Effectiveness of a Pharmacist-Led Educational Intervention on Safe Disposal of Unused and Expired Medications in Klang Valley, Malaysia: A Pre-Post Interventional Study
Main Article Content
Keywords
Educational intervention, expired medications, pharmacist, unused medications
Abstract
Background: The consequences of unused and expired medications encompass environmental contamination, increased global warming risks, wastage of public resources, and unintentional poisoning resulting from accidental ingestion. Methods: An interventional research study was carried out for a duration of eleven months. The respondents participated in this study via invitation from email, WhatsApp messages, and other social media platforms. All respondents had answered a pre-intervention questionnaire prior to the educational intervention, followed by seven days of educational intervention, as well as a final data collection on the seventh day. Results: The study successfully obtained 397 responses in pre-intervention, and 353 responses in post-intervention, thereby achieving a response rate of 89%. The knowledge score of the respondents had enhanced to a sufficient level from 44.4% to 91.2% upon completion of the educational intervention. Vitamins (Npre=194, 48.9%; Npost=222, 62.9%), and cough preparation (Npre=193, 48.6%; Npost=219, 62.0%) were the two most widely existing unused and/or expired medications in pre-and post-intervention. An excessive number of medications (Npre=230, 57.9%; Npost=215, 60.9%), and improvement in the illness condition (Npre=158, 39.8%; Npost=261, 73.9%) were known as the two most common reasons for having unused and/or expired medications in pre-and post- intervention. Approximately 90% of the respondents (n=317) would participate in the “Return Your Medicines Program” in managing unused and/or expired medications after receiving the educational intervention. Conclusion: The educational intervention demonstrated a positive impact in enhancing the knowledge, attitude, and practice regarding the safe disposal of unused and expired medications.
References
2. Lai PS, Tan KM, Lee HG, Wong YY, Wasi NA, Sim SM. Effectiveness of an intervention to increase the knowledge, attitude, and practice regarding the return and disposal of unused medications. Malays Fam Physician. 2021;16(1):56.
3. Nairat LL, Abahri NA, Hamdan YA, Abdel-Khaliq RT, Odeh SM, Abutaha S, Al-Jabi SW, Koni AA, Abushanab AS, Zyoud SH. Assessment of practices and awareness regarding the disposal of unwanted pharmaceutical products among community pharmacies: a cross-sectional study in Palestine. BMC Health Serv Res. 2023;23(1):1035. doi:10.1186/s12913-023-09888-5.
4. Michelin AF, Bonifácio NA, Nagata WB, da Silva VMS, Gobbo LEM, Bresciani KDS. Guidance provided by pharmacists to customers regarding the destination of unused household medications. BMC Health Serv Res. 2023;23(1):1350. doi:10.1186/s12913-023-10319-8.
5. Köksoy S. Unused, expired pharmaceuticals and their disposal practices among the general public in Burdur-Türkiye: a cross-sectional study. BMC Public Health. 2024;24(1):1303. doi:10.1186/s12889-024-18788-0.
6. Ong SC, Ooi GS, Shafie AA, Hassali MA. Knowledge, attitude and disposing practice of unused and expired medicines among the general public in Malaysia. J Pharm Health Serv Res. 2020;11(2):141-148.
7. Pharmaceutical Services Division, Ministry of Health Malaysia. Return Your Medicines Program. 2013. Available from: https://www.pharmacy.gov.my/v2/en/content/return-your-medicines-program.html
8. Muhammad M. Handling Unused Medicines. Portal MyHEALTH, Ministry of Health Malaysia. 2014. Available from: http://www.myhealth.gov.my/en/handling-unused-medicines/
9. Hassali MA, Shakeel S. Unused and expired medications disposal practices among the general public in Selangor, Malaysia. Pharmacy. 2020;8(4):196.
10. Lordan R. Dietary supplements and nutraceuticals market growth during the coronavirus pandemic—implications for consumers and regulatory oversight. PharmaNutrition. 2021;18:100282.
11. Hamulka J, Jeruszka-Bielak M, Górnicka M, Drywień ME, Zielinska-Pukos MA. Dietary supplements during COVID-19 outbreak: results of Google Trends analysis supported by PLifeCOVID-19 online studies. Nutrients. 2021;13(1):54.
12. Samha R, Wali A, Kadri S, Al-Assi F, Al-Khalaf A, Al-Deeb A, et al. Knowledge and practices on home medication storage and disposal in Syria: a population-based cross-sectional study. BMC Public Health. 2024;24(1):2428. doi:10.1186/s12889-024-19981-x.
