Pharmaceutical Disposal Pattern Survey

Unused medications and disposal patterns at home: Findings from a Medicare patient survey and claims data finds that current take back programs are not working. Only 11% were disposed of in drug take back programs.

Maeng DDSnyder RCMedico CJMold WMManeval JE.

Abstract 

OBJECTIVE:

To examine what medications are most frequently left unused by patients, how much is left unused, and how these medications are disposed of among Medicare beneficiaries.

DESIGN:

Secondary data analysis combining insurance claims and telephone survey data of Medicare Advantage members.

SETTING:

Regional health plan in Central Pennsylvania.

PARTICIPANTS:

Seven hundred twenty-one Medicare Advantage members who had Part D coverage through the plan as of December 31, 2013, and completed the telephone survey in May 2014.

INTERVENTION:

Telephone survey conducted by a survey research center.

MAIN OUTCOME MEASURE:

Member survey response.

RESULTS:

Of the 2,994 medications in the dataset, 247 (8%) were reported being left unused by patients. Of the 247, the most common medications were those for pain (15%), hypertension (14%), antibiotics (11%), and psychiatric disorders (9%). Approximately 15% of unused medications were controlled substances. The reasons for being unused varied by drug type. For example, for pain medications, adverse effects and overprescribing were the most commonly cited reasons; for hypertension medications, “dosage changed by doctor” was the most common reason. Most commonly, unused portions accounted for approximately 25% to 50% of the unused medications identified by patients. Approximately 11% of unused medication was disposed of via drug take-back programs, whereas the majority was kept in a cabinet (55%), thrown in the trash (14%), or flushed down the toilet (9%).

CONCLUSION:

A lack of patient adherence alone does not explain unused medications and their improper disposal. Community-level interventions designed to improve prescription efficiency and patient awareness of appropriate disposal methods-particularly of controlled substances-are necessary to reduce the potentially harmful effects of improper disposal of unused medications.

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