine over the counter. Among the respondents, 46.5/100 purchased antibiotics and the remaining purchased NSAIDs, anti-hypertensive and anti-diabetic medicines. Significantly, 97/100 checked the expiry date of medicine before buying. Majority (95.3%) of the respondents’ stored medicines at home. 77.7% of the respondents discarded the expired medicines in household trash. Majority of respondents held government responsible for creation of awareness for proper medicine disposal. Almost entire sample (98%) felt that improper disposal of unused and expired medicines can affect the environment and health. Conclusion Gaps exist in practices, therefore robust, safe and cost-effective pharmaceutical waste management program supported with media campaign is needed. Healthcare practitioners and community pharmacists should offer training to educate customers on standard medicine disposal practices.
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            Public practice regarding disposal of unused medicines in Ireland.

            Over recent years, a global increase in the use of pharmaceutical products has been observed. EU directives state that "Member states shall ensure that appropriate collection systems are in place for medicinal products that are unused or have expired" (Directive 2001/83/EC and Directive 2004/27/EC).
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              An economic assessment of the extent of medication use and wastage among families in Saudi Arabia and Arabian Gulf countries.

              Expenditures for prescription and over-the-counter medications constitute a large percentage of total health care costs. Governments, health care providers, and consumers must work together to find ways to control these costs while continuing to provide quality health care for their nations. To this end, medication wastage is an unnecessary burden on an already fiscally restrained health care system. This study was conducted to identify the extent of medication use and wastage among families in the Arabian Gulf countries, with an emphasis on Saudi Arabia. A questionnaire was developed and administered to households in 5 regions in Saudi Arabia and other Gulf countries. A total of 1641 households participated in the study (1554 in Saudi Arabia; 87 in other countries). The mean (SD) family size of household respondents from Saudi Arabia was 6.60 (3.20) members, with 0.32% reporting no medicines present in the household, 81.8% of households reporting 5 or more medicines, and 29.9% of respondents reporting having at least 10 medications at home. Overall, the mean (SD) number of medicines per household in Saudi Arabia was 8.0 (4.3). The most common therapeutic classes of medications kept at home in Saudi Arabia were respiratory medications (16.8%), central nervous system agents (16.4%), and antibiotics (14.3%). The mean (SD) number of drug products unused, deteriorated, or expired was 2.2 (2.7) and 2.7 (1.9) per household in Saudi Arabia and other Gulf countries, respectively. From these data, mean medication wastage was estimated to be 25.8% (Saudi Arabia) and 41.3% (other Gulf countries). When analyzed on the basis of total medication cost, medication wastage was 19.2% and 25.0% in Saudi Arabia and other Gulf countries, respectively. The mean out-of-pocket expenditure (based on the percentage of annual income) for medications was 0.72% for households in Saudi Arabia compared with 0.48% in other Gulf countries. Families in Saudi Arabia and other Gulf countries spent a total of approximately US $150 million on medications that were never consumed. However, there appear to be no immediate solutions to the problem of medication wastage's impact on health care costs. The use of generic alternatives should be promoted, and drug use assessments should be implemented on a national level.
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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                20 March 2020
                March 2020
                : 17
                : 6
                : 2068
                Affiliations
                [1 ]Department of Nursing Administration and Education, College of Nursing, King Saud University, Riyadh 11362, Saudi Arabia
                [2 ]Department Clinical Pharmacy, Drug and Poison Information Centre, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia; wali@ 123456ksu.edu.sa
                Author notes
                [* ]Correspondence: abashatah@ 123456KSU.EDU.SA ; Tel.: +96-650-547-3496
                Article
                ijerph-17-02068
                10.3390/ijerph17062068
                7142560
                32244973
                fd78d9cf-c5a6-4ef0-a6f1-fce53b2adcab
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 16 February 2020
                : 18 March 2020
                Categories
                Article

                Public health
                expired,medicine,unused,nurses,pharmacist,saudi arabia
                Public health
                expired, medicine, unused, nurses, pharmacist, saudi arabia

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