Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2017

Open Access 01-12-2017 | Research article

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

Authors: Mohammad Bashaar, Vijay Thawani, Mohamed Azmi Hassali, Fahad Saleem

Published in: BMC Public Health | Issue 1/2017

Login to get access

Abstract

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.
Literature
1.
Seehusen DA, Edwards J. Patient practices and beliefs concerning disposal of medications. J Am Board Fam Med. 2006;19(6):542–7.CrossRefPubMed
2.
Ruhoy IS, Daughton CG. Beyond the medicine cabinet: an analysis of where and why medications accumulate. Environ Int. 2008;34(8):1157–69.CrossRefPubMed
3.
4.
5.
Ananth AP, Prashanthini V, Visvanathan C. Healthcare waste management in Asia. Waste Manag. 2010;30(1):154–61.CrossRefPubMed
6.
Daughton CG, Ternes TA. Pharmaceuticals and personal care products in the environment: agents of subtle change? Environ Health Perspect. 1999;107 Suppl 6:907.CrossRefPubMedPubMedCentral
7.
Zuccato E, Castiglioni S, Fanelli R, Bagnati R, Reitano G, Calamari D. Risks related to the discharge of pharmaceuticals in the environment: further research is needed. Pharmaceuticals in the Environment. Springer; 2004. p. 431–37.
8.
Vollmer G. Disposal of pharmaceutical waste in households–a European survey. Green and Sustainable pharmacy. Springer; 2010. p. 165–78.
9.
Wu M, Atchley D, Greer L, Janssen S, Rosenberg D, Sass J. Dosed without prescription: preventing pharmaceutical contamination of our nation’s drinking water. Natural Resources Defense Council White Paper. 2009. p. 1–60.
10.
Oaks JL, Gilbert M, Virani MZ, Watson RT, Meteyer CU, Rideout BA, Shivaprasad H, Ahmed S, Chaudhry MJI, Arshad M. Diclofenac residues as the cause of vulture population decline in Pakistan. Nature. 2004;427(6975):630–3.CrossRefPubMed
11.
Boehringer S. What’s the best way to dispose of medications. Pharm Lett. 2004;20(4).
12.
Jobling S, Williams R, Johnson A, Taylor A, Gross-Sorokin M, Nolan M, Tyler CR, van Aerle R, Santos E, Brighty G. Predicted exposures to steroid estrogens in UK rivers correlate with widespread sexual disruption in wild fish populations. 2005.
13.
Costanzo SD, Murby J, Bates J. Ecosystem response to antibiotics entering the aquatic environment. Mar Pollut Bull. 2005;51(1):218–23.CrossRefPubMed
14.
IRIN. Medical waste poses health risk in urban areas. In: IRIN News. 2008.
15.
Harhay MO, Halpern SD, Harhay JS, Olliaro PL. Health care waste management: a neglected and growing public health problem worldwide. Trop Med Int Health. 2009;14(11):1414–7.CrossRefPubMed
16.
17.
Pruss A, Cirouit E, Rushbrook P. Definition and characterization of health-care waste. Safe Management of Wastes From Health-Care Activities. 1999. p. 2–46.
18.
Prüss A, Giroult E, Rushbrook P. Safe management of wastes from health-care activities: World Health Organization; 1999.
19.
Braund R, Peake BM, Shieffelbien L. Disposal practices for unused medications in New Zealand. Environ Int. 2009;35(6):952–5.CrossRefPubMed
20.
Gagnon E. Pharmaceutical disposal programs for the public: A Canadian perspective. Ottawa, Ontario: Health Canada, Environmental Impact Initiative; 2009.
21.
Götz K, Keil F. Drug disposal in private households: does the disposal of pharmaceuticals via domestic sanitary devices contribute to water contamination. Z Umweltchem Ökotox. 2007;18:180–8.CrossRef
22.
Abahussain EA, Ball DE. Disposal of unwanted medicines from households in Kuwait. Pharm World Sci. 2007;29(4):368–73.CrossRefPubMed
23.
Tong AY, Peake BM, Braund R. Disposal practices for unused medications around the world. Environ Int. 2011;37(1):292–8.CrossRefPubMed
24.
MOPH. Afghanistan National Medicines Policy. In: Ministry of Public Health IRoA, editor. General Directorate of Pharmaceutical Affairs, Avicenna Pharmaceutical Institute. 2014. p. 49.
25.
MOPH. Comprehensive Health Care Waste Management Plan (HCWMP) for the System Enhancement for Health Action in Transition (SEHAT) project. In: Ministry of Public Health, Afghanistan. 2014.
26.
GDPA. Technical Report: Waste Management of Pharmaceuticals in Afghanistan. Submitted to the US Agency for International Development by the Strengthening Pharmaceutical Systems (SPS) Program. Arlington, VA: Management Sciences for Health. In: Ministry of Public Health. 2015.
27.
Fayaz SH, Higuchi M, Hirosawa T, Sarker MAB, Djabbarova Z, Hamajima N. Knowledge and practice of universal precautions among health care workers in four national hospitals in Kabul, Afghanistan. J Infect Dev Ctries. 2014;8(04):535–42.CrossRefPubMed
28.
Glassmeyer ST, Hinchey EK, Boehme SE, Daughton CG, Ruhoy IS, Conerly O, Daniels RL, Lauer L, McCarthy M, Nettesheim TG. Disposal practices for unwanted residential medications in the United States. Environ Int. 2009;35(3):566–72.CrossRefPubMed
