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RxMEDS Results from a Partnership for an Ongoing Medication Disposal Program

RxMEDS Results from a Partnership for an Ongoing Medication Disposal Program. R egional e X cess ME dication D isposal S ervice Partnership. Dr. Amy Tiemeier, Pharm.D., BCPS St. Louis College of Pharmacy. Background.

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RxMEDS Results from a Partnership for an Ongoing Medication Disposal Program

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  1. RxMEDSResults from a Partnership for an Ongoing Medication Disposal Program Regional eXcess MEdication Disposal Service Partnership Dr. Amy Tiemeier, Pharm.D., BCPS St. Louis College of Pharmacy

  2. Background

  3. Goal of RxMEDS Partnership: Create an efficient regional model that removes and disposes of unwanted medications and informs the citizens of related health and environmental issues.

  4. St. Louis: • Missouri & • Mississippi Rivers • converge • MO and IL • 5 counties

  5. Goal: Create an efficient regional model that removes and disposes of unwanted medications and informs the citizens of related health and environmental issues.

  6. Outreach

  7. Publications, Outreach and Schools • Publications have had a circulation of 704,300 in metropolitian area. • Belleville News Democrat • Schnucks Advertising Circulars • Metropolitan Sewer District Bill Inserts • Community outreach activities of the partners included over 20 community based programs that contacted an additional 2,136 area residents. • Mideast Area Agency on Aging (MEAAA) • OASIS • AARP • School based programs were offered in 15 different class settings and reached 387 students and 15 teachers.

  8. Disposal Day Educating atAARP HealthFair

  9. Partnerships

  10. RxMEDS’ Partners Area Resources for Community and Human Services (ARCHS) Schnuck Markets, Inc. Cintas Corporation St. Louis College of Pharmacy Missouri AARP Mid-East Area Agency on Aging St. Louis OASIS Senior Services Plus

  11. Partnership Growth WK Health Saint Louis University Stericycle Metropolitan Sewer District St. Louis City Agency on Aging PhRMA MO Environmental Water Association STL County Waste Management Program Living Lands and Waters American Water Company

  12. Program

  13. Time Line Phase 3 Phase 2 Phase 1

  14. Approvals • US EPA • US EPA Human Subjects Review & St. Louis University IRB Board • Hazardous Materials Information Center (US Dept of Transportation) • MO Bureau of Narcotics and Dangerous Drugs (BNDD) • US DEA, MO & IL • MO Board of Pharmacy • MO and IL EPA

  15. Hurdle: Controlled Medication • EPA and federal DEA approved plan of separate bins, multiple person check off, and officer picks up immediately following the drop off period. • Specifically for this grant • MO State BNDD would not agree • Therefore, we did not accept control medications

  16. Unwanted Medication Disposal Program Set-up • 20 locations, 3 hour drop off time once a month • Document controls but do not accept • Accept non-controlled unwanted medications • Inform patrons what to do with non-returnable materials • Only collect medications during collection times

  17. Personnel Student Extern Tech Pharmacist Greeter • Check drug • documentation • Feedback • Market • Ready • materials • Assist with • workflow • Document • Determine • drug • Discuss • drug related • problems • Show • location • Manage flow Liability/reliability of information

  18. Policies and Procedures • Greet and explain purpose • Background • Facts & Comparisons 4.0 drug database on students laptop for quick tablet identification • Clinical Pharmacology used for identifying potential controls • Educational materials offered

  19. Hurdle: Incineration Company • 1st contracted company did not have enough manpower on Fridays although we were assured by management that this could happen • Little to no response from company when issues brought to their attention • Company was not invested in project • Contract was cancelled • Did not cost grant as there was a breech in contract

  20. Preparing for Incineration Box 2 Plastic bags (one for backup in case of leakage, you can double bag the meds) Tape roll (use every month) Bill of Lading (“manifest”) via email Tie for plastic bag (not pictured) Preprinted shipping label

  21. Bill of Lading (Manifest)

  22. Incineration

  23. Results

  24. Plastics Recycling • Through September 2008 • 1,949 lbs. • Does not include box or container

  25. Secondary survey • Completed: 547 surveys • Demographics • Average Age: 57 • Ethnicity • Caucasian: 80% • Gender: 71% female • 72% did not bring back any medications • 70% preferred to bring back to pharmacy

  26. Preliminary Results: Medications Collected • Overall Participation: > 900 patients • Store Participation: four patients per store per event • Average # of Meds Returned: 9 • Average age: 63.5 • Gender: 75% female • Ethnicity: 96% Caucasian

  27. Preliminary Results: Medications Collected “How did you dispose of your medications previously?” • Kept: 20% • Flushed: 44% • Trash: 20% • Saved for future use: 1% • Gave to friend: 1% • Collection Program: 4% • Other: 10%

  28. Preliminary Results: Medications Collected • 8,800 individual prescriptions, OTC and herbals collected • ½ were tablet or capsules non-control prescription items • Controlled substances: 500 tablets and capsules attempted • OTC: 1,700 tablets and capsules • Herbal: 24 tablets and capsules

  29. Preliminary Results: Medications Collected • Tablets and Capsules • > 190,000 • Liquids • Over 800 bottles • Inhalers • 110 (MDI or DPI)

  30. RxMEDS Community Partners • ARCHS (www.stlarchs.org) • Schnuck Markets, Inc. (www.schnucks.com/pharmacy/rxreturns.asp) • St. Louis College of Pharmacy (www.stlcop.edu) • Cintas (www.cintas.com) • AARP Missouri Chapter, Senior Services Plus • OASIS & Mid-East Area Agency on Aging

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