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Pharmaceutical waste stream measurements as an avenue to sustainable pharmacy. Staffan Castensson, Ph.D., Assoc. Prof. 2009 International Symposium on Pharmaceuticals in the Home and Environment October 18-20, 2009. Sustainable pharmacy.

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Pharmaceutical waste stream measurements as an avenue to sustainable pharmacy

Pharmaceutical waste stream measurements as an avenue to sustainable pharmacy

Staffan Castensson, Ph.D., Assoc. Prof.

2009 International Symposium on Pharmaceuticals in the Home and Environment

October 18-20, 2009

Staffan Castensson/Research & Development


Sustainable pharmacy
Sustainable pharmacy sustainable pharmacy

Healthcare footprint

Rational drug use grade ≈

Ecological footprint

1

Rational drug use grade ≈

Waste level

Staffan Castensson/Research & Development


References
References sustainable pharmacy

  • Castensson S, Ekedahl A. Pharmaceutical Waste: The Patient Role. In: Kümmerer K, Hempel M, eds. Green and Sustainable Pharmacy. Berlin, Heidelberg, New York: Springer (forthcoming)

  • Fant H, Bennet R, Ekedahl A, Castensson S. Antibiotic waste levels at an infectious disease ward for children. Poster at the CleanMed Europe Congress; 2006 May 29-31, Stockholm, Sweden

Staffan Castensson/Research & Development


Pharmaceutical waste the patient role
Pharmaceutical Waste: The Patient Role sustainable pharmacy

  • Studies are summarized in seven tables in the following order

    • Amounts returned to pharmacies

    • Packages returned to pharmacies past their expiry date

    • Storage time of drugs before bringing back to the pharmacy

    • Distribution of drugs returned to pharmacies

    • Proportion of retired patients and proportion of packages returned by these patients

    • Reasons

      • Primary factors related to the pharmacotherapy

      • Secondary factors related to the pharmacotherapy and unrelated

Staffan Castensson/Research & Development


DDD sustainable pharmacy = Defined Daily Doses. aDrugs instead of packages. bIncludes drugs without package.

Staffan Castensson/Research & Development


Packages returned to pharmacies
Packages returned to pharmacies sustainable pharmacy

Sweden 10 years ago

  • 65 % with > 2/3 of the content left

  • 38 % were intact

  • 51 % were expired

Staffan Castensson/Research & Development


a sustainable pharmacyDrugs instead of packages. bCalculated Rx sample. cCalculated OTC sample

Staffan Castensson/Research & Development


a sustainable pharmacyDrugs instead of packages. b49% < 3 months. cPlus 2 months. d < 4 months. e < 16 months.

Staffan Castensson/Research & Development


Basic reasons for accumulation and disposal
Basic reasons for accumulation and disposal sustainable pharmacy

  • Diagnosis and prescription may fail or is not adequate

  • Excess/double prescribing

  • Greater purchase than need

  • Hoarding

  • Design of drug benefit schemes

  • Deceased patient

  • Polypharmacy

Staffan Castensson/Research & Development


a sustainable pharmacyDrugs instead of packages. bOnly drug returns ≥3 were included

Staffan Castensson/Research & Development


a sustainable pharmacyDrugs instead of packages

Staffan Castensson/Research & Development


Understanding why leftover drugs accumulate
Understanding why leftover drugs accumulate sustainable pharmacy

Staffan Castensson/Research & Development


a sustainable pharmacyDrugs instead of packages

Staffan Castensson/Research & Development


a sustainable pharmacyDrugs instead of packages. bExcess/double prescribing. cGreater purchase than need. dHospitalization 4%.

Staffan Castensson/Research & Development


Flow of antibiotics and data recording
Flow of antibiotics and data recording sustainable pharmacy

Delivery

Cost per item

  • Di

Hospital Pharmacy

Drug room

Infection ward

Administration record

Oral liquids

Administration & Saving record

Patient

Refrigerator

Disposal record

Record of expired drugs

Disposal record

Disposal container

Content record

Staffan Castensson/Research & Development


Total usage and waste of antibiotics
Total usage and waste of antibiotics sustainable pharmacy

Staffan Castensson/Research & Development


Conclusion
Conclusion sustainable pharmacy

  • Accumulation and disposal of drugs represent

    • A large, diverse array of data that can be mined to design measures to reduce drug wastage

    • A potential to reduce drug consumption by those for whom the medication was never intended (reduced accidential poisoning and improper or abusive usage)

    • An indicator of potential chemical stressors in the environment when not disposed of in a proper way

    • Wasted healthcare resources and lost opportunities for medical treatment

Staffan Castensson/Research & Development


Thank you for your time and attention i welcome your questions and comments

Thank you for your time and attention. I welcome your questions and comments.

[email protected]

Staffan Castensson/Research & Development


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