Publication: MANAGEMENT OF MEDICINE WASTAGE, MEDICINE RETURN AND SAFE DISPOSAL OF MEDICINES IN MALAYSIAN COMMUNITY PHARMACIES
Date
2021-11
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
International Medical University
Abstract
Introduction
Medicinal wastage and improper medicine disposal are global issues that pose negative impacts on the environment, economy and patient safety. There are very limited local guidelines that provided a glimpse of how community pharmacies manage unused, expired, and returned medications. A local guideline published by Professor Dr Debra Sim et al. titled “Guidelines on The Proper Disposal of Unused Medications” had recommended the public to return unwanted medicines to pharmacies at government hospitals but has not discussed much on medicine returns available among community pharmacies. (1) Another local guideline published by Pharmaceutical Services Division, Ministry of Health Malaysia in 2016 titled “Community Pharmacy Benchmarking Guideline, Second Edition” had only stated arrangement must be made for the regular collection and safe disposal of pharmaceutical waste but did not explain how the process was monitored or regulated. (2) Therefore, the present study was aimed to explore the management of medicine wastage and medicine return methods in community pharmacies and to investigate safe disposal of medicines techniques in community pharmacies.
Methods
This study is a qualitative study, where semi-structured interviews guided by a pilot-tested interview guide were conducted with 18 full-time community pharmacists across Malaysia from December 2020 to June 2021. Purposive and snowball sampling were employed to ensure a well-rounded perspective. The interviews were audio-recorded and transcribed verbatim. The collected data was then thematically analysed for common themes, which were then used to generate significant implications and conclusion. Data collection, coding, and interpretation were carried out until thematic saturation. Any topics related to safe medicine disposal and practices that arose during the interviews were included as significant data and were included for thematic analysis.
Results
Five common themes were identified from the verbatim transcript. From the study results, there were no specific techniques identified on how community pharmacies manage medicine returns from the public and different methods were employed in different pharmacies. Majority of the respondents do not accept medicine returns from the public, whereas some voluntarily accept them for safe disposal. None of the returned medications are redispensed or resold. Respondents employed different strategies to avoid medication stocks from expiring, including rational stocking, periodic stock checks on expiry dates, and selling close-expiry medications at discounted prices. Expired medications are centralised at a designated organisation facility, such as a warehouse, before being transferred to waste management companies for safe disposal.
Conclusion
Medication wastage due to unused medications in community pharmacy is kept minimal to reduce profit loss and there are various steps done by pharmacists to minimise medication wastage. Medicine returns are generally not accepted in community pharmacies except for a handful of pharmacies outlets that had Medicine Return Program (MRP) supported at organisational level. Disposal of unused medications are done by centralising the stocks at an organisation facility before being disposed by outsourced waste management companies. Majority of the respondents find MRP in community pharmacies would not be widely
available unless there is improvement in public awareness about safe medicine disposal, increased needs of such service from customers and implementation of official MRP with subsidisation from the government.
(502 words)
Keywords: Malaysia; Practices; Medicine disposal; Community pharmacy; Pharmacists; Unused medications
Description
Keywords
Community Pharmacy Services, Pharmacists, Waste Management, Patient Safety, Pharmacies, Medicine