Estoque e descarte de medicamentos no domicílio: uma revisão sistemática / Storage and disposal of pharmaceuticals at home: a systematic review

Resumo Este estudo teve como objetivo analisar a evidência científica nacional e internacional existente sobre o motivo do estoque e a forma de descarte dos medicamentos no domicílio. Realizou-se uma revisão sistemática da literatura de 2001 a 2016 nas bases de dados PubMed, Lilacs e Elsevier's Scopus Database, utilizando os seguintes unitermos: "Disposal of medicines in household", "Disposal of expired drugs", "Residential expired drugs", "Management of expired medications in household". Foram selecionados 33 estudos originais após aplicação dos critérios de inclusão e exclusão. Os estudos analisados demonstraram que os principais motivos de estoque no domicílio foram: automedicação; guarda para uso futuro e sobras de tratamentos anteriores. E quanto ao descarte dos medicamentos, prevalecem práticas inadequadas, como descarte no lixo comum e na rede de esgoto. Alguns países têm adotado programas de orientação sobre o armazenamento e o descarte correto, no entanto, foi apenas encontrado um estudo que descreve um programa nacional gratuito, para orientar essas práticas. A partir das evidências cientificas verificou-se a importância do incentivo para a elaboração e a implementação de políticas públicas voltadas para o uso e descarte adequado de medicamentos no domicílio.

Abstract This study's objective was to analyze Brazilian and international scientific evidence on the reasons people store medication at home and the disposal methods used. This systematic literature review includes studies published from 2001 to 2016 and indexed in PubMed, Lilacs and Elsevier's Scopus Database, using the following key words: Disposal of medicines in household, Disposal of drugs expired, Residential expired drugs, Management of expired medications in household. Thirty-three studies were selected after applying inclusion and exclusion criteria. The studies reveal that the main reasons people keep a stock of medicines at home include the possibility of future use, leftovers from previous treatments, and self-medication. Inappropriate disposal methods prevail, such as throwing medicines in the household trash or flushing them into the sewer. Some countries have adopted programs to educate on proper storage and disposal of medicines, though only one study describes a national program guiding these practices that is free of charge. Evidence shows there is a need to implement public policies intended to provide guidance on the proper storage and disposal of medicines at home.

Perceptions and Knowledge of Storing Medications at Home in Al-Qassim Region, Saudi Arabia

Objective: Globally people store medications at home, which is also common among the residents of Al-Qassim Region, Saudi Arabia. They should be stored safely to prevent the accidental ingestion or unintended use. However, the method of storing medications at homes in Al-Qassim region, Kingdom of Saudi Arabia is unknown. Therefore, in this study, we aimed to explore the perception and knowledge of medications stored at Al-Qassim region, Saudi Arabia. Methodology: This is a descriptive, cross-sectional survey which was conducted through the random distribution of a pre-validated structured questionnaire with the public and private sector employees and with general population from all walks of life above the age of 18 years in Al-Qassim region. The survey was designed electronically through the Survey Monkey system and was distributed through social media. Results: A total of 708 participants responded to this survey. Most of the responders (485 (68.10%)) were females. About half of the responders were in the age group of 18–29 years (393 (58.31%)) with a significantly dominant female population compared to males (p<0.05). Most of the responders checked or almost checked the instructions of storing medications (192 (28.24%) and 273 (40.15%), respectively) without any significant difference between education level (p>0.05). Most of the responders checked the expiry date of stored medications (496 (70.06%)). Most of the responders did not receive instructions on storage of medications from pharmacist or physician (597 (84.32%)). Most of the resources regarding storage of medications were obtained from the physician (388 (54.8%)), drug leaflet (320 (45.2%)) followed by pharmacist (318 (44.92%)) and self-learned (154 (21.75%)). Therapeutic classes of stored medication were analgesics and antipyretics (322 (41.87%)) followed by cardiovascular drugs (64 (8.32%)) and oral anti-diabetic drugs (58 (7.54%)). Conclusion: The results of this study showed that people at Al-Qassim region tend to store medication at home not just over the counter medications but also medications of chronic illnesses. They should be educated on the need of medications, safety of medications and requirements of storing medications at home. Educational activities should be conducted through all possible channels to increase the awareness and to educate people on the proper method of storing medications.

Poisoning Due to Stored Medications at Home in Al-Qassim Region, Saudi Arabia

Objective: Storing medications at home is a global practice. By storing medications in an appropriate and safe environment, we can prevent accidental poisoning. Information is scarce regarding the storage of different types of medications at homes in Al-Qassim region, Kingdom of Saudi Arabia. Therefore, in this study, we aimed to explore the cases of poisoning due to stored medications at home in Al-Qassim region. Methodology: This is a descriptive, cross-sectional survey conducted through the random distribution of a pre-validated structured questionnaire among the public and private sector employees and people from all walks of life above the age of 18 years in Al-Qassim region. The survey was designed electronically through the Survey Monkey system and was distributed through social media. Results: A total of 708 subjects responded to the survey. Most of the responders (485 (68.10%)) were females. About half of the responders were in the age group of 18–29 years (393 (58.31%)) with females being significantly dominant than males (p<0.05). Majority of the responders stored their medications separated from households’ chemicals (524 (77.06%)). Most of the responders did not store multiple medications in the same container without any significant difference related to gender or educational level (p>0.05). The total number of poisonous cases were 41 (5.79%) without any significant difference related to gender or educational level (p>0.05). Poisoning due to medications were mostly caused due to the medications stored in refrigerator (15 (40.54%)) and bedroom (10 (27.03%)). Most of the stored medications were disposed into the trash after their expiry dates (463 (65.4%)) while 189 items remained at home (26.69%). A total of 33 different types of stored medications caused poisoning in 44 cases. Paracetamol caused 6 cases of poisoning (18.18%), followed by ibuprofen 3 (9.09%) and multivitamins 3 (9.09%). Conclusion: The results of this study revealed an alarming setting of poisoning cases due to stored medications in Al-Qassim region. Awareness campaigns and more educational sessions should be conducted through social media. By doing so, people can be educated regarding the proper storage of medications to prevent poisoning. Thus, public awareness programs stressing on the safe storage and identification of the right ways to dispose of medication are highly recommended.

Medication Storage at Home among People in Al-Qassim Region, Saudi Arabia

Objective: Storing medications at home is a global practice. By storing medications in an appropriate and safe environment, we can prevent accidental poisoning. Information is scarce regarding the storage of different types of medications at homes in Al-Qassim region, Kingdom of Saudi Arabia. Therefore, in this study, we aimed to explore the types of medications stored at homes among people residing in Al-Qassim region. Methodology: This is a descriptive, cross-sectional survey conducted through the random distribution of a pre-validated structured questionnaire among the public and private sector employees and people from all walks of life above the age of 18 years in Al-Qassim region. The survey was designed electronically through Survey Monkey system and was distributed through social media. Results: A total of 708 subjects responded to the survey. Most of the responders were females (485 (68.10%)). About half of the responders were in the age group of 18–29 years (393 (58.31%)) with a significantly dominant female population as compared to males (p<0.05). The most frequently stored medications were related to headache (462 (65.25%)) and pain (445 (62.85%)). Most of the responders stored their medications in the refrigerator (467 (65.96%)) or in their bedroom (324 (45.76%)). A total of 633 medications were found to be stored at homes during this survey. The top 20 most frequently stored medications were paracetamol (266 (42.02%)) and ibuprofen (42 (6.64%)). Conclusion: The results of this study show an alarming situation about the methods of storing medication and types of medicines stored among the residents of Al-Qassim region. More and more campaigns and awareness programs should be conducted through different types of social media to educate the people regarding the appropriate methods of storing medications at home. Such awareness programs should stress more regarding safe methods of storage and spread awareness regarding how to identify the appropriate method of disposal to prevent harmful impact on the environment.