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Alsulami FT. Hospital Pharmacists' Attitudes and Intentions Toward Adverse Drug Reaction Reporting in Saudi Arabia: Insights from the Theory of Planned Behavior. Healthcare (Basel) 2025; 13:1111. [PMID: 40427948 PMCID: PMC12111136 DOI: 10.3390/healthcare13101111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2025] [Revised: 05/04/2025] [Accepted: 05/09/2025] [Indexed: 05/29/2025] Open
Abstract
Objective: This study assessed hospital pharmacists' awareness, attitudes, and behaviors regarding adverse drug reaction (ADR) reporting and explored cognitive factors shaping hospital pharmacists' intentions to report ADRs, using the theory of planned behavior (TPB) as a framework. Methods: A cross-sectional survey was conducted among hospital pharmacists from various regions of Saudi Arabia. Data were collected on their intentions to report ADRs to the national pharmacovigilance center (NPC), along with their attitudes, subjective norms, and perceived behavioral control related to ADR reporting. Descriptive statistics summarized the data, while multivariate logistic regression analyzed the influence of TPB constructs on reporting intentions. Results: A total of 141 hospital pharmacists participated in the study. While 86.5% of them were aware of the Saudi NPC, only 30% had reported ADRs in the past year. A strong intention to report ADRs was observed in 56% of the hospital pharmacists. Additionally, 53% exhibited a highly positive attitude, 57% perceived strong social norms, 52.5% reported high perceived behavioral control, and 63.8% expressed a strong moral obligation to report ADRs. Subjective norms and moral obligation emerged as significant predictors of the hospital pharmacists' intention to report ADRs, according to the TPB constructs. Conclusions: While awareness of the Saudi NPC among hospital pharmacists was high, ADR reporting rates were low. Enhancing education, addressing barriers, and leveraging moral and normative drivers may strengthen pharmacovigilance practices and improve ADR reporting adherence among hospital pharmacists, ultimately fostering safer healthcare delivery.
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Affiliation(s)
- Fahad T Alsulami
- Clinical Pharmacy Department, College of Pharmacy, Taif University, Taif 21944, Saudi Arabia
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Abbas MO, Beshir S, Kamal AlKhalidi D, Shamseldin Al Gailani Ali E, Lozon Y, Assadi RA, Ghdaiba H, Adnan Al-Zeer R. UAE pharmacists' perceptions of the causes of unwanted or unused medications, their practices, and barriers to promoting safe medication disposal by the public. BMC Public Health 2025; 25:236. [PMID: 39833822 PMCID: PMC11744944 DOI: 10.1186/s12889-025-21332-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2024] [Accepted: 01/06/2025] [Indexed: 01/22/2025] Open
Abstract
BACKGROUND The improper disposal of unwanted or unused medications is a pressing issue that can lead to drug misuse and environmental contamination. Pharmacists play a crucial role in promoting safe drug disposal by the public. This study explores pharmacists' perceptions of the causes of unwanted and unused medications, their practices, and the barriers to promoting safe medication disposal among the public in the United Arab Emirates. METHODS This cross-sectional study included pharmacists working in the UAE's community and hospital settings with direct patient contact. A convenience sampling approach was used, where pharmacists who were available during the data collection period were invited to participate. Printed copies or a survey link to the questionnaire were provided to pharmacists to complete independently during in-person visits. Participants were categorised into three levels: extensive, adequate, or minimal involvement, based on their engagement in activities such as reviewing patients' medications, educating them on proper storage and disposal, and participating in drug take-back programmes. Chi-square test was used to assesses the association between categorical variables and pharmacists practice levels. The data was analysed using the Statistical Package for the Social Sciences (SPSS) software version 29. RESULTS A total of 370 pharmacists participated in this survey, most of whom were between 18 and 34 years old (69.2%). The top three perceived causes of unwanted or unused medications include changes in prescriptions due to patients' poor clinical outcomes (83.8%), inappropriate storage conditions (79.7%), and expiration of medications (78.6%). Moreover, factors such as pharmacist age, type of pharmacy, country of education, pharmacy location, employment status, and years of experience were significantly associated with pharmacists' level of involvement in promoting safe medication disposal practices. The most cited barriers were a lack of public awareness about the risks of improper medication disposal (88.9%), lack of time due to workload (82.4%), and lack of training and education (78.1%). Most pharmacists believed in collaborating with public health agencies to promote medication disposal awareness (97.6%) and developing national guidelines (97.6%). CONCLUSION This study's findings have significant implications for public health, highlighting the necessity of essential groundwork for developing targeted interventions and policies to enhance public awareness and identify specific areas where pharmacists can actively encourage safe medication disposal practices in the UAE.
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Affiliation(s)
- Maram O Abbas
- Institute of Public Health, College of Medicine & Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates.
| | - Semira Beshir
- Dubai Pharmacy College for Girls, Dubai Medical University, Dubai, United Arab Emirates.
| | - Doaa Kamal AlKhalidi
- Dubai Pharmacy College for Girls, Dubai Medical University, Dubai, United Arab Emirates
| | | | - Yosra Lozon
- Dubai Pharmacy College for Girls, Dubai Medical University, Dubai, United Arab Emirates
| | - Rizah Anwar Assadi
- Dubai Pharmacy College for Girls, Dubai Medical University, Dubai, United Arab Emirates
| | - Hana Ghdaiba
- Dubai Pharmacy College for Girls, Dubai Medical University, Dubai, United Arab Emirates
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Lam J, El Nsouli D, Lee EL, Alqeisi T, Kane R, McGonagle I, Laparidou D, Nelson D, Armani K. Assessing the knowledge, attitudes and practices of healthcare staff and students regarding disposal of unwantead medications: a systematic review. BMJ Open 2024; 14:e093636. [PMID: 39719285 PMCID: PMC11667366 DOI: 10.1136/bmjopen-2024-093636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2024] [Accepted: 11/29/2024] [Indexed: 12/26/2024] Open
Abstract
OBJECTIVES We sought to review studies that examine healthcare professionals' and students' knowledge, attitudes and practices (KAP) regarding medication disposal. We also explore recommendations and barriers related to appropriate medication disposal. DESIGN A systematic review was conducted that adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses. DATA SOURCES MEDLINE, Embase, CINAHL, Web of Science, PsycINFO and Google Scholar were searched up to 23 February 2024. STUDY ELIGIBILITY CRITERIA AND SETTING Qualitative, quantitative and mixed-method primary research studies. There was no limitation on the publication date, geographical locations or the study settings. PARTICIPANTS Pharmacists, doctors, nurses and students from these respective professional groups in any country. PRIMARY OUTCOME MEASURES The levels of healthcare staff and students' KAPs about disposal of unwanted medications. DATE EXTRACTION AND SYNTHESIS Data extraction was conducted by four of the researchers independently. The study details were categorised into three main domains, that is, KAP using the KAP model. Other relevant information was also extracted, and synthesised in overall themes, such as challenges and recommendations. RESULTS Thirty-seven studies from 18 countries (Asia n=21, the USA n=7, Africa n=5, EU n=2, South America n=2) were included. 86.5% (n=32) investigated participants' knowledge of medication disposal. Although there was a good level of awareness about the environmental impacts, there were significant gaps in knowledge regarding correct disposal methods, available services, guidelines and training. Thirty studies explored participants' attitudes towards medication disposal. There was a generally positive attitude towards the need for environmentally safe disposal practices. Thirty-five studies evaluated participants' practices in relation to medication disposal. Although there was generally a positive attitude and some understanding of appropriate disposal methods, the majority of the participants did not follow the practice guidelines, especially outside healthcare settings. DISCUSSIONS AND CONCLUSIONS Although healthcare staff and students have fair knowledge and positive attitudes towards medicine disposal, their actual practices are lacking. One significant challenge identified is the limited awareness about proper disposal methods coupled with a lack of established services or guidelines. Even in cases where take-back programmes are available, they often face issues with accessibility. To tackle these challenges, it is suggested that governmental bodies should establish and enforce clear policies on medication disposal while also expanding educational initiatives to increase understanding among professionals and students. Furthermore, improving access to take-back programmes is crucial for ensuring safe medication disposal and minimising potential environmental and health hazards. PROSPERO REGISTRATION NUMBER CRD42024503162.
