Quality Use of Medicines (QUM) Network, School of Pharmacy and Pharmacology, Griffith University, Brisbane, Australia.
School of Pharmacy and Pharmacology, Menzies Health Institute, Griffith University, Brisbane, Australia.
BMC Public Health. 2018 Aug 17;18(1):1026. doi: 10.1186/s12889-018-5753-6.
Consumers most commonly discard unwanted medicines in household rubbish or drains, however, there are global concerns over the extent, environmental impact and health risks. When consumers procure or store medicines for future use, this can impact negatively on quality use of medicines and consumer safety. We sought greater insight into the extent of these practices by exploring the volume and types of medicines in Australian homes, and self-reported practices related to medicine accumulation, use and disposal. This qualitative study formed part of a larger project that included a general population survey on household medicine disposal practices.
Semi-structured telephone interviews were undertaken with a subset of respondents (n = 166) from the survey. Participants were eligible if they were experienced medicine users, i.e. used five or more prescribed, over the counter, and/or complementary and alternative medicines. Participants were asked to collect and name all medicines in their household; further detail was obtained about medicines used only when required or no longer used, such as expiry dates and quantity remaining. The quantitative data on the number and type of medicines stored at home were analysed descriptively. All interviews were transcribed verbatim and thematically analysed.
A total of 2301 medicines were identified as 1424 medicines not in everyday use (unused, unwanted, expired or when required) in 166 households, and 877 regularly used medicines by 119 participants. Medicines were often stored in multiple locations, particularly kitchens. Although accidental ingestion in children and pets and decreased efficacy were recognised health risks, this did not always translate to appropriate storage, usage or disposal practices. Individual risk-benefit assessments were applied to decisions to retain, use or dispose of medicines, including expired medicines.
Inappropriate medicine storage, use, and/or disposal practices raises public health concerns, particularly as there is a free returned medicines scheme available, and that this particular participant group were considered experienced medicine users. Healthcare professionals must act to address consumer misconceptions around the quality use of medicines, including medicine retention, storage and disposal. Future research is warranted to explore consumer practices in this context and confirm these findings in a younger, or healthier population.
消费者通常会将不需要的药品丢弃在家庭垃圾或下水道中，但全球对这些药品的数量、环境影响和健康风险都存在担忧。当消费者为未来使用而采购或储存药品时，这可能会对药品的合理使用和消费者安全产生负面影响。为了更深入地了解这些做法的程度，我们探索了澳大利亚家庭中药品的数量和类型，以及与药品积累、使用和处置相关的自我报告做法。这项定性研究是一个更大项目的一部分，该项目包括一项关于家庭药品处置做法的总体人群调查。
从调查中抽取了一部分符合条件的受访者（n=166）进行半结构化电话访谈。如果参与者是经验丰富的药品使用者，即使用五种或更多种处方、非处方和/或补充和替代药品，则有资格参与。要求参与者收集并命名家中所有的药品；对于仅在需要时或不再使用时使用的药品，例如有效期和剩余数量，获取了更多详细信息。对家中储存的药品数量和类型的定量数据进行了描述性分析。所有访谈均逐字转录，并进行了主题分析。
在 166 户家庭中，共发现 2301 种药品，其中 1424 种为不常用药品（未使用、不需要、过期或需要时使用），119 名参与者使用 877 种常用药品。药品通常存放在多个地方，特别是厨房。尽管儿童和宠物意外摄入以及疗效降低被认为是健康风险，但这并不总是转化为适当的储存、使用或处置做法。个人对保留、使用或处置药品（包括过期药品）的风险-收益评估决定了这些做法。
不适当的药品储存、使用和/或处置做法引起了公共卫生关注，特别是因为有一个免费退还药品的计划，而且这个特定的参与者群体被认为是经验丰富的药品使用者。医疗保健专业人员必须采取行动，解决消费者对药品合理使用的误解，包括药品保留、储存和处置。需要进一步研究来探索这种情况下的消费者做法，并在更年轻或更健康的人群中证实这些发现。