13. Abbas MO, Beshir S, Kamal AlKhalidi D, Shamseldin Al Gailani Ali E, Lozon Y, Assadi RA, et al. UAE pharmacists’ perceptions of unwanted or unused medications and barriers to promoting safe disposal. BMC Public Health. 2025;25(1):236. doi:10.1186/s12889-025-21332-3.
14. Kaya A, Genç F. Rational drug use and the disposal cost of unused medications within households: a descriptive cross-sectional study. BMC Public Health. 2025;25(1):622. doi:10.1186/s12889-025-21501-4.
15. Limenh LW, Simegn W, Bizuneh GK, Chanie GS, Seid AM, Mengesha AK, et al. Management of pharmaceutical waste from hospitals and community pharmacies in Bahir Dar and Gondar cities, Ethiopia. BMC Health Serv Res. 2025;25(1):379. doi:10.1186/s12913-025-12555-6.
16. Yazie TS, Siyum Z, Assefa A, Teshome AA, Belete AM, Debasu Addisu Z. Disposal practices, knowledge and attitude toward unused medicines among adult patients in Debre Tabor, Ethiopia. BMJ Open. 2024;14(10):e085124. doi:10.1136/bmjopen-2024-085124.
17. Wang LS, Aziz Z, Chik Z. Disposal practice and factors associated with unused medicines in Malaysia: a cross-sectional study. BMC Public Health. 2021;21(1).
18. Ayele Y, Mamu M. Assessment of knowledge, attitude and practice toward disposal of unused pharmaceuticals among the community in Harar city, Ethiopia. J Pharm Policy Pract. 2018;11(1).
19. Martin K, Martin N, Hanzooma H, Davies K, Christabel NH. Household knowledge, attitude and practices on disposal of expired medicines in Lusaka, Zambia. Afr J Pharm Pharmacol. 2020;14(7):221-228.
20. Nepal S, Giri A, Bhandari R, Chand S, Nepal S, Aryal S, et al. Poor disposal of expired and unused pharmaceuticals: a global issue. Curr Drug Saf. 2020;15(3):167-172.
21. Yimer A, Moges G, Kahissay MH. Household storage and disposal of unused medicines in Dessie, Ethiopia. Front Public Health. 2024;12:1422304. doi:10.3389/fpubh.2024.1422304.
22. Manocha S, Suranagi UD, Sah RK, Chandane RD, Kulhare S, Goyal N, et al. Disposal practices of unused medicines among the general public in Delhi, India. Curr Drug Saf. 2020;15(1):13-19.
23. Paut Kusturica M, Tomas A, Sabo A. Disposal of unused drugs: knowledge and behavior among people worldwide. Rev Environ Contam Toxicol. 2017;240:71-104.
24. Köksoy S. Unused pharmaceuticals disposal practices among the general public in Türkiye. BMC Public Health. 2024;24(1):1303. doi:10.1186/s12889-024-18788-0.
25. Rogowska J, Zimmermann A. Household pharmaceutical waste disposal as a global problem—a review. Int J Environ Res Public Health. 2022;19(23):15798.
26. Hiew SY, Low BY. Knowledge, attitude and practice of healthcare professionals toward household pharmaceutical waste disposal: a systematic review. Explor Res Clin Soc Pharm. 2024;17:100556.
27. Alfian SD, Adhinagoro B, Winardi DO, Angela F, Griselda M, Gathera VA, et al. Pharmacist-led interventions addressing improper disposal of medications: a systematic review. Heliyon. 2024;10(18):e37764.
28. Abbas MO, Beshir S, Kamal AlKhalidi D, Shamseldin Al Gailani Ali E, Lozon Y, Assadi RA, et al. UAE pharmacists’ perceptions of unwanted medications and barriers to safe disposal. BMC Public Health. 2025;25(1):236.
29. Nairat LL, Abahri NA, Hamdan YA, Abdel-Khaliq RT, Odeh SM, Abutaha S, et al. Disposal awareness among community pharmacies in Palestine. BMC Health Serv Res. 2023;23(1):1035.
30. Alfian SD, Azzahra AM, Khoiry QA, Griselda M, Puspitasari IM, Abdulah R. Pharmacists’ perspectives on medication take-back programs in Indonesia: a qualitative study. SAGE Open Med. 2024;12:20503121241290968.
31. Alfian SD, Rendrayani F, Khoiry QA, Pratama MAA, Griselda M, Pradipta IS, Nursiswati N, Abdulah R. Do pharmacists counsel customers on disposal of unused medications? A national survey in Indonesia. Saudi Pharm J. 2024;32(5):102020. doi:10.1016/j.jsps.2024.102020.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.