Ecopharmacovigillance aspect of unwanted and expired medications in Sulaimani, Kurdistan Region, Iraq
Keywords:Medication disposal, Expired medication, Community pharmacy, Safety
Background and objective: Unwanted and expired medications are accumulated at the homes and the community Pharmacies due to many reasons. Improper disposal and its hazardous impact on the environment is one of the major issues. This study aimed to identify the currently followed methods of disposing expired/unused medications at the homes and the community pharmacies and to report the response of the pharmacists regarding disposal of medications in Sulaimani city.
Methods: This study was carried out between July 2015 and February 2016. A total of 145 houses and 62 pharmacies were observed utilizing a self-administered questionnaire. All expired/unwanted drugs were quantitatively analyzed.
Results: The results revealed that 95.2% of respondents throw away their unwanted pharmaceuticals in the garbage. Around 41% of respondents showed their awareness of the potential harm to the environment by improper disposal of medication while 59.3% were unaware. Most participants (91%) believed that returning expired/unused medications to a community pharmacy is a proper way for disposal of them. Around 39% of the community pharmacies throw away the expired medications in the garbage, while 46.8% of them returned them to the suppliers. Additionally, 58.1% of the community pharmacists agreed to use their workplace as a collection point for collecting expired/unused medications.
Conclusion: High amount of expired/unused medications were kept in the households that necessitate establishing a procedure for disposal that ensures safety to human and environment. There was good interest in the collection of unused medications for proper disposal in the community pharmacies.
Gray-Winnett MD, Davis CS, Yokley SG, Franks AS. From dispensing to disposal: the role of student pharmacists in medication disposal and the implementation of a take-back program. J Am Pharm Asso 2010; 50(5):613-8.
Smolen A. Role of the pharmacist in proper medication disposal. US Pharm 2011; 36:52-5.
El-Hamamsy M. Unused medications: How cost and how disposal of in Cairo, Egypt. IJPSR 2011; 2:21-7.
Kuspis A, Krenzelok P. What happens to expired medications? A survey of community medicine disposal. Vet Hum Toxicol 1996; 38:48-9.
Atinafu T, Takele A, Kassie A, Yehualaw A, Tesfaw G, Desseno T, et al. Unused medications disposal practice: The case of patients visiting university of gondar specialized teaching hospital, Gondar, Ethiopia. IJPSR 2014; 5:999-1005.
Glassmeyer ST, Hinchey EK, Boehme SE, Daughton CG, Ruhoy IS, Conerly O, et al. Disposal practices for unwanted residential medications in the United States. Environ Int 2009; 35(3):566-72.
Daughton CG, Ruhoy IS. The afterlife of drugs and the role of pharmecovigilance. Drug Saf 2008; 31:1069-82.
Woodhouse B. Pharmaceuticals and other waste water products in our waters: a new can of worms? Southwest Hydrology 2003; 30:12-3.
Stackelberg PE, Furlong ET, Meyer MT, Zaugg SD, Henderson AK, Reissman DB.Persistence of pharmaceutical compounds and other organic wastewater contaminants in a conventional drinking water treatment plant. Sci Total Environ 2004; 329:99-113.
Kumar R, Somrongthong R, Shaikh BT. Effectiveness of intensive healthcare waste management training model among health professionals at teaching hospitals of Pakistan: a quasi-experimental study. BMC Health Serv Res 2015; 15:81.
Jarvis CL, Seed SM, Silva M, Sullivan KM. Educational campaign for proper medication disposal. J Am Pharm Assoc 2009; 49:65-8.
Prakash V, Green RE, Pain DJ, Ranade SP, Saravanan S, Prakash N, et al. Recent changes in populations of resident Gyps vultures in India. J Bombay Nat Hist Soc 2007; 104:129-35.
Velo G, Moretti U. Ecopharmacovigilance for better health. Drug Saf 2010; 33(11):963-8.
Charles PG, Grayson ML. The dearth of new antibiotic development: Why we should be worried and what we can do about it. Med J Aust 2004; 181:549-53.
Tong AY, Peake BM, Braund R. Disposal practices for unused medications in New Zealand community pharmacies.J Prim Health Care 2011; 3(3):197-203.
Auta A, Omale S, Shalkur D, Abiodun AH. Unused medicines in Nigerian households: Types and disposal practices. J Pharmacol Pharmacother 2011; 2:195-6.
Law AV, Sakharkar P, Zargarzadeh A, Tai BW, Hess K, Hata M, et al. Taking stock of medication wastage: Unused medications in US households. Res Social Adm Pharm 2015; 11(4):571-8.
Ruhoy IS, Daughton CG. Beyond the medicine cabinet: An analysis of where and why medications accumulate. Environ Int 2008; 34:1157-69.
Abahussain EA, Waheedi M, Koshy S. Practice, awareness and opinion of pharmacists toward disposal of unwanted medications in Kuwait. Saudi Pharm J 2012; 20(3):195-201.
Joss A, Zabczynski S, Gobel A, Hoffmann B, Loffler D, McArdell CS, et al. Biological degradation of pharmaceuticals in municipal wastewater treatment: Proposing a classification scheme. Water Res 2006; 40:1686-96.
McKie MJ, Andrews SA, Andrews RC. Conventional drinking water treatment and direct biofiltration for the removal of pharmaceuticals and artificial sweeteners: A pilot-scale approach. Sci Total Environ 2015; 544:10-17.
Coma A, Modamio P, Lastra CF, Bouvy ML, Marino EL. Returned medicines in community pharmacies of Barcelona, Spain. Pharm World Sci 2008; 30:272-7.
Tong AYC, Peake BM, Braund R. Disposal practices for unused medications around the world. Environ Int 2011; 7(1):292-8.
Aditya S. Safe medication disposal: Need to sensitize undergraduate students. Int J Pharm Life Sci 2013; 4:2475-80.
Seeheusen DA, Edwards J. Patient practices and beliefs concerning disposal of medications. J Am Board Fam Med 2006; 19:542-7.
Auta A, Banwat SB, Sarien CN, Nasara B, Atuluku MO. Medicines in pharmacy students’ residence and self-medication practices. J Young Pharm 2012; 4:119-23.
Abahussain EA, Ball DE, Matowe WC. Practice and opinion towards disposal of unused medication in Kuwait. Med PrincPract 2006; 15(5):352-7.
Ali SE, Ibrahim MI, Palaian S. Medication storage and self-medication behavior among female students in Malaysia. Pharm Pract 2010; 8:226-32.
Persson M, Sabelstrom E, Gunnarsson B. Handling of unused prescription drugs, knowledge, behavior and attitude among Swedish people. Environ Int 2009; 35(5):771-4.
How to Cite
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The copyright on any article published in Zanco J Med Sci is retained by the author(s) in agreement with the Creative Commons Attribution Non-Commercial ShareAlike License (CC BY-NC-SA 4.0).