Medication Use Research Group, Department of Clinical Pharmacology and Therapeutics, Faculty of Medicine and Surgery, University of Malta, Msida, Malta.
College of Pharmacy, Qatar University, Doha, Qatar; School of Pharmacy and Life Sciences, Robert Gordon University, Garthdee Road, Aberdeen, Scotland, UK.
Res Social Adm Pharm. 2020 May;16(5):654-662. doi: 10.1016/j.sapharm.2019.08.003. Epub 2019 Aug 1.
While literature quantifying medication wastage and assessing public's knowledge and practices about medication disposal is substantial, less attention is given to the public's knowledge and behavior pertaining to medication wastage prevention. This study aimed to determine the public's knowledge of medication wastage, any association between knowledge and adherence, and behavioral determinants potentially leading to wastage.
A mixed-method explanatory sequential approach was adopted with a quantitative survey followed by qualitative semi-structured interviews. Maltese residents ≥18 years attending social/educational events were recruited in this mixed-methods study. Participants completed a structured questionnaire comprising: 1) demographics; 2) medication adherence using 'Tool for Adherence Behaviour Screening' dichotomized into 'good adherence'/'suboptimal adherence'; 3) eight knowledge statements each carrying one point (total, 0 = lowest; 8 = highest); 4) and whether they had unused medication at home. Chi-square analysis determined associations between demographics and adherence, and having unused medication. Multiple regression was performed to predict knowledge based on demographics, adherence, having regular medication and having unused medication, p ≤0.05. Questionnaire respondents expressing interest in participating in semi-structured face-to-face interviews, based on the Theoretical Domains Framework (TDF), were recruited consecutively until data saturation. Interviews were audio-recorded, transcribed and analyzed using the Framework Approach.
Of the 524 individuals attending 14 events, 80.5% completed the questionnaire (mean age±standard deviation (SD): 65 ± 13 years). Thirty-one percent (n = 130/422) of respondents reported having unused medication and 18.8% (58/309 taking chronic medication) classified as 'optimal' adherence. Mean ± SD knowledge score was 4.7 ± 1.5. Knowledge and adherence were not significantly related. Most prevalent TDF domains influencing wastage emerging from 15 interviews were knowledge, beliefs about consequences and behavioral regulation.
Public's knowledge about medication wastage and adherence were inadequate, necessitating implementation of tailored educational interventions based on behavioral determinants recognized within this study. Identified inadequate behavior around disposal mandates inclusion of environmental/social planning issues when developing policies.
虽然有大量文献定量描述了药物浪费，并评估了公众对药物处置的知识和实践，但对公众在预防药物浪费方面的知识和行为关注较少。本研究旨在确定公众对药物浪费的认识、知识与依从性之间的任何关联，以及可能导致浪费的行为决定因素。
本研究采用混合方法解释性顺序方法，首先进行定量调查，然后进行定性半结构化访谈。在这项混合方法研究中，招募了年龄在 18 岁及以上、参加社会/教育活动的马耳他居民。参与者完成了一份结构问卷，包括：1）人口统计学信息；2）使用“药物依从行为筛查工具”将药物依从性分为“良好依从性”/“非最佳依从性”；3）八项知识陈述，每项陈述得 1 分（总分，0=最低；8=最高）；4）他们家中是否有未使用的药物。卡方检验确定了人口统计学因素与依从性以及家中是否有未使用药物之间的关联。多元回归根据人口统计学、依从性、是否定期服用药物和家中是否有未使用药物来预测知识，p 值≤0.05。基于理论领域框架（TDF），对表达有兴趣参加半结构化面对面访谈的问卷受访者进行了连续招募，直到数据饱和。访谈进行了录音、转录，并使用框架方法进行了分析。
在参加了 14 次活动的 524 人中，有 80.5%（n=422）完成了问卷（平均年龄±标准差（SD）：65±13 岁）。31%（n=130/422）的受访者报告家中有未使用的药物，18.8%（n=58/309 服用慢性药物）归类为“最佳”依从性。平均±SD 知识得分为 4.7±1.5。知识和依从性之间没有显著相关性。15 次访谈中出现的影响浪费的最常见 TDF 领域包括知识、对后果的信念和行为调节。
公众对药物浪费和依从性的知识不足，需要根据本研究中确定的行为决定因素实施有针对性的教育干预措施。对处置规定的认识不足，需要在制定政策时纳入环境/社会规划问题。
