Wheeler Amanda J, Spinks Jean, Bettington Emilie, Kelly Fiona
Menzies Health Institute Queensland, Griffith University, Brisbane, Australia.
Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
J Pharm Policy Pract. 2017 Dec 7;10:38. doi: 10.1186/s40545-017-0126-6. eCollection 2017.
The National Return of Unwanted Medicines (NatRUM) program in Australia is one of the few nationally coordinated, free-to-consumer schemes to dispose of unwanted medicines globally. This scheme has been in operation since 1996, however, little is known about public awareness of the scheme and its effectiveness in reducing unsafe disposal practices. The study objectives are to undertake a review of (1) the current use of the NatRUM scheme by consumers; and (11) to investigate disposal practices and beliefs of the general population.
METHODS/DESIGN: A two-stage, mixed-methods study will be undertaken. Stage One will include a nation-wide audit of a representative sample of unwanted medicine bins, collected by community pharmacies, for incineration. The audit will detail the type and amount of unwanted medicines collected and if they are subsidised on the national formulary (Pharmaceutical Benefits Scheme). Stage Two will include: (i) a large, representative, general population survey; and (ii) more detailed interviews with a sub-set of this sample, who take five or more medications. Results will quantitatively describe the awareness of the NatRUM scheme, disposal practices and the volume of unwanted medicines stored in the home. It will qualitatively describe beliefs and perceptions about storage and disposal practices.
It is anticipated that this study will provide valuable insights about how Australians dispose of unwanted medicines, their awareness of the NatRUM scheme and how the scheme might be strengthened. Results will inform the Federal Department of Health and NatRUM Ltd. Board at a local level, as well as other countries who are yet to develop or implement coordinated disposal schemes. A number of challenges are expected, including ensuring the consistency of medicines terminology during the bin audit and recruiting a representative sample of Australians for the general population survey. Results of this study will be widely disseminated to support the translation of findings into practice.
澳大利亚的全国 unwanted 药品回收（NatRUM）计划是全球少数几个全国协调、面向消费者免费的 unwanted 药品处置计划之一。该计划自 1996 年开始实施，然而，对于公众对该计划的知晓情况及其在减少不安全处置行为方面的有效性知之甚少。研究目标是对以下方面进行审查：（1）消费者目前对 NatRUM 计划的使用情况；以及（2）调查普通人群的处置行为和观念。
方法/设计：将开展一项两阶段的混合方法研究。第一阶段将包括对社区药房收集的用于焚烧的 unwanted 药品回收箱的代表性样本进行全国范围的审计。审计将详细说明收集的 unwanted 药品的类型和数量，以及它们是否在国家药品目录（药品福利计划）上得到补贴。第二阶段将包括：（i）一项大规模、具有代表性的普通人群调查；以及（ii）对该样本中服用五种或更多药物的子集进行更详细的访谈。结果将定量描述对 NatRUM 计划的知晓情况、处置行为以及家中储存的 unwanted 药品数量。它将定性描述关于储存和处置行为的观念和看法。
预计这项研究将提供有关澳大利亚人如何处置 unwanted 药品、他们对 NatRUM 计划的知晓情况以及该计划如何得到加强的宝贵见解。结果将为联邦卫生部和 NatRUM 有限公司董事会提供地方层面的信息，以及为尚未制定或实施协调处置计划的其他国家提供信息。预计会有一些挑战，包括在回收箱审计期间确保药品术语的一致性，以及为普通人群调查招募具有代表性的澳大利亚样本。这项研究的结果将广泛传播，以支持将研究结果转化为实践。
