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CPA-MPS 2007, PARK ROYAL, KUALA LUMPUR.

RETURN UNUSED MEDICINES FOR DISPOSAL PROGRAMME IN PUTRAJAYA HOSPITAL – A 3 MONTH PRELIMINARY REPORT. CPA-MPS 2007, PARK ROYAL, KUALA LUMPUR. SUBRAMANIAM THANIMALAI CHING MIN WEI HALIMATUS SA’DIAH AHMAD. Contents. BACKGROUND. 1. OBJECTIVES. 2. METHODOLOGY. 3. RESULTS & DISCUSSION.

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CPA-MPS 2007, PARK ROYAL, KUALA LUMPUR.

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  1. RETURN UNUSED MEDICINES FOR DISPOSAL PROGRAMME IN PUTRAJAYA HOSPITAL – A 3 MONTH PRELIMINARY REPORT. CPA-MPS 2007,PARK ROYAL, KUALA LUMPUR. SUBRAMANIAM THANIMALAI CHING MIN WEI HALIMATUS SA’DIAH AHMAD

  2. Contents BACKGROUND 1 OBJECTIVES 2 METHODOLOGY 3 RESULTS & DISCUSSION 4 5 CONCLUSION

  3. BACKGROUND • The value of unused medicines throughout the world was immense : Saudi Arabia & Gulf countries 2002 US150 million, Texas, USA 2003: US 26,000 Puy-de-Dome,France 2001 : 87456FF. Hisham S. et al 2002, Kevin Garey et al 2004 • There is little published information on why unused medicines are returned to the pharmacies. S.Braybrook et al. The Pharmaceutical Journal (TPJ) Sept.1999 • The waste of medicines represents the end-point of sub-optimal drug use and is an anti-thesis of good medicines management. Adam Mackridge et al TPJ January 2004

  4. AIM OF STUDY To obtain preliminary data on unused medicines, reasons for non-consumption, storage and disposal practices of unused medication among Putrajaya Hospital patients.

  5. OBJECTIVE 1 2 3 To identify types of unused drugs stored at home and reasons for non- consumption. To analyze the costs of the unused drugs. To assess public awareness on storage conditions and disposal.

  6. METHODOLOGY • Single-centered, Prospective, observational study. • Posters, Banners displayed and flyers were distributed.

  7. Public who return medications voluntarily were asked to fill an investigator - assisted questionnaire. • Patients were given token of appreciation for their participation.

  8. EXCLUSION CRITERIA • Drugs returned from the ward. • Expired drugs from hospitals, clinics and other institutions. • Drugs returned from non governmental sources and unidentifiable/ unquantifiable drugs were accepted but not included in the analysis.

  9. DATA ANALYSIS • Drugs returned were assessed in terms of type, source, quantity, expiry, reasons for returning and ownership. • Cost of the drugs were accounted according to the Putrajaya Hospital purchase price at the end of 2006. • Data gathered were analysed using Microsoft Excel.

  10. ASSUMPTIONS • All answers to the questionnaire were assumed to be a true reflection of the respondents practice. • Voluntary participation, without coercion from any healthcare personnel.

  11. COST OF THE PROJECT ESTIMATED TOTAL COST OF THE PROJECT RM 2670 Token of Appreciation - Courtesy of Hospital Management Estimated Disposal Cost RM2000 RM 620 POSTERS & BANNERS BROCHURES & FLIERS RM 50

  12. RESULTS & DISCUSSION

  13. General Information • The result reflects the data collected in the first 3 month of the study (Nov 2006 – Jan 2007). • A total of 81 patients responded to the program and 145 types of medications were returned for various reasons.

  14. Age Group of the Respondents • Respondents age varies from the age • 11-80 years old. • 65% of the respondents were the age group of 21-60*. • Mean age group of the highest respondents were 56 years. • This correlates with the M’sian • population( UNDP Data 2001)

  15. GENDER OF RESPONDENTS • There were almost equal amount of males and females who returned unused medicines.

  16. ETHNIC DISTRIBUTION

  17. EDUCATION LEVEL OF RESPONDENTS

  18. Medication Storage Conditions

  19. RESULTS - Disposal Methods

  20. Discussion - Disposal Methods • Majority (68%) of the disposal methods were non-environmental friendly way (rubbish bin, toilet, sink and drain). • 90% of the respondents claimed to be aware of the environment risks related to the environmentally unfriendly method of medicines disposal. 72% of the knowledgeable respondents disposed it via the methods.

  21. RESULTS - RETURNED REASON

  22. ADVERSE DRUG REACTIONS

  23. DRUGS RETURNED - TOP 5 CLASSES

  24. RETURNED DRUGS – AMOUNT (TABs/ CAPs)

  25. RETURNED DRUGS - Amount

  26. RETURNED DRUGS – COST (M’SIAN RINGGIT)

  27. CASE STUDY • PT: AHD • AGE: 63 years old • ETHNIC : Malay • GENDER : Male • OWN MEDICATION (6 TYPES)

  28. DRUG ASSESSMENT

  29. TOTAL COST OF UNUSED DRUGS RM 14,813.57

  30. RECOMMENDATIONS • The project should be continuous and be made a regular program in more centers : i) to account the amount of wastage; ii) to encourage environmentally safe ways to dispose drugs iii) to identify medication wastage related issues including non compliance, ADRs and side effects. • Physicians are recommended to practice prudent prescribing in chronic diseases. • Patients should be educated on the need and importance of adherence to medication, reporting of side effects, ADRs, proper storage and disposal and appreciation of the value of the drugs dispensed. • A more comprehensive study is recommended to investigate the issue of excessive stock.

  31. CONCLUSION • Pharmacist involvement in medication management review could address issues of over-stocking, drug storage, compliance, side-effects and/or adverse drug reaction monitoring. The study also indicates the need for an appropriate method of disposal of unused medication.

  32. Thank You !

  33. ACKNOWLEDGEMENT • Pn. Hasnah Ismail • Pn. Norliah Ardee • Pn.Fathimah

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