29.
Persson M, Sabelström E, Gunnarsson B. Handling of unused prescription drugs—knowledge, behaviour and attitude among Swedish people. Environ Int. 2009;35(5):771–4.CrossRefPubMed
30.
Kusturica MP, Sabo A, Tomic Z, Horvat O, Šolak Z. Storage and disposal of unused medications: knowledge, behavior, and attitudes among Serbian people. Int J Clin Pharm. 2012;34(4):604–10.CrossRefPubMed
31.
Vellinga A, Cormican S, Driscoll J, Furey M, O'Sullivan M, Cormican M. Public practice regarding disposal of unused medicines in Ireland. Sci Total Environ. 2014;478:98–102.CrossRefPubMed
32.
Azad MAK, Ansary MRH, Akhter MA, Al-Mamun SM, Uddin M. Disposal practice for unused medications amongthe students of the International Islamic UniversityMalaysia. J Appl Pharm Sci. 2012;2(7):11.
33.
Hughes CM, McElnay JC, Fleming GF. Benefits and risks of self medication. Drug Saf. 2001;24(14):1027–37.CrossRefPubMed
34.
Shah A, Parmar S, Kumkishan A, Mehta A. Knowledge, Attitude and Practice (KAP) Survey Regarding the safe use of Medicines in rural area of Gujurat. Adv Trop Med Pub Health. 2011;1(2):66–70.
35.
De Bolle L, Mehuys E, Adriaens E, Remon J-P, Van Bortel L, Christiaens T. Home medication cabinets and self-medication: a source of potential health threats? Ann Pharmacother. 2008;42(4):572–9.CrossRefPubMed
36.
Ellis J, Mullan J. Prescription medication borrowing and sharing: risk factors and management. Aust Fam Physician. 2009;38(10):816.PubMed
37.
Hwang B-D. Storage and disposal of unused medications for housewives in the Busan Metropolitan City. Korean J Health Serv Manag. 2013;7(2):69–79.CrossRef
38.
39.
Kuspis D, Krenzelok E. What happens to expired medications? A survey of community medication disposal. Vet Hum Toxicol. 1996;38(1):48–9.PubMed
40.
Lamb A. Pharmacists’ Role in Safe and Legal Medication Disposal. 2012.
41.
42.
Macarthur D. Any old drugs? Two schemes for the disposal of unwanted medicines in Europe. Pharm J. 2000;264(7082):223–4.
43.
44.
45.
American Pharmacists Association. APhA provides guidance on proper medication disposal: use with respect and discard with care. 2007. 2013.
46.
47.
Smith CA. Managing pharmaceutical waste. J Pharm Soc Wis. 2002;5:17–22.
48.
Jarvis CI, Seed SM, Silva M, Sullivan KM. Educational campaign for proper medication disposal. Journal of the American Pharmacists Association: JAPhA. 2009;49(1).
49.
Chien H-Y, Ko J-J, Chen Y-C, Weng S-H, Yang W-C, Chang Y-C, Liu H-P. Study of medication waste in Taiwan. J Exp Clin Med. 2013;5(2):69–72.CrossRef
50.
West LM, Diack L, Cordina M, Stewart D. A cross-sectional survey of the Maltese general public on medication wastage. Int J Clin Pharm. 2016;38(2):261–70.CrossRefPubMed
51.
52.
Arkaravichien W, Ruchipiyarak T, Thawinwan W, Benjawilaikul S. Genotoxicity Assessment of Mercuric Chloride in the Marine Fish Therapon jaruba: A Threat to the Environment from Practice of Drug Disposal in Thailand. Environment Asia. 2014;7(1):13–8. doi:10.​14456/​ea.​2014.​3.
53.
Daughton CG. Cradle-to-cradle stewardship of drugs for minimizing their environmental disposition while promoting human health. II. Drug disposal, waste reduction, and future directions. Environ Health Perspect. 2003;111(5):775.CrossRefPubMedPubMedCentral
54.
Bound JP, Kitsou K, Voulvoulis N. Household disposal of pharmaceuticals and perception of risk to the environment. Environ Toxicol Pharmacol. 2006;21(3):301–7.CrossRefPubMed
Metadata
Title
Disposal practices of unused and expired pharmaceuticals among general public in Kabul
Authors
Mohammad Bashaar
Vijay Thawani
Mohamed Azmi Hassali
Fahad Saleem
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2017
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-016-3975-z

Other articles of this Issue 1/2017

BMC Public Health 1/2017 Go to the issue

Study protocol

Early food for future health: a randomized controlled trial evaluating the effect of an eHealth intervention aiming to promote healthy food habits from early childhood

Research article

Developing a comprehensive measure of mobility: mobility over varied environments scale (MOVES)

Study protocol

Women Epidemiology Lung Cancer (WELCA) study: reproductive, hormonal, occupational risk factors and biobank

Research article

Maternal blood cadmium, lead and arsenic levels, nutrient combinations, and offspring birthweight

Study protocol

HealtheSteps™ Study Protocol: a pragmatic randomized controlled trial promoting active living and healthy lifestyles in at-risk Canadian adults delivered in primary care and community-based clinics

Research article

The role of self-control and cognitive functioning in educational inequalities in adolescent smoking and binge drinking