A Survey of Disposal of Unused Medications in General Public, Sub-district Health Promotion Hospitals and Management of Pharmaceutical Waste Discarded from Household by Municipalities in Pathumthani Province

Abstract

Objectives: 1) To survey disposal practices of unused medications among the general public and at sub-district Health Promoting Hospitals (sHPHs); 2) To obtain municipalities’ management of household pharmaceutical wastes, and 3) To identify characteristics associated with appropriate disposal practices among the general public. Methods: This study was conducted in Pathumthani Province. The participants consisted of three groups: 1) 509 general public, 2) 79 sHPHs; and 3) 3 levels of municipalities (one each of city, town, and sub-district municipalities). The study collected the data from the public and the sHPHs using questionnaires, and using semi-structured interviews for municipal representatives. Data were analyzed using binary logistic regression. Results: The most common disposal practice among the general public was discarding unwanted medications into general waste receivers (68.3%). Twenty percent brought the medications to health care facilities. Factors significantly associated with appropriate disposal were: age 55 years or older (aOR 3.98, 95% CI 1.77–10.69), being female (aOR 1.82, 95% CI 1.04–3.19), and prior receipt of information regarding proper disposal (aOR 9.04, 95% CI 5.15–15.88). In contrast, people with Social Security Scheme (aOR 0.30, 95% CI 0.12–0.77) or Universal Coverage Scheme (aOR 0.40, 95% CI 0.18–0.90) were associated with improper disposal. Sixty-eight percent of sHPHs transferred leftover medicines to appropriate authorities or outsourced waste management services. All 3 municipalities reported no disposal system for household pharmaceutical wastes, as it was perceived that sHPHs were primarily responsible for collecting and managing unused medications from the general public. Conclusion: Majority of general public had inappropriate medication disposal practice. Age over 55 years, being female, and having received proper disposal information were positive predictors of appropriate practice.  People under Social Security or Universal Coverage Schemes were less likely to practice proper disposal.  While most sHPHs followed disposal standards, municipalities at all levels in the study lacked specific policies for managing household pharmaceutical waste.