title: Medicines discarded in household garbage: analysis of a pharmaceutical waste sample in Vienna.
abstract: OBJECTIVE
  To analyze a sample of pharmaceutical waste drawn from household garbage in Vienna, with the aim to learn whether and which medicines end up unused in normal household waste.
  
  
  METHODS
  We obtained a pharmaceutical waste sample from the Vienna Municipal Waste Department. This was drawn by their staff in a representative search in October and November 2009. We did a manual investigation of the sample which contained packs and loose blisters, excluded medical devices and traced loose blisters back to medicines packs. We reported information on the prescription status, origin, therapeutic group, dose form, contents and expiry date. We performed descriptive statistics for the total data set and for sub-groups (e.g. items still containing some of original content).
  
  
  RESULTS
  In total, 152 packs were identified, of which the majority was prescription-only medicines (74%). Cardiovascular medicines accounted for the highest share (24%). 87% of the packs were in oral form. 95% of the packs had not expired. 14.5% of the total data set contained contents but the range of content left in the packs varied. Results on the packs with contents differed from the total: the shares of Over-the Counter medicines (36%), of medicines of the respiratory system (18%) and of the musculo-skeletal system (18%), for dermal use (23%) and of expired medicines (19%) were higher compared to the full data set.
  
  
  CONCLUSIONS
  The study showed that some medicines end up unused or partially used in normal household garbage in Vienna. Our results did not confirm speculations about a high percentage of unused medicines improperly discarded. There is room for improved patient information and counseling to enhance medication adherence and a proper discharge of medicines.
authors.affiliation: WHO Collaborating Centre for Pharmaceutical Pricing and Reimbursement Policies, Health Economics Department, Gesundheit Österreich GmbH/Geschäftsbereich ÖBIG - Austrian Health Institute, Vienna, Austria.
authors.forename: Sabine
authors.initials: S
authors.lastname: Vogler
authors.affiliation: WHO Collaborating