Welham Grace C, Mount Jeanine K, Gilson Aaron M
Social Administrative Sciences Division, School of Pharmacy, University of Wisconsin-Madison, 777 Highland Avenue, Madison, WI 53705 USA.
Social Administrative Sciences Division, School of Pharmacy, University of Wisconsin-Madison, 777 Highland Avenue, Madison, WI 53705 USA ; Department of Pharmacy and Health Systems Sciences, School of Pharmacy, Northeastern University, 360 Huntington Ave., Boston, MA 02115 USA.
Drugs Real World Outcomes. 2015;2(2):129-135. doi: 10.1007/s40801-015-0019-4.
Prescription opioids have increasingly been involved in overdose deaths and treatment admissions. Disposal programs may play an important role in curbing this trend. The objectives of this study were to: (1) quantify the prescription opioids returned for disposal to a local take-back program, and (2) explore selected drug characteristics that may predict the quantity of unused opioids. Leftover prescription opioid medications returned for disposal to a community drug take-back event were quantified and analyzed according to controlled substances schedule, formulation, number of active ingredients, and directions for use. Days' supply of medication remaining, calculated using the number of dosage units remaining divided by the maximum number of dosage units per day allowed by the prescriber, was the primary outcome variable. Opioid prescriptions returned for disposal had greater than 60 % of the amount dispensed remaining unused. Short-acting C-II and C-III combination opioids accounted for greater than 80 % of the prescriptions returned. Day supply dispensed was the strongest predictor of day supply remaining, regardless of other drug characteristics. These findings indicate that disposal programs are effective at removing unused medication from patient homes. To reduce leftover medication, prescriber education programs should address the amount to be prescribed. Continual monitoring of quantities prescribed and returned for disposal may be useful in evaluating the effects of these programs on leftover medication. Further research on drug characteristics may inform prescribing practices and reduce leftover medication.
处方阿片类药物越来越多地与过量死亡和治疗入院相关。药品回收计划可能在遏制这一趋势方面发挥重要作用。本研究的目的是：（1）量化返还给当地回收计划进行处理的处方阿片类药物数量，以及（2）探索可能预测未使用阿片类药物数量的选定药物特征。对返还给社区药品回收活动进行处理的剩余处方阿片类药物，根据管制药品分类、剂型、活性成分数量和使用说明进行了量化和分析。使用剩余剂量单位数除以开处方者允许的每日最大剂量单位数计算得出的剩余药物供应天数，是主要结局变量。返还进行处理的阿片类药物处方中，超过60%的已配药量仍未使用。短效C-II和C-III复方阿片类药物占返还处方的80%以上。无论其他药物特征如何，已配药量天数是剩余量天数的最强预测因素。这些发现表明，药品回收计划在从患者家中清除未使用药物方面是有效的。为减少剩余药物，开处方者教育计划应涉及开药量。持续监测开药量和返还处理量可能有助于评估这些计划对剩余药物的影响。对药物特征的进一步研究可能为处方实践提供信息并减少剩余药物。