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Affiliation(s)
- Janeme Lam
- Department of Pharmacy, Northampton General Hospital NHS Trust, Northampton, UK
| | - Dayana El Nsouli
- Department of Pharmacy, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
| | - E Lyn Lee
- Department of Pharmacy, IMU University, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Tawfiq Alqeisi
- Trauma and Orthopaedics, Queen's Medical Centre, Nottingham, UK
| | - Ros Kane
- School of Health and Care Sciences, University of Lincoln, Lincoln, UK
| | - Ian McGonagle
- School of Health and Care Sciences, University of Lincoln, Lincoln, UK
| | - Despina Laparidou
- Community and Health Research Unit, School of Health and Care Sciences, University of Lincoln, Lincoln, Lincolnshire, UK
| | - David Nelson
- Lincoln Institute for Rural and Coastal Health, College of Health and Science, University of Lincoln, Lincoln, UK
| | - Keivan Armani
- Department of Primary Care and Public Health, School of Public Health, Imperial College London Faculty of Medicine, London, UK
- UCSI University Faculty of Pharmaceutical Sciences, Cheras, Kuala Lumpur, Malaysia
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Alfian SD, Adhinagoro B, Winardi DO, Angela F, Griselda M, Gathera VA, Abdulah R. Pharmacist-led interventions in addressing improper disposal practices of unused and expired household medication: A systematic review. Heliyon 2024; 10:e37764. [PMID: 39315146 PMCID: PMC11417203 DOI: 10.1016/j.heliyon.2024.e37764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 09/09/2024] [Accepted: 09/09/2024] [Indexed: 09/25/2024] Open
Abstract
Background Improper household medication disposal practices are a source of significant threat to environmental safety and public health. Pharmacists play a crucial role in mitigating these risks by educating the public about proper medication disposal. Evidence regarding the effectiveness of efforts conducted by health professionals to reduce the risks associated with improper disposal practices is still lacking. Therefore, this study aimed to systematically review pharmacist-led interventions in addressing unused and expired household medication disposal. Method A comprehensive literature search was conducted using PubMed, Scopus, and Google Scholar databases to identify studies evaluating pharmacist-led interventions and the effectiveness in improving household medication disposal practices until January 2024 with no constraints on publication year. Two reviewers independently performed the study selection process, data extraction, and outcomes assessment. Subsequently, the entire collected data were extracted and synthesized using qualitative and quantitative methods. Results The results showed that two among the total 83 studies retrieved during the search process met the inclusion criteria. The identified pharmacist-led interventions included the provision of an at-home medication disposal kit and an informational handout on proper disposal. However, these interventions showed no significant effects in improving household medication disposal practices, and all studies reported a low engagement rate with interventions. Conclusion The systematic review identified limited literature on pharmacist-led interventions for unused and expired household medication disposal practices, with no observed significant effects. Active patient and pharmacist engagement were required to enhance the effectiveness of interventions. Furthermore, the included limited studies suggested the need for the development of more pharmacist-led interventions to facilitate the role of pharmacist in educating the public on proper household medication disposal.
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Affiliation(s)
- Sofa D. Alfian
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Jatinangor, Indonesia
- Drug Utilization and Pharmacoepidemiology Research Group, Centre of Excellence for Pharmaceutical Care Innovation, Universitas Padjadjaran, Jatinangor, Indonesia
- Center for Health Technology Assessment, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Bagus Adhinagoro
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Devani O. Winardi
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Fidelia Angela
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Meliana Griselda
- Drug Utilization and Pharmacoepidemiology Research Group, Centre of Excellence for Pharmaceutical Care Innovation, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Vesara A. Gathera
- Department of Clinical Pharmacy, Universiti Kuala Lumpur, Malaysia
- Department of Biology Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Indonesia
| | - Rizky Abdulah
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Jatinangor, Indonesia
- Drug Utilization and Pharmacoepidemiology Research Group, Centre of Excellence for Pharmaceutical Care Innovation, Universitas Padjadjaran, Jatinangor, Indonesia
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Barnett MJ, Clubbs B, Woodyard A, Wasem V, Prinze J, Tirupasur A, Hosseini S, Kim M, Gallardo F, Polich N, Desselle S. Barriers and motivational factors for engaging in novel opioid and medication disposal-related services in community pharmacies. Res Social Adm Pharm 2024; 20:713-722. [PMID: 38719767 DOI: 10.1016/j.sapharm.2024.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 03/20/2024] [Accepted: 03/23/2024] [Indexed: 06/17/2024]
Abstract
OBJECTIVE This study aimed to explore and identify motivational factors and barriers for pharmacy personnel participation in specific opioid mitigation programs, using the Theory of Planned Behavior (TPB) as an investigational framework. METHODS A naturalistic inquiry method was employed involving semi-structured interviews with pharmacy personnel to assess their intentions, attitudes, normative beliefs, and behaviors towards participating in naloxone dispensing and provision of at-home drug disposal solutions. Purposive sampling was utilized to recruit participants, with saturation achieved after 12 interviews. Interviews were transcribed and coded to identify recurring themes. RESULTS Four primary themes emerged: 1) the value and benefits of helping others, emphasizing societal, patient, and environmental benefits; 2) limits and barriers to participation, including financial concerns, management support, and time constraints; 3) pharmacists' intrinsic motivators, highlighting personal motivations and differentiation between programs for specific patient types; and 4) program implementation challenges and strategies. CONCLUSION The findings underscore the applicability of the TPB in understanding pharmacy engagement in opioid abatement programs. Despite facing barriers such as financial considerations and time constraints, the overall positive attitudes towards the programs indicate a strong motivation to contribute to public health efforts. Addressing identified barriers and leveraging motivators could enhance participation, potentially mitigating the opioid crisis. Future research should incorporate patient perspectives to fully understand the impact and effectiveness of pharmacy-led interventions, such as naloxone dispensing and disposal solutions, in opioid misuse prevention.
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Affiliation(s)
- Mitchell J Barnett
- Touro University California College of Pharmacy, 1310 Club Dr, Vallejo, CA, 94592, USA.
| | - Brooke Clubbs
- Southeast Missouri State University, One University Plaza, Cape Girardeau, MO, 63701, USA.
| | - Ashley Woodyard
- Touro University California College of Pharmacy, 1310 Club Dr, Vallejo, CA, 94592, USA.
| | - Valerie Wasem
- Touro University California College of Pharmacy, 1310 Club Dr, Vallejo, CA, 94592, USA.
| | - Joyce Prinze
- Touro University California College of Pharmacy, 1310 Club Dr, Vallejo, CA, 94592, USA.
| | - Anuradha Tirupasur
- Touro University California College of Pharmacy, 1310 Club Dr, Vallejo, CA, 94592, USA.
| | - Sina Hosseini
- Touro University California College of Pharmacy, 1310 Club Dr, Vallejo, CA, 94592, USA.
| | - Madison Kim
- Touro University California College of Pharmacy, 1310 Club Dr, Vallejo, CA, 94592, USA.
| | - Faviola Gallardo
- University of Iowa, College of Pharmacy, 180 S Grand Ave, Iowa City, IA, 52242, USA.
| | - Natalie Polich
- Drake University College of Pharmacy & Health Sciences, 2507 University Avenue, Des Moines, IA, 50311, USA.
| | - Shane Desselle
- Touro University California College of Pharmacy, 1310 Club Dr, Vallejo, CA, 94592, USA.
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Alfian SD, Rendrayani F, Khoiry QA, Pratama MA, Griselda M, Pradipta IS, Nursiswati N, Abdulah R. Do pharmacists counsel customers on the disposal of unused or expired household medications? A national survey among 1,596 pharmacists in Indonesia. Saudi Pharm J 2024; 32:102020. [PMID: 38525264 PMCID: PMC10960135 DOI: 10.1016/j.jsps.2024.102020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 03/03/2024] [Indexed: 03/26/2024] Open
Abstract
Introduction Pharmacists play a vital role in counseling customers on proper medication disposal, yet their consistency in providing such information is often lacking. This study aimed to assess pharmacists' awareness of appropriate disposal practices for unused and expired household medications. Additional objectives included evaluating whether pharmacists offer disposal information during counseling, measuring their willingness to receive medication waste from the public, and identifying associated factors. Methods A national cross-sectional online survey employing convenience sampling was conducted among pharmacists working in hospitals, pharmacies, clinics, or community health centers (CHCs) in Indonesia, using a validated questionnaire to assess awareness, information provision, and willingness to receive medications for disposal. Binary logistic regression, with 95% confidence intervals (CI) and odds ratios (OR), explored potential associations between factors and outcomes. Results This study involved 1,596 pharmacists across 37 Indonesian provinces. Most pharmacists were women (80.4 %), aged 31-40 years (49.3 %), with a pharmacist professional background (93.8 %), working in CHCs (41.2 %), and practicing for 1-5 years (51.0 %). More than half were unaware of guidelines for returning medications to health facilities. While 69.9 % never counseled customers on disposal practices, 64.9 % expressed willingness to receive unused and expired medication from the public. Pharmacists practicing for at least six years were more likely to provide disposal information during counseling (OR: 2.54; 95 % CI: 1.44-4.47). Conversely, those in clinics (OR: 2.16; 95 % CI: 1.29-3.62), CHCs (OR: 2.07; 95 % CI: 1.45-2.95), or hospitals (OR: 2.00; 95 % CI: 1.27-3.14) were more likely to be unwilling to receive expired and unused household medication. Conclusions The study reveals that most pharmacists, particularly those with limited practice duration, lacked awareness regarding the importance of proper medication disposal and did not provide counseling on appropriate medication disposal to patients. To address this issue, there is a pressing need for intensified education intensified education at the undergraduate level, continuous training for pharmacists, and a clear policy and practical guidelines, particularly targeting pharmacists in clinics, CHCs, and hospitals, to facilitate the acceptance of unused and expired household medications.
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Affiliation(s)
- Sofa D. Alfian
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Jatinangor, Indonesia
- Drug Utilization and Pharmacoepidemiology Research Group, Centre of Excellence for Pharmaceutical Care Innovation, Universitas Padjadjaran, Jatinangor, Indonesia
- Center for Health Technology Assessment, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Farida Rendrayani
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Qisty A. Khoiry
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Mochammad A.A. Pratama
- Drug Utilization and Pharmacoepidemiology Research Group, Centre of Excellence for Pharmaceutical Care Innovation, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Meliana Griselda
- Drug Utilization and Pharmacoepidemiology Research Group, Centre of Excellence for Pharmaceutical Care Innovation, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Ivan Surya Pradipta
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Jatinangor, Indonesia
- Drug Utilization and Pharmacoepidemiology Research Group, Centre of Excellence for Pharmaceutical Care Innovation, Universitas Padjadjaran, Jatinangor, Indonesia
| | | | - Rizky Abdulah
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Jatinangor, Indonesia
- Drug Utilization and Pharmacoepidemiology Research Group, Centre of Excellence for Pharmaceutical Care Innovation, Universitas Padjadjaran, Jatinangor, Indonesia
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Michelin ADF, Bonifácio NA, Nagata WB, da Silva VMS, Gobbo LEM, Bresciani KDS. Guidance provided by pharmacists to customers regarding to destination of unused household medications: disposal of household medications. BMC Health Serv Res 2023; 23:1350. [PMID: 38049849 PMCID: PMC10694965 DOI: 10.1186/s12913-023-10319-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 11/14/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND Discarding pharmaceuticals in the garbage or into the sewage system are still the most common methods in many countries. This study aims to investigate the guidance provided by pharmacists to customers on the disposal of unused and expired household medications in São Paulo State, Brazil. METHOD The study population consisted of 630 pharmacists from the State of São Paulo, who work in community pharmacies. They answered an online questionnaire with questions composed in three blocks: demographic, work, and academic information on the pharmacist; guidance about the disposal of household medications; and knowledge regarding the reverse logistics of these medications. An invitation to participate in the questionnaire was made via WhatsApp, individually and collectively. Inferential statistics were performed using the chi-square test and were considered significant when p < 0.05%. RESULTS Among the participating pharmacists, the majority were women under 60 years old,56 (8.89%) stated that they never orient the customer regarding the disposal of unused and expired household medications, while 574 (91,12%) indicated that they almost provide guidance. The frequency with which they provided guidance was influenced by the number of years since graduation (p = 0.0047), the time they had worked in pharmacies and drugstores (p = 0.0007), and whether or not they had a graduate degree (p = 0.0181). Regarding the disposal of medications, among the 643 responses provided by the pharmacists,516 (80.25%) indicated that they oriented customers to return them to a pharmacy. CONCLUSION A small number of pharmacists always orient customers on the proper disposal that should be followed for unused and expired household medications, prioritizing their return to a pharmacy. In general, these pharmacists have longer periods of work experience and higher academic qualifications. Thus, it is important to increase knowledge through professional training and further education programs.
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Affiliation(s)
- Aparecida de Fatima Michelin
- School of Veterinary Medicine, São Paulo State University (Unesp), Rua Clóvis Pestana, no 793, Araçatuba, 16050-680, SP, Brazil.
- Institute of Health Sciences, Paulista University, Araçatuba, SP, Brazil.
| | - Neuza Alves Bonifácio
- School of Veterinary Medicine, São Paulo State University (Unesp), Rua Clóvis Pestana, no 793, Araçatuba, 16050-680, SP, Brazil
- Institute of Health Sciences, Paulista University, Araçatuba, SP, Brazil
| | | | - Valéria Maria Savoya da Silva
- School of Veterinary Medicine, São Paulo State University (Unesp), Rua Clóvis Pestana, no 793, Araçatuba, 16050-680, SP, Brazil
| | | | - Katia Denise Saraiva Bresciani
- School of Veterinary Medicine, São Paulo State University (Unesp), Rua Clóvis Pestana, no 793, Araçatuba, 16050-680, SP, Brazil
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Mohammed AUM, Al-Hamadani F. Assessment of general population knowledge, attitude, and practice on safe unused and expired drugs disposal: a cross-sectional study. F1000Res 2023; 12:1333. [PMID: 38515859 PMCID: PMC10955187 DOI: 10.12688/f1000research.142146.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/09/2023] [Indexed: 03/23/2024] Open
Abstract
Background The appropriate disposal of medication is a well-recognized issue that has convened growing recognition in several contexts. Insufficient awareness relating to appropriate methods for the disposal of unneeded medicine may result in notable consequences. The current research was conducted among the public in Iraq with the aim of examining their knowledge, attitude, and practices regarding the proper disposal of unused and expired medicines. Methods The present study used an observational cross-sectional design that was community-based. The data were obtained from using an online questionnaire. The study sample included people of diverse genders, regardless of their race or occupational status. The study mandated that all participants meet two criteria: firstly, they had to be a minimum of 18 years old, and secondly, they needed to have permanent residency status in Iraq. Results The research population consisted of 591 participants from general population. The majority of participants were men (64.8%) with average age of 33.5±9.1 years. The majority of participants (˃50%) answered four out of eight knowledge questions correctly. There were significant (P-value ˂0.05) differences in four knowledge items about disposing of unused/expired medications according to the educational level. Elder participants had significantly higher knowledge about the disposing of unused/expired medications compared to younger ones. More than 84% correctly agreed that improper disposal of unused and expired medication has adverse effects on environment. Although the majority of the participants had positive attitude toward the safe disposal of unused/expired medications, their actual practice was improper for these medications. Approximately 70% of the participants have disposed unused/expired medications into their home trash can. Conclusion Despite increasing awareness from the general populace about the possible harm and substantial hazards linked to expired medicines, there is an absence of understanding concerning the proper techniques for disposing of and managing these prescriptions.
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Affiliation(s)
| | - Fadya Al-Hamadani
- Clinical Pharmacy, College of Pharmacy, University of Baghdad, Baghdad, 10045, Iraq
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Tecen-Yucel K, Ozdemir N, Kara E, Demirkan K, Sancar M, Okuyan B. Factors associated with intention of clinical pharmacists and candidates to provide pharmaceutical care: application of theory planned behaviour. BMC MEDICAL EDUCATION 2023; 23:682. [PMID: 37730582 PMCID: PMC10512481 DOI: 10.1186/s12909-023-04658-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 09/06/2023] [Indexed: 09/22/2023]
Abstract
BACKGROUND Postgraduate education programs in clinical pharmacy have become widespread in Türkiye. This study aimed to identify factors associated with the intention of Turkish clinical pharmacists and candidates (who were graduates and students of postgraduate clinical pharmacy programs) to provide pharmaceutical care. METHODS This prospective observational study was conducted between June 2021 and May 2022. After searching relevant studies, an expert panel discussion, translation, cultural adaptation, and a pilot study developed a 52-item Turkish scale based on the Theory of Planned Behavior (TBP). Cronbach alpha for each construct was calculated after an explanatory factor and test-retest reliability analysis. An online survey link was sent to all graduates or candidates of postgraduate clinical pharmacy programs in Türkiye. After univariate regression analysis, the multiple linear regression model was performed. RESULTS One hundred fifty-six participants completed the survey (response rate: 59.1%). The Cronbach's alpha for attitude (9 items), subjective norm (6 items), perceived behavioural control (5 items), self-efficacy (6 items), intention (11 items) and past behaviour (15 items) were 0.945, 0.720, 0.751, 0.864, 0.934 and 0.955 respectively. The multiple linear regression analysis found a higher score of the subjective norm (p = 0.016), a higher score of self-efficacy (p < 0.001), younger age (p < 0.001) and having PhD (p = 0.038) were associated with increased intention score. CONCLUSIONS It was shown that higher self efficacy and positive beliefs of their peers and other healthcare professionals were associated with their higher intention score for providing pharmaceutical care. Younger age and having a PhD were other factors associated with their intention to provide pharmaceutical care.
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Affiliation(s)
- Kamer Tecen-Yucel
- Department of Clinical Pharmacy, Anadolu University, Faculty of Pharmacy, 26210, Eskisehir, Türkiye.
| | - Nesligul Ozdemir
- Department of Clinical Pharmacy, Inönü University, Faculty of Pharmacy, Malatya, Türkiye
| | - Emre Kara
- Department of Clinical Pharmacy, Hacettepe University, Faculty of Pharmacy, Ankara, Türkiye
| | - Kutay Demirkan
- Department of Clinical Pharmacy, Hacettepe University, Faculty of Pharmacy, Ankara, Türkiye
| | - Mesut Sancar
- Department of Clinical Pharmacy, Marmara University, Faculty of Pharmacy, Istanbul, Türkiye
| | - Betul Okuyan
- Department of Clinical Pharmacy, Marmara University, Faculty of Pharmacy, Istanbul, Türkiye
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Mathers A, Fan S, Austin Z. Climate change at a crossroads: Embedding environmental sustainability into the core of pharmacy education. Can Pharm J (Ott) 2023; 156:55-59. [PMID: 36969305 PMCID: PMC10034526 DOI: 10.1177/17151635231152882] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 12/07/2022] [Indexed: 02/18/2023]
Affiliation(s)
- Annalise Mathers
- University of Toronto, Leslie L. Dan Faculty of Pharmacy, Toronto
| | - Shirley Fan
- University of Toronto, Leslie L. Dan Faculty of Pharmacy, Toronto
- University of Waterloo, School of Pharmacy, Waterloo, Ontario
| | - Zubin Austin
- University of Toronto, Leslie L. Dan Faculty of Pharmacy, Toronto
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11
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Rogowska J, Zimmermann A. Household Pharmaceutical Waste Disposal as a Global Problem-A Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192315798. [PMID: 36497873 PMCID: PMC9737308 DOI: 10.3390/ijerph192315798] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/18/2022] [Accepted: 11/24/2022] [Indexed: 05/31/2023]
Abstract
The negative effect of the pharmaceuticals presence (persistence?) in various components of the environment is a global problem today. These compounds are released into the environment as a result of, inter alia, their use and improper disposal. Therefore, it is important to reduce excessive drug consumption and to develop a system for the collection of unused/expired pharmaceuticals. The effectiveness of actions in this area is inextricably linked with the need to educate society on how to deal properly with unwanted medications. The aim of the study was to show that the inappropriate handling of unused/expired drugs by society is an important problem in waste management systems, and it impacts the state of the environment. Forty-eight scientific articles published between 2012 and 2021 were taken into account that discussed the systems in various countries for the collection of unused/expired pharmaceuticals. This literature review shows that the main method of disposing of unused/expired medications, according to respondents from different countries, is either by disposing of them in household waste or flushing them into the sewage system. This is also the case in countries with systems or programs for the return of redundant drugs, which indicates that these systems are not sufficiently effective. This may be influenced by many factors, including the lack or ineffective education of the society.
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12
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Instruments to assess the role of the clinical pharmacist: a systematic review. Syst Rev 2022; 11:175. [PMID: 35996155 PMCID: PMC9396863 DOI: 10.1186/s13643-022-02031-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 07/17/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The clinical pharmacist is an essential member of the healthcare team and plays an important role in health care in the primary care and the hospital setting. Knowledge regarding the instruments that evaluate the different activities of the clinical pharmacist, as well as the evaluation of the psychometric properties of these instruments, is necessary. METHODS A literature search was performed in the PubMed and Scopus electronic databases without time and language restrictions. For the search strategy, the "pharmaceutical services," "validity studies," and "professional performance" domains were used. To assess the quality of the instruments, the five sources of validity evidence of contemporary psychometry were used, and the Joanna Briggs Institute's standardized instrument was used to assess the methodological quality of the studies. After screening 4096 articles, 32 studies were selected. RESULTS A total of 32 studies were included, and 32 instruments were identified to be used by pharmacists acting in various pharmaceutical practice scenarios. It was found that the available instruments were developed or adapted from others, with variation in the methods, constructs, dimensions, and domains, as well as the psychometric properties. Most of the instruments addressed community pharmacies, and evidence of content validity and internal structure was found most frequently. A standardized and validated instrument that comprehensively assessed the performance of the clinical pharmacist, addressing clinical activities, was not identified for all practice environments. CONCLUSIONS Without standardized and validated instruments specifics to assess the performance of the clinical pharmacist, it is hard to establish the main clinical activities performed by pharmacists in their pharmaceutical practice environments and to propose training actions to improve professional practice. Despite the large number of instruments available and considered validated by the authors, it is questioned to what extent the validity indicators presented in the different studies really show the validation status. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD 42018099912.
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13
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Talebi R, Miller C, Abboudi J, Brahmabhatt S, Emper W, Lonner J, Kistler J, Mazur D, Pedowitz D, Ilyas AM. How Patients Dispose of Unused Prescription Opioids: A Survey of over 300 Postoperative Patients. Cureus 2022; 14:e28111. [PMID: 36134102 PMCID: PMC9481200 DOI: 10.7759/cureus.28111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2022] [Indexed: 11/06/2022] Open
Abstract
Introduction Diversion of unused prescription opioids is a common source of opioid sensitization in the community. Educating patients about safe opioid use has been shown to be effective in decreasing opioid use. However, decreasing diversion will also require educating patients on proper opioid disposal. A survey was administered to better understand patients’ habits with opioid disposal for opioids prescribed after orthopedic surgery. Methods A cross-sectional survey study of 469 patients who had undergone orthopedic surgery was conducted to learn their preferences and habits regarding the disposal of unused prescription opioids received after orthopedic surgery. Results The survey respondents consisted of 48.8% female and 51.2% male patients. Ninety-four point two percent (94.2%) of those receiving opioid prescriptions reported having leftover unused opioids. In terms of voluntary disposal, 68.8% claimed to dispose of their prescription opioids while 31.2% did not. Gender, but not age, had a significant effect on plans for opioid disposal and how seriously respondents viewed issues of opioid misuse. When asked their preferred location for prescription opioid disposal, the most common preference was a local pharmacy. Discussion This survey identified that most patients do not store their prescription opioids in a locked location, claim to dispose of their unused prescription opioids, and would prefer to dispose of them at a pharmacy if possible. This information points to the need for close prescriber-to-pharmacy collaboration to promote the safe disposal of prescription opioids and mitigate drug diversion.
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14
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Jha N, Kafle S, Bhandary S, Shankar PR. Assessment of knowledge, attitude, and practice of disposing and storing unused and expired medicines among the communities of Kathmandu, Nepal. PLoS One 2022; 17:e0272635. [PMID: 35925995 PMCID: PMC9352092 DOI: 10.1371/journal.pone.0272635] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 07/25/2022] [Indexed: 11/18/2022] Open
Abstract
Background Unused medicines can be stored by many people at their places of residence and houses for later use. This study evaluated knowledge, and attitudes regarding unused and expired medicines and explored medicine storage and disposal practices among selected households in the Kathmandu valley, Nepal. Method A cross-sectional study with a two-stage cluster survey design was done using a semi-structured questionnaire from April to October 2021. The sample size (total number of households) after adjusting for design effect and non-response rate was 210 and the study population was the household heads. Simple random sampling was done to select clusters during the first stage and systematic random sampling to select households during the second stage. Descriptive statistics and t-test/one-way ANOVA were used to compare the respondents’ average knowledge scores. Practice variables were presented using frequency distribution. Results Around half the respondents were from the Kathmandu district, nearly 20% were from Bhaktapur and 30% were from Lalitpur. Nearly two-thirds were male and about 25% had a bachelor’s degree. Nearly 90% of respondents agreed that storage of excess medicines at home may promote self-medication. Similarly, 97.6% of respondents agreed there is a lack of adequate information on the safe disposal of unused medicines. The majority [125 (59.5%)] of participants always checked the expiry date of medicines. The safe methods of medicine disposal were not known by 137 (65.2%) participants. Throwing in a dustbin was the preferred method of expired medicine disposal. Conclusion The level of knowledge and practice of disposing of unused and expired medicines requires improvement. Educational interventions may help improve awareness further. Creating a chart summarizing disposal procedures of common medicines is important. Similar studies in other regions are required.
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Affiliation(s)
- Nisha Jha
- Department of Clinical Pharmacology and Therapeutics, KIST Medical College, Lalitpur, Nepal
- * E-mail:
| | - Sajala Kafle
- Department of Clinical Pharmacology and Therapeutics, KIST Medical College, Lalitpur, Nepal
| | - Shital Bhandary
- Department of Community Health Sciences and School of Public Health, Patan Academy of Health Sciences, Patan, Lalitpur, Nepal
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15
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Jelić AG, Tasić L, Škrbić R, Marinković V, Šatara SS, Stojaković N, Peković VM, Godman B. Pharmacists' clinical knowledge and practice in the safe use of contraceptives: real knowledge vs. self-perception and the implications. BMC MEDICAL EDUCATION 2021; 21:430. [PMID: 34399761 PMCID: PMC8365278 DOI: 10.1186/s12909-021-02864-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 08/03/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Pharmacists are often the first healthcare professionals that patients contact with their illnesses and requests for medical information, which is enhanced following the recent COVID-19 pandemic. Community pharmacists are expected and required to possess a broad spectrum of knowledge and skills. Self-assessment of these competencies is needed for their self-improvement. PURPOSE OF THE STUDY To assess pharmacists' clinical knowledge and practice in the safe use of contraceptives, and to compare the scores obtained by external observation with pharmacists' self-assessment of their knowledge as well as investigate the significance of preceptorship experiences. Contraceptives was chosen as the subject area in view of high rates of abortions as a means of contraception in Bosnia and Herzegovina. METHODS A questionnaire approach was used. The questionnaire included the following: the first domain contained two case scenarios (safe use of contraceptives), which evaluated clinical knowledge, a second domain in which pharmacists self-assessed their knowledge to resolve cases from the first domain and a third domain that measured the demographics of pharmacists (including experience in preceptorship). Dispensing practice was evaluated in the second domain. The questionnaires were distributed to a convenient sample of 100 pharmacists at the Annual Meeting of Bosnia and Herzegovina Pharmacists. The results were presented as counts (%). The groups (preceptors and non-preceptors) were compared using Mann-Whitney U test, paired assessments were analyzed by Wilcoxon signed-rank test and Spearman's correlation was used to assess the correlation between variables. RESULTS Of the 100 pharmacists invited to participate, 84 completed the questionnaire (84 % response rate). There was no agreement between pharmacists' real knowledge (average score - case 1: 2.71, case 2: 3.3) and their self-assessment (average score - case 1: 3.77, case 2: 3.91). There was no statistically significant difference in the actual knowledge of pharmacists (experienced/non-experienced in precepting), while the difference in the self-assessment was significant between these two groups. CONCLUSION Pharmacists appear to overrate themselves, which leads to self-enhancement bias, in which the experience in precepting has some influence. Pharmacists' capability in performing an objective self-assessment of their clinical knowledge needs to be carefully studied in the future to fully benefit patients.
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Affiliation(s)
- Ana Golić Jelić
- Department of Pharmacology, Toxicology and Clinical Pharmacology, University of Banja Luka – Medical Faculty, Save Mrkalja 14, 78000 Banja Luka, Bosnia and Herzegovina
- Faculty of Pharmacy, Department of Social pharmacy and Pharmaceutical legislation, University of Belgrade, Vojvode Stepe 450, 11221 Belgrade, Serbia
| | - Ljiljana Tasić
- Faculty of Pharmacy, Department of Social pharmacy and Pharmaceutical legislation, University of Belgrade, Vojvode Stepe 450, 11221 Belgrade, Serbia
| | - Ranko Škrbić
- Department of Pharmacology, Toxicology and Clinical Pharmacology, University of Banja Luka – Medical Faculty, Save Mrkalja 14, 78000 Banja Luka, Bosnia and Herzegovina
| | - Valentina Marinković
- Faculty of Pharmacy, Department of Social pharmacy and Pharmaceutical legislation, University of Belgrade, Vojvode Stepe 450, 11221 Belgrade, Serbia
| | - Svjetlana Stoisavljević Šatara
- Department of Pharmacology, Toxicology and Clinical Pharmacology, University of Banja Luka – Medical Faculty, Save Mrkalja 14, 78000 Banja Luka, Bosnia and Herzegovina
| | - Nataša Stojaković
- Department of Pharmacology, Toxicology and Clinical Pharmacology, University of Banja Luka – Medical Faculty, Save Mrkalja 14, 78000 Banja Luka, Bosnia and Herzegovina
| | - Vanda Marković Peković
- Medical Faculty, Department of Social Pharmacy, University of Banja Luka, Save Mrkalja 14, Banja Luka, Bosnia and Herzegovina
| | - Brian Godman
- Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Scotland Glasgow, UK
- School of Pharmacy, Sefako Makgatho Health Sciences University, Ga-Rankuwa, Pretoria, South Africa
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16
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Raghvan HPN, Fatokun O. Factors associated with the intention of community pharmacists to report adverse drug reactions to regulatory authority in Malaysia: application of the theory of planned behaviour. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2021; 29:435-442. [PMID: 34244775 DOI: 10.1093/ijpp/riab036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 06/09/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES It is known that community pharmacists in Malaysia underreport adverse drug reactions (ADRs). In order to improve ADR reporting, a theory-based understanding of the factors associated with the community pharmacists' reporting behaviour is important. This study used the theory of planned behaviour (TPB) to identify the predictors of behavioural intention to report ADRs to the regulatory authority among community pharmacists in Malaysia and to assess the relative importance of the predictors. METHODS A questionnaire-based study was conducted among 188 randomly selected community pharmacists in the state of Johor, Malaysia. The questionnaire included four main TPB constructs (intention, attitude, subjective norms and perceived behavioural control) and related measures, including perceived moral obligation, past reporting behaviour and sociodemographic variables. Descriptive and hierarchical regression analyses were conducted. KEY FINDINGS A total of 164 questionnaires were collected. The mean score of intention to report ADRs was 15.43 (SD = 2.99). The final model of the hierarchical regression analysis showed that attitude towards ADR reporting (P = 0.004), subjective norm (P = 0.010) and perceived moral obligation (P = 0.014) were significant predictors of intention to report ADRs. Attitude was the most significant predictor, followed by subjective norm and perceived moral obligation. CONCLUSIONS Interventions targeting community pharmacists' attitude, subjective norms and perceived moral obligations towards ADR reporting, with a specific focus on attitude would likely have a positive impact on improving ADR reporting in Malaysia.
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Affiliation(s)
- Hari Pretha Nair Raghvan
- Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, UCSI University, Kuala Lumpur, Malaysia
| | - Omotayo Fatokun
- Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, UCSI University, Kuala Lumpur, Malaysia
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Implementation of a Real-Time Medication Intake Monitoring Technology Intervention in Community Pharmacy Settings: A Mixed-Method Pilot Study. PHARMACY 2021; 9:pharmacy9020105. [PMID: 34070544 PMCID: PMC8162977 DOI: 10.3390/pharmacy9020105] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 05/10/2021] [Accepted: 05/19/2021] [Indexed: 11/16/2022] Open
Abstract
Innovative dispensing products offering real-time medication intake monitoring are being developed to address medication non-adherence. However, implementation of these interventions within the workflow of a community pharmacy is unknown. The purpose of this study was to explore factors affecting implementation of a real-time adherence-monitoring, multidose-dispensing system in community pharmacies. A mixed-method study was conducted with pharmacy staff, who packaged and dispensed medications in smart multidose packages and monitored real-time medication intake via web-portal. Pharmacy staff participated in semi-structured interviews. The Technology Acceptance Model, Theory of Planned Behaviour and Capability, Opportunity, Motivation, Behaviour Model informed the interview guide. Interview transcripts were analyzed thematically and findings were mapped back to the frameworks. The usability was assessed by the System Usability Scale (SUS). Three pharmacists and one pharmacy assistant with a mean of 19 years of practice were interviewed. Three themes and 12 subthemes were generated. Themes included: pharmacy workflow factors, integration factors, and pharmacist-perceived patient factors. The mean SUS was found to be 80.63. Products with real-time adherence monitoring capabilities are valued by pharmacists. A careful assessment of infrastructure—including pharmacy workload, manpower and financial resources—is imperative for successful implementation of such interventions in a community pharmacy setting.
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Vatovec C, Kolodinsky J, Callas P, Hart C, Gallagher K. Pharmaceutical pollution sources and solutions: Survey of human and veterinary medication purchasing, use, and disposal. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2021; 285:112106. [PMID: 33588165 DOI: 10.1016/j.jenvman.2021.112106] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 01/13/2021] [Accepted: 01/31/2021] [Indexed: 05/26/2023]
Abstract
Human and veterinary pharmaceuticals offer many benefits, but they also pose risks to both the environment and public health. Life-cycle stewardship of medications offers multiple strategies for minimizing the risks posed by pharmaceuticals, and further insight is required for developing best practices for pharmaceutical management. The goal of this study was to clarify points of intervention for minimizing environmental and public health risks associated with pharmaceuticals. Specifically, our objectives were to provide insight on purchasing, use, and disposal behaviors associated with human and veterinary medications. This study used a state-wide representative sample of Vermont adults (n = 421) to survey both human and veterinary pharmaceuticals as potential sources of the unintended consequences of prescribed and over-the-counter (OTC) medications. The majority (93%) of respondents had purchased some form of medication within the past twelve months, including OTC (85%), prescription (74%), and veterinary (41%) drugs. Leftover drugs of any kind were reported by 59% of respondents. While 56% of people were aware of drug take-back programs, the majority reported never being told what to do with leftover medications by their physician (78%), pharmacist (76%), or veterinarian (53%). Among all respondents, take-back programs were the most common disposal method (22%), followed by trash (19%), and flushing (9%), while 26% of respondents reported keeping unused drugs. Awareness of pharmaceutical pollution in the environment and having received information about proper disposal were both significantly associated with participation in take-back programs. These findings indicate that a large volume of drugs are going unused annually, and that only a portion of leftover medications are returned to take-back programs where they can be appropriately disposed. Our results warrant further investigation of clinical interventions that support lower dose prescribing and dispensing practices in order to reduce the unintended environmental and public health consequences of pharmaceuticals within the consumer sphere. In addition, our findings suggest that directed efforts to raise awareness of proper disposal may be more effective than broad awareness campaigns, and we recommend research on the efficacy of providing disposal instructions on drug packaging.
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Affiliation(s)
- Christine Vatovec
- Gund Institute for Environment & Larner College of Medicine, University of Vermont, Burlington, VT, USA.
| | - Jane Kolodinsky
- Community Development and Applied Economics, University of Vermont, Burlington, VT, USA
| | - Peter Callas
- Department of Mathematics & Statistics, University of Vermont, Burlington, VT, USA
| | - Christine Hart
- Rubenstein School of Environment & Natural Resources, University of Vermont, Burlington, VT, USA
| | - Kati Gallagher
- Community Development and Applied Economics, University of Vermont, Burlington, VT, USA
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Malcolm O, Nelson A, Modeste NN, Gavaza P. Factors influencing implementation of personalized prevention plans among annual wellness visit patients using the theory of planned behavior: A quantitative study. Res Social Adm Pharm 2021; 17:1636-1644. [PMID: 33678585 DOI: 10.1016/j.sapharm.2021.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 01/03/2021] [Accepted: 01/04/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND The Affordable Care Act provides Medicare Part B beneficiaries access to cost-free Annual Wellness Visits (AWVs). Patients receive health behavior recommendations from a Personalized Prevention Plan (PPP) during AWV encounters. AIMS To identify factors clinical pharmacists can use to influence adoption of PPPs in primary care practices. METHOD Utilizing a cross-sectional design, 77 Medicare patients (mean age 74.05 ± 8.04 years) presenting for subsequent AWV completed a theory of planned behavior (TPB) based questionnaire at two primary care practices. RESULTS 66.2% reported they were in the process of implementing PPPs and 51.9% reported implementing recommendations in the previous 12 months. TPB constructs accounted for 35.8% (p < .001) of the variation in intention, with subjective norm (SN) (β = 0.359, p = 0.004) as the strongest determinant, followed by attitude (β = 0.195, p = 0.093), and perceived behavioral control (PBC) (β = 0.103, p = 0.384). Intention accounted for 27.1% of the variance for implementing PPPs and was not a significant determinant (β = 0.047, p = 0.917). Addition of past behavior with TPB constructs significantly improved the predictability of the TPB model, accounted for 55% of the variation in intention (p < .001), and demonstrated a significant positive influence (β = 0.636, p < 0.001) on future PPP implementations. DISCUSSION This study demonstrates utility of the TPB in predicting implementation of PPPs. CONCLUSIONS Clinical pharmacists positioned as providers of AWVs can strengthen intention to adopt PPPs by integrating referents into AWV processes, and evaluating past behavior trends to improve future PPP implementation.
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Affiliation(s)
- O'Neal Malcolm
- Loma Linda University, School of Public Health, Loma Linda, CA, USA.
| | - Anna Nelson
- Health Promotion and Education, Loma Linda University, School of Public Health, Loma Linda, CA, USA
| | - Naomi N Modeste
- Health Promotion and Education, Loma Linda University, School of Public Health, Loma Linda, CA, USA
| | - Paul Gavaza
- Pharmaceutical and Administrative Sciences, Loma Linda University, School of Pharmacy, Loma Linda, CA, USA
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Gahbauer A, Gruenberg K, Forrester C, Saba A, Schauer S, Fravel M, Lam A, Brock T. Climate care is health care: A call for collaborative pharmacy action. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2021. [DOI: 10.1002/jac5.1412] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Alice Gahbauer
- University of Charleston School of Pharmacy Charleston West Virginia USA
| | - Katherine Gruenberg
- University of California, San Francisco School of Pharmacy San Francisco California USA
| | - Catherine Forrester
- Monash University Faculty of Pharmacy & Pharmaceutical Sciences Melbourne Victoria Australia
| | - Amir Saba
- University of Iowa College of Pharmacy, University of Iowa College of Public Health Iowa City Iowa USA
| | - Samuel Schauer
- University of Iowa College of Pharmacy Iowa City Iowa USA
| | | | - Ashley Lam
- University of Charleston School of Pharmacy Charleston West Virginia USA
| | - Tina Brock
- Monash University Faculty of Pharmacy & Pharmaceutical Sciences Melbourne Victoria Australia
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21
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Alhomoud FK, Alsadiq Y, Alghalawin L, Alhifany A, Alhomoud F. Pharmacy students' knowledge and practices concerning the storing and disposal of household medication in Saudi Arabia. CURRENTS IN PHARMACY TEACHING & LEARNING 2021; 13:5-13. [PMID: 33131618 DOI: 10.1016/j.cptl.2020.08.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 07/05/2020] [Accepted: 08/10/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Pharmacists, and thus pharmacy students, must participate in promoting awareness about proper storage and disposal of expired or unused medications. This study aimed to determine Saudi Arabian pharmacy students' knowledge and personal practices regarding storing and disposing of household medications. METHODS This was a descriptive, cross-sectional, questionnaire-based study of pharmacy undergraduates or postgraduates across Saudi Arabia. The online survey was distributed to a convenience sample of participants and supplemented with snowball sampling on social media. RESULTS Of 807 pharmacy students who viewed the questionnaire, 464 students completed it (response rate 57.5%). Common reasons for keeping medications included having left-over medication (74%) and self-discontinuation of therapy (63.5%). The majority of students (79%) stored their medication in a bedroom or kitchen. Gender-specific variables revealed a gender difference in storing and disposing of these medications. Many students reported previously discarding medicines in the garbage (89%) or giving them to someone else to use (22%). More than half of the sample (60%) had not received any information on how to store or dispose of medications. CONCLUSIONS The current practice and knowledge of Saudi Arabian pharmacy students regarding storage and disposal of household medications was inappropriate. Concerned authorities (e.g., Ministry of Health, Ministry of Education) should provide proper education to all students on the safe storage and disposal of medications, which may necessitate curriculum reform.
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Affiliation(s)
- Farah Kais Alhomoud
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, 2835 King Faisal Road, Dammam 34212, Saudi Arabia.
| | - Yara Alsadiq
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Laila Alghalawin
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Abdullah Alhifany
- Clinical Pharmacy Department, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Faten Alhomoud
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Ehrhart AL, Granek EF, Nielsen-Pincus M, Horn DA. Leftover drug disposal: Customer behavior, pharmacist recommendations, and obstacles to drug take-back box implementation. WASTE MANAGEMENT (NEW YORK, N.Y.) 2020; 118:416-425. [PMID: 32949811 DOI: 10.1016/j.wasman.2020.08.038] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 08/17/2020] [Accepted: 08/20/2020] [Indexed: 06/11/2023]
Abstract
Production and use of pharmaceuticals in the United States is high and continues to grow. This, combined with poor wastewater removal rates for drugs in excreted waste, and improper pharmaceutical disposal leads to the presence of pharmaceuticals in fresh- and marine waters and wildlife. In the United States, safe drug take-back boxes, or dropboxes, were established in pharmacies after federal legislation passed in 2014, allowing for year-round safe collection of leftover pharmaceuticals. The overarching objective of this work was to identify opportunities for improving access to proper pharmaceutical disposal. We assessed consumer behavior regarding drug disposal choices and knowledge of dropboxes at pharmacies, investigated pharmacist attitudes toward and recommendations about leftover drug disposal, and compared responses at locations with and without dropboxes. We also explored obstacles to dropbox adoption and usage. We found that customer awareness of dropboxes as well as knowledge about risks of improper disposal are low, however awareness was greater at pharmacies with dropboxes. Additionally, pharmacists at dropbox locations were more consistent in their messaging to customers, more likely to recommend proper disposal methods, and more supportive of drug take-back programs. Through a focus group, we learned that further consumer education would overwhelm the capacity of the existing dropboxes. Based on our findings, we recommend solutions to improper disposal focus on legislation mandating dropboxes at pharmacies and pressure on the pharmaceutical industry to fund proper disposal of unused pharmaceuticals.
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Affiliation(s)
- Amy L Ehrhart
- Portland State University, Department of Environmental Science and Management, Science Research and Teaching Center, 1719 SW 10 th Ave, Rm. 218, Portland, OR 97201, United States.
| | - Elise F Granek
- Portland State University, Department of Environmental Science and Management, Science Research and Teaching Center, 1719 SW 10 th Ave, Rm. 218, Portland, OR 97201, United States
| | - Max Nielsen-Pincus
- Portland State University, Department of Environmental Science and Management, Science Research and Teaching Center, 1719 SW 10 th Ave, Rm. 218, Portland, OR 97201, United States
| | - Dorothy A Horn
- Portland State University, Department of Environmental Science and Management, Science Research and Teaching Center, 1719 SW 10 th Ave, Rm. 218, Portland, OR 97201, United States
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Development and validation of a theory-based instrument to predict community pharmacists' intention to provide pharmaceutical care services. Res Social Adm Pharm 2020; 17:664-676. [PMID: 32859503 DOI: 10.1016/j.sapharm.2020.06.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 06/12/2020] [Accepted: 06/29/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Predicting pharmacists' intention to provide Pharmaceutical Care (PC) and identifying modifiable factors associated with their intention can aid in the design and tailoring of behavior-based interventions to promote the adoption of PC as a standard of pharmacy practice. There is a need for valid and reliable instruments that are theoretically grounded to measure these factors. OBJECTIVE To develop and test the psychometric properties of the "Pharmaceutical Care Intention (PCI) scale" to identify socio-cognitive factors associated with community pharmacists' intention to provide PC services to patients with chronic conditions. METHODS A self-administered questionnaire was developed in English and translated into Arabic, guided by constructs derived from a modified Theory of Planned Behavior (TPB) framework and a thorough review of the PC literature. The questionnaire was reviewed for face and content validity, pilot tested, and then administered to a sample of community pharmacists in Alexandria, Egypt. Exploratory factor analysis (EFA) was employed to identify and refine the underlying dimensional structure of the PCI scale and test for its convergent and discriminant validity. Reliability was assessed by computing Cronbach's α. RESULTS Out of the 109 approached pharmacists, 97 usable responses were analyzed (response rate = 89%). EFA resulted in a 23-item, 6-factor solution explaining 52.14% of the variance in responses and providing evidence for convergent and discriminant validity. The resulting factors aligned with the modified TPB constructs: intention (α = 0.74), attitude (α = 0.89), subjective norm (α = 0.58), perceived behavioral control to identify (α = 0.66) and intervene (α = 0.82) to address drug-related problems, and perceived moral obligation (α = 0.72). Cronbach's α of the pooled items of the PCI scale was 0.77. CONCLUSION The PCI scale is a parsimonious, theory-driven instrument with acceptable construct validity and reliability to examine factors associated with community pharmacists' intention to provide PC.
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Scudder AT, Bucey JC, Loughran MJ, Korach N, Strong G, Anderson J, Doas M, Jameson S, O’Keefe L. Screening, brief intervention, and referral to treatment (SBIRT) expansion of training to non-physician healthcare graduate students: Counseling psychology, nursing, occupational therapy, physical therapy, and physician assistant studies. Subst Abus 2019; 42:76-86. [DOI: 10.1080/08897077.2019.1695705] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Ashley T. Scudder
- Counseling Psychology, Chatham University, Pittsburgh, Pennsylvania, USA
| | - Janet C. Bucey
- Occupational Therapy, Chatham University, Pittsburgh, Pennsylvania, USA
| | - Mary Jo Loughran
- Counseling Psychology, Chatham University, Pittsburgh, Pennsylvania, USA
| | - Nicholas Korach
- Program Evaluation and Research Unit, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- School of Health Sciences, Chatham University, Pittsburgh, Pennsylvania, USA
| | - Gabrielle Strong
- School of Health Sciences, Chatham University, Pittsburgh, Pennsylvania, USA
| | - Jessica Anderson
- Physicians Assistant, Chatham University, Pittsburgh, Pennsylvania, USA
| | - Michelle Doas
- Nursing, Chatham University, Pittsburgh, Pennsylvania, USA
| | - Sarah Jameson
- Physical Therapy, Chatham University, Pittsburgh, Pennsylvania, USA
| | - Lea O’Keefe
- Physicians Assistant, Chatham University, Pittsburgh, Pennsylvania, USA
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Health care practitioner counseling encourages disposal of unused opioid medications. J Am Pharm Assoc (2003) 2019; 59:809-815.e5. [DOI: 10.1016/j.japh.2019.07.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 06/27/2019] [Accepted: 07/18/2019] [Indexed: 02/06/2023]
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Dowling-McClay K, Mospan CM, Subedi P, Hagemeier NE. Explaining Pharmacy Students' Dispensing Intentions in Substance Abuse-Related Gray Areas Using the Theory of Planned Behavior. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2019; 83:6767. [PMID: 31333256 PMCID: PMC6630868 DOI: 10.5688/ajpe6767] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 04/09/2018] [Indexed: 06/10/2023]
Abstract
Objective. To examine the extent to which theory of planned behavior (TPB) constructs and demographic characteristics explain pharmacy students' dispensing intentions in ethically or legally gray areas involving potential substance misuse or abuse. Methods. Two cohorts of third-year Doctor of Pharmacy (PharmD) students (n=159) were provided with five written cases describing common "gray area" dispensing scenarios in community practice involving medications and devices with potential for misuse or abuse (eg, long-term buprenorphine maintenance prescription without evidence of tapering, early refill of a narcotic for an out-of-town patient, non-prescription sale of pseudoephedrine). Students completed a 12-item survey instrument for each case. Items assessed whether the student would dispense the medication or device in the given scenario, how many times in 10 similar scenarios the student would dispense the medication or device, attitudes regarding dispensing, and subjective norm and perceived behavioral control beliefs. Results. Wide variation in the percentages of students who would dispense the medications or devices was noted across the five scenarios (14% in the buprenorphine scenario to 61% in the pseudoephedrine scenario). Attitude scores significantly predicted dispensing decisions in all scenarios (p<.001), whereas subjective norm and perceived behavioral control beliefs were significant predictors of dispensing only in select case scenarios. Gender and community pharmacy work experience did not consistently predict dispensing intentions. Conclusion. Student attitudes consistently predicted intent to dispense across five gray practice scenarios. These findings can be used to inform development of educational interventions that influence students' attitudes and self-awareness in community practice decision-making scenarios involving potential substance misuse or abuse.
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Affiliation(s)
| | | | - Pooja Subedi
- East Tennessee State University College of Public Health, Johnson City, Tennessee
| | - Nicholas E. Hagemeier
- East Tennessee State University Bill Gatton College of Pharmacy, Johnson City, Tennessee
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Michael I, Ogbonna B, Sunday N, Anetoh M, Matthew O. Assessment of disposal practices of expired and unused medications among community pharmacies in Anambra State southeast Nigeria: a mixed study design. J Pharm Policy Pract 2019; 12:12. [PMID: 31016021 PMCID: PMC6469121 DOI: 10.1186/s40545-019-0174-1] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 11/30/2018] [Indexed: 02/02/2023] Open
Abstract
Background Expired or unused medicines are potentially toxic substances that should be managed effectively to avoid accumulation of potentially toxic pharmaceuticals in the environment. In Nigeria, there is currently limited literature on the methods and protocols used by community pharmacists in the disposal of expired drugs. This study assessed disposal practices of expired and unused medications by pharmacists in Anambra State and compared them to the National Agency for Food and Drug Administration and Control (NAFDAC) guideline on disposal of expired drugs. Methods A questionnaire survey and key informant interview (KII) was used for the study. The pre-tested revised and adapted questionnaires were sent to all the 103 community pharmacies in Pharmacists Council of Nigeria (PCN) 2015 record of registered pharmacies in Anambra State. The participants were asked questions about how they disposed of expired and unused medications. The respondents that used NAFDAC or drug wholesalers were asked questions on how the third party destroys their expired drugs. In addition to the use of a questionnaire, KII was conducted to assess relevant professionals and stakeholders in this area. Results The study recorded 77 successfully returned questionnaires out of the 103 distributed and a response rate of 74.8%. The various disposal methods were: through NAFDAC 28.0 (31.8%), drug distributors 21.0 (23.9%), rubbish bins 8.0 (9.1%); this was mainly for solid dosage forms. However, 6.0(7.1%) reported that they used the sink to dispose of their liquid dosage forms and 24.0 (29.6%) noted they do not stock Class B controlled drugs. A lesser proportion of respondents 18.0 (23.4%) complied fully with the national guideline on disposal of expired drugs, while 17.0 (22.1%) complied partially and 42.0 (54.5%) did not comply. Some of the respondents 17.0 (22.1%) reported that NAFDAC uses incineration or other forms of heat to dispose of expired drugs, but 19.0 (24.7%) reported they do not know how NAFDAC dispose of their expired drugs. Majority of the respondents 55.0 (71.4%) suggested the state-run disposal system. Conclusion Poor compliance with the national guideline for medication disposal increases the potential risk of contamination of our environment and increases the possibility of ingesting toxic pharmaceutical wastes by humans and animals. This underscores the need for improvement on expired drugs management protocols to prevent contaminations and the attendant health hazards.
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Affiliation(s)
- Iweh Michael
- 1Department of Clinical Pharmacy and Pharmacy Management, Nnamdi Azikiwe University, Awka, Anambra State Nigeria
| | - Brian Ogbonna
- 1Department of Clinical Pharmacy and Pharmacy Management, Nnamdi Azikiwe University, Awka, Anambra State Nigeria
| | - Nduka Sunday
- 1Department of Clinical Pharmacy and Pharmacy Management, Nnamdi Azikiwe University, Awka, Anambra State Nigeria
| | - Maureen Anetoh
- 1Department of Clinical Pharmacy and Pharmacy Management, Nnamdi Azikiwe University, Awka, Anambra State Nigeria
| | - Okonta Matthew
- 2Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, Nsukka, Nigeria
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Painter N, He J, Agyapong T. Pharmacist Intention to Provide Medication Disposal Education. JOURNAL OF CONTEMPORARY PHARMACY PRACTICE 2018. [DOI: 10.37901/jcphp17-00021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Nathan Painter
- UC San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences
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Wahab MSA, Sakthong P, Winit-Watjana W. Qualitative exploration of pharmacist care for herbal and dietary supplement users in Thai community pharmacies. JOURNAL OF PHARMACEUTICAL HEALTH SERVICES RESEARCH 2018. [DOI: 10.1111/jphs.12238] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Abstract
Objectives
Herbal and dietary supplements (HDS) can cause adverse effects or interact with diseases and medications. Community pharmacists have a role in ensuring the safe use of HDS, but they have been reported to not being proactive in providing pharmacist care (PCare) for HDS users. The reasons for this warranted investigation. The study aimed to explore pharmacists’ understanding of PCare for HDS users, and to investigate the underlying beliefs or factors influencing its provision by community pharmacists, guided by the theory of planned behaviour.
Methods
A qualitative study using a semi-structured interview guide was conducted in a purposive sample of community pharmacists working in Bangkok, Thailand, from December 2016 to June 2017. All interviews were audio-recorded, transcribed and analysed using qualitative content analysis.
Key findings
Twenty-two pharmacists were interviewed. Several professional pharmacy activities were regarded as PCare for HDS users. The pharmacists reported that the provision of such care was advantageous in terms of promoting rational use of HDS, ensuring safety of users, enhancing own knowledge and promote customers’ loyalty. Facilitators for PCare included the initiation of conversation about HDS by the users, professional training and the availability of reference materials. The reluctance of HDS users to accept pharmacists’ opinions, insufficient education in HDS and limited sources of information were identified as barriers. Most pharmacists believed that PCare for HDS users is part of their responsibilities.
Conclusions
The pharmacists expressed their views on the meaning of PCare for HDS users, and described the beliefs and factors that facilitate or impede its provision. Information from this study can be used to inform strategies that can promote pharmacists to become more proactive in providing PCare for HDS users.
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Affiliation(s)
- Mohd Shahezwan Abd Wahab
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
- Department of Pharmacy Practice, Faculty of Pharmacy, Universiti Teknologi MARA Cawangan Selangor, Puncak Alam, Malaysia
| | - Phantipa Sakthong
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Win Winit-Watjana
- Department of Clinical Pharmacy, Faculty of Pharmacy, Srinakharinwirot University, Nakhon Nayok, Thailand
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Lee S, Hata M, Law A. Medication Disposal: The Final Step in Medication Safety. JOURNAL OF CONTEMPORARY PHARMACY PRACTICE 2018. [DOI: 10.37901/jcphp17-00005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Sun Lee
- Western University of Health Sciences
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Kinrys G, Gold AK, Worthington JJ, Nierenberg AA. Medication disposal practices: Increasing patient and clinician education on safe methods. J Int Med Res 2018; 46:927-939. [PMID: 29322845 PMCID: PMC5972255 DOI: 10.1177/0300060517738681] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Recent research suggests that the nation’s water supply is contaminated with trace pharmaceuticals that exert a negative environmental and public health impact. Incorrect medication disposal methods (e.g. flushing medications down the toilet or drain) are a significant factor contributing to the presence of medication compounds in the aquatic environment. In this commentary, we provide a summary of the existing data on pharmaceuticals in the nation’s water as well as the role of improper medication disposal methods on water contamination. We discuss statistics on improper medication disposal practices among patients and clinicians as well as recent advances in proper medication disposal methods as a solution to this problem. Currently, many patients and clinicians are not aware of proper medication disposal practices. We summarize the importance of patient and clinician education in advancing environmental-safe medication disposal methods.
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Affiliation(s)
- Gustavo Kinrys
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Gustavo Kinrys, Department of Psychiatry, Massachusetts General Hospital, 50 Staniford Street, Suite 580, Boston, MA 02114, USA.
| | - Alexandra K. Gold
- Department of Psychological & Brain Sciences, Boston University, Boston, MA, USA
| | - John J. Worthington
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Andrew A. Nierenberg
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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Frankfurter C, Cunningham C, Morrison KM, Rimas H, Bailey K. Understanding academic clinicians’ intent to treat pediatric obesity. World J Clin Pediatr 2017; 6:60-68. [PMID: 28224097 PMCID: PMC5296631 DOI: 10.5409/wjcp.v6.i1.60] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Revised: 07/29/2016] [Accepted: 10/27/2016] [Indexed: 02/06/2023] Open
Abstract
AIM To examine the extent to which the theory of planned behavior (TPB) predicts academic clinicians’ intent to treat pediatric obesity.
METHODS A multi-disciplinary panel iteratively devised a Likert scale survey based on the constructs of the TPB applied to a set of pediatric obesity themes. A cross-sectional electronic survey was then administered to academic clinicians at tertiary care centers across Canada from January to April 2012. Descriptive statistics were used to summarize demographic and item agreement data. A hierarchical linear regression analysis controlling for demographic variables was conducted to examine the extent to which the TPB subscales predicted intent to treat pediatric obesity.
RESULTS A total of 198 physicians, surgeons, and allied health professionals across Canada (British Columbia, Alberta, Manitoba, Saskatchewan, Nova Scotia, Ontario and Quebec) completed the survey. On step 1, demographic factors accounted for 7.4% of the variance in intent scores. Together in step 2, demographic variables and TPB subscales predicted 56.9% of the variance in a measure of the intent to treat pediatric obesity. Perceived behavioral control, that is, confidence in one’s ability to manage pediatric obesity, and subjective norms, congruent with one’s context of practice, were the most significant predictors of the intent to treat pediatric obesity. Attitudes and barriers did not predict the intent to treat pediatric obesity in this context.
CONCLUSION Enhancing self-confidence in the ability to treat pediatric obesity and the existence of supportive treatment environments are important to increase clinicians’ intent to treat pediatric obesity.
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Sonowal S, Desai C, Kapadia JD, Desai MK. A Survey of Knowledge, Attitude, and Practice of Consumers at a Tertiary Care Hospital Regarding the Disposal of Unused Medicines. J Basic Clin Pharm 2017; 8:4-7. [PMID: 28104967 PMCID: PMC5201063 DOI: 10.4103/0976-0105.195079] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objectives: To evaluate the knowledge, attitude and practice of consumers in India about disposal of unused medicines. Materials and Methods: A questionnaire comprising 11 questions evaluating the Knowledge (2), Attitude (3) and Practice (6) of unused medicines was prepared and pre validated before administering to 200 consumers of medicines attending the outpatient department of Civil Hospital Ahmedabad, a tertiary care teaching hospital in Western India. Requisite permissions from Institutional Ethics Committee and informed consent were obtained prior to recruiting them for the study. Responses were recorded, in Microsoft Excel® spreadsheet and evaluated for percentage response. Results: Majority of the respondents (136, 68%) stored unused medicines at home. Analgesics (26.5%) were the most common unused medicine stored. Safe disposal of medicine was considered necessary by majority respondents (160, 80%) for different reasons like prevention of illegal/unintended use (84, 42%), prevention of environmental pollution (32, 16%) or possible ADR caused by old drugs (54, 27%). Only 78 (39%) respondents were aware of appropriate methods of disposal. Disposal in household trash (61, 30.5%) was the most common method used. Majority of respondents felt the need for a facility or programme to collect unused medicines (152, 76%) and an increased awareness among consumers regarding hazards and methods of disposal of unused medicines (154, 77%). Conclusion: Majority of consumers are aware about the need for safe disposal of unused medicines. But the right attitude for and practice of safe disposal of medicines is lacking. A need for increased awareness regarding safe disposal of medicines is acknowledged by majority of consumers.
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Affiliation(s)
- Supriya Sonowal
- Department of Pharmacology, B. J. Medical College, Ahmedabad, Gujarat, India
| | - Chetna Desai
- Department of Pharmacology, B. J. Medical College, Ahmedabad, Gujarat, India
| | - Jigar D Kapadia
- Department of Pharmacology, B. J. Medical College, Ahmedabad, Gujarat, India
| | - Mira K Desai
- Department of Pharmacology, B. J. Medical College, Ahmedabad, Gujarat, India
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