When is a medicine unwanted, how is it disposed, and how might safe disposal be promoted? Insights from the Australian populationEmilie Bettington A B , Jean Spinks A B , Fiona Kelly C , Alejandra Gallardo-Godoy D , Son Nghiem E and Amanda J. Wheeler B D F G
B Menzies Health Institute Queensland, G40 Griffith Health Centre, Level 8.86, Southport, Qld 4222, Australia. Email: firstname.lastname@example.org
C School of Pharmacy & Pharmacology, Griffith University, Parklands Dr, Southport, Qld 4222, Australia. Email: email@example.com
D School of Human Services and Social Work, Griffith University, University Dr, Meadowbrook, Qld 4131, Australia. Email: firstname.lastname@example.org
E Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Ave, Kelvin Grove, Qld 4059, Australia. Email: email@example.com
F Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand.
G Corresponding author. Email: firstname.lastname@example.org
Australian Health Review - https://doi.org/10.1071/AH16296
Submitted: 22 December 2016 Accepted: 26 June 2017 Published online: 19 December 2017
Objective The aim of the present study was to explore disposal practices of unwanted medicines in a representative sample of Australian adults, compare this with previous household waste surveys and explore awareness of the National Return and Disposal of Unwanted Medicines (RUM) Project.
Methods A 10-min online survey was developed, piloted and conducted with an existing research panel of adult individuals. Survey questions recorded demographics, the presence of unwanted medicines in the home, medicine disposal practices and concerns about unwanted medicines. Descriptive statistical analyses and rank-ordered logit regression were conducted.
Results Sixty per cent of 4302 respondents reported having unwanted medicines in their household. Medicines were primarily kept just in case they were needed again and one-third of these medicines were expired. Two-thirds of respondents disposed of medicines with the household garbage and approximately one-quarter poured medicines down the drain. Only 17.6% of respondents had heard of the RUM Project, although, once informed, 91.7% stated that they would use it. Respondents ranked the risk of unintended ingestion as the most important public health message for future social marketing campaigns.
Conclusions Respondents were largely unaware of the RUM Project, yet were willing to use it once informed. Limited awareness could lead to environmental or public health risks, and targeted information campaigns are needed.
What is known about the topic? There is a growing international evidence base on how people dispose of unwanted medicines and the negative consequences, particularly the environmental effects of inappropriate disposal. Although insight into variation in disposal methods is increasing, knowledge of how people perceive risks and awareness of inappropriate disposal methods is more limited.
What does this paper add? This study provides evidence of inappropriate medicines disposal and potential stockpiling of medicines in Australian households that could contribute to environmental and/or public health risks. It also reveals possible trends towards a higher frequency of inappropriate disposal practices in the Australian context. Insights into respondents’ perceptions of associated risks and awareness of a national scheme for appropriate disposal of medicines have not previously been reported.
What are the implications for practitioners? The findings of the present study provide important insights for all health professionals as stakeholders in the quality use of medicines. It is important for those health professionals who assist consumers to manage their medicines to have strategies in place that routinely identify potential stockpiling and inform consumers about appropriate methods of medicines disposal. Although the findings of this study are specific to the Australian context, they may usefully inform policy, public health campaigns and the individual practices of health professionals and other stakeholders in promoting the quality use of medicines nationally and internationally.
Additional keywords: Australia, medicines disposal, waste.
References The National Return & Disposal of Unwanted Medicines Limited. Return unwanted medicines. 2011. Available at: http://www.returnmed.com.au/pharmacists/ [verified 22 February 2016].
 Glassmeyer ST, Hinchey EK, Boehme SE, Daughton CG, Ruhoy IS, Conerly O, Daniels RL, Lauer L, McCarthy M, Nettesheim TG, Sykes K, Thompson VG. Disposal practices for unwanted residential medications in the United States. Environ Int 2009; 35 566–72.
| Disposal practices for unwanted residential medications in the United States.CrossRef | 1:CAS:528:DC%2BD1MXivVOnsL0%3D&md5=22189fb6514d7ca998e57c373cdf134eCAS |
 Bound J, Voulvoulis N. Household disposal of pharmaceuticals as a pathway for aquatic contamination in the United Kingdom. Environ Health Perspect 2005; 113 1705–11.
| Household disposal of pharmaceuticals as a pathway for aquatic contamination in the United Kingdom.CrossRef |
 Kotchen M, Kallaos J, Wheeler K, Wong C, Zahller M. Pharmaceuticals in wastewater: behavior, preferences, and willingness to pay for a disposal program. J Environ Manag 2009; 90 1476–82.
| Pharmaceuticals in wastewater: behavior, preferences, and willingness to pay for a disposal program.CrossRef |
 Bound J, Kitsou K, Voulvoulis N. Household disposal of pharmaceuticals and perception of risk to the environment. Environ Toxicol Pharmacol 2006; 21 301–7.
| Household disposal of pharmaceuticals and perception of risk to the environment.CrossRef | 1:CAS:528:DC%2BD28XivValurk%3D&md5=def057db251a8a241e8f4cf65a37fa69CAS |
 Braund R, Chuah F, Gilbert R, Gn G, Soh A, Tan LY, Tiong HS, Yuen YC. Identification of the reasons for medication returns. N Z Fam Physician 2008; 35 248–52.
 Australian Bureau of Statistics (ABS). Environmental issues. Waste management and transport use, March 2009 (additional datacube) – Table 11 (March 2000 to March 2009). Canberra: ABS; 2009. Available at: http://www.ausstats.abs.gov.au/ausstats/subscriber.nsf/0/3E3CECBBAC078860CA257673001C024B/$File/4602055002_Mar%202009.pdf [verified 15 February 2016].
 Australian Bureau of Statistics (ABS). Environmental issues. Waste management, transport and motor vehicle usage, March 2012. Canberra: Australian Bureau of Statistics; 2012. Available at: http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4602.0.55.002Mar%202012?OpenDocument [verified 15 February 2016].
 Brushin B. Returned unwanted medicines survey: Victorian report (Melbourne metropolitan area). Canberra: Department of Health; 2005.
 Australian Bureau of Statistics (ABS). 2011 Census basic data. Canberra: ABS; 2011. Available at: http://www.abs.gov.au/websitedbs/censushome.nsf/home/tablebuilderdata2011basic?opendocument&navpos=240-tbb14_1_7 [verified 5 July 2016].
 Australian Bureau of Statistics (ABS). National Health Survey 2014-15. Questionnaire. Canberra: ABS; 2014. Available at: http://www.ausstats.abs.gov.au/Ausstats/subscriber.nsf/0/B784413255EBB01BCA25816B001373AF/$File/national%20health%20survey%202014-15%20questionnaire.pdf [verified 19 May 2016].
 Braund R, Peake BM, Shieffelbien L. Disposal practices for unused medications in New Zealand. Environment International 2009; 35 952–5.
| 1:CAS:528:DC%2BD1MXms1yisro%3D&md5=b2113025a09cc5d43b66adbf54a55652CAS |
 Coma A, Modamio P, Lastra C, Bouvy M, Marino E. Returned medicines in community pharmacies of Barcelona, Spain. Pharm World Sci 2008; 30 272–7.
| Returned medicines in community pharmacies of Barcelona, Spain.CrossRef |