评估药物浪费情况：美国家庭中的未使用药物。
Taking stock of medication wastage: Unused medications in US households.
作者信息
Law Anandi V, Sakharkar Prashant, Zargarzadeh Amir, Tai Bik Wai Bilvick, Hess Karl, Hata Micah, Mireles Rudolph, Ha Carolyn, Park Tony J
机构信息
Department of Pharmacy Practice and Administration, College of Pharmacy, Western University of Health Sciences, 309 E. Second Street, Pomona, CA 91766, USA.
Department of Pharmacy Practice and Administration, College of Pharmacy, Western University of Health Sciences, 309 E. Second Street, Pomona, CA 91766, USA.
出版信息
Res Social Adm Pharm. 2015 Jul-Aug;11(4):571-8. doi: 10.1016/j.sapharm.2014.10.003. Epub 2014 Oct 17.
BACKGROUND
Despite the potential deleterious impact on patient safety, environmental safety and health care expenditures, the extent of unused prescription medications in US households and reasons for nonuse remain unknown.
OBJECTIVE
To estimate the extent, type and cost of unused medications and the reasons for their nonuse among US households.
METHODS
A cross-sectional, observational two-phased study was conducted using a convenience sample in Southern California. A web-based survey (Phase I, n = 238) at one health sciences institution and paper-based survey (Phase II, n = 68) at planned drug take-back events at three community pharmacies were conducted. The extent, type, and cost of unused medications and the reasons for their nonuse were collected.
RESULTS
Approximately 2 of 3 prescription medications were reported unused; disease/condition improved (42.4%), forgetfulness (5.8%) and side effects (6.5%) were reasons cited for their nonuse. "Throwing medications in the trash" was found being the common method of disposal (63%). In phase I, pain medications (23.3%) and antibiotics (18%) were most commonly reported as unused, whereas in Phase II, 17% of medications for chronic conditions (hypertension, diabetes, cholesterol, heart disease) and 8.3% for mental health problems were commonly reported as unused. Phase II participants indicated pharmacy as a preferred location for drug disposal. The total estimated cost for unused medications was approximately $59,264.20 (average retail Rx price) to $152,014.89 (AWP) from both phases, borne largely by private health insurance. When extrapolated to a national level, it was approximately $2.4B for elderly taking five prescription medications to $5.4B for the 52% of US adults who take one prescription medication daily.
CONCLUSION
Two out of three dispensed medications were unused, with national projected costs ranging from $2.4B to $5.4B. This wastage raises concerns about adherence, cost and safety; additionally, it points to the need for public awareness and policy to reduce wastage. Pharmacists can play an important role by educating patients both on appropriate medication use and disposal.
背景
尽管未使用的处方药可能会对患者安全、环境安全和医疗保健支出产生有害影响，但美国家庭中未使用处方药的程度及其未使用的原因仍不明确。
目的
估计美国家庭中未使用药物的程度、类型和成本以及未使用的原因。
方法
在南加州使用便利样本进行了一项横断面观察性两阶段研究。在一家健康科学机构进行了基于网络的调查（第一阶段，n = 238），并在三家社区药房的计划药物回收活动中进行了纸质调查（第二阶段，n = 68）。收集了未使用药物的程度、类型和成本以及未使用的原因。
结果
约三分之二的处方药被报告未使用；疾病/状况改善（42.4%）、遗忘（5.8%）和副作用（6.5%）是未使用的原因。发现“将药物扔进垃圾桶”是常见的处理方式（63%）。在第一阶段，止痛药（23.3%）和抗生素（18%）最常被报告为未使用，而在第二阶段，17%的慢性病（高血压、糖尿病、胆固醇、心脏病）药物和8.3%的精神健康问题药物常被报告为未使用。第二阶段的参与者表示药房是药物处理的首选地点。两个阶段未使用药物的估计总成本约为59,264.20美元（平均零售处方药价格）至152,014.89美元（平均批发价），主要由私人医疗保险承担。推算到全国范围，对于每天服用五种处方药的老年人来说约为24亿美元，对于每天服用一种处方药的52%的美国成年人来说约为54亿美元。
结论
三分之二的配发药物未被使用，全国预计成本在24亿美元至54亿美元之间。这种浪费引发了对依从性、成本和安全性的担忧；此外，这表明需要提高公众意识并制定政策以减少浪费。药剂师可以通过教育患者正确用药和处理药物发挥重要作用。
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