Study of Medication Waste in Taiwan

BackgroundMore than 3 tons of unused and expired medications are wastefully discarded every year in Taiwan, having a significant impact on environmental contamination and a financial burden on Taiwan's National Health Insurance. The aim of this study was to investigate how to instigate patient education according to their behaviors and attitudes in the hope of reducing medication waste.MethodsDiscarded drugs from the Drug Discarding Bin at the Shuang-Ho Hospital, a university-affiliated teaching hospital in Taiwan, were collected and analyzed. A paper-based questionnaire was utilized to study the attitudes and perspectives of the out-patients and/or patients’ family members about discarding unused medications that were prescribed and covered by the National Health Insurance policy.Results and DiscussionA total of 98 kg of medications were collected during the study period of 4 weeks. Among the discarded medications, gastrointestinal drugs were at the top of the list, followed by cardiovascular drugs and anti-inflammatory drugs. Five main reasons that out-patients did not take the discarded medicines were revealed based on the results of a questionnaire: (i) I didn’t notice the expiration date or didn’t store the drugs well; (ii) I felt my disease was much better or was not improving, so I stopped taking the drugs; (iii) I was afraid of the side effects of the drugs, and refused to take them; (iv) I often forgot to take medications, thus I had many unused drugs at home; and (v) I didn’t want to take the herbal products anymore because they may have harmful ingredients, such as heavy metals. In addition, individuals with higher education would stop taking medications of their own volition, and people under 40 years old would forget to take medications more often than older people. Based on the results of the present survey, we designed an educational pharmacist intervention booklet to teach people how to use and store their medications appropriately. Hopefully, through various educational means the medication waste reduction program will gradually reduce the medication wasted by outpatients at this hospital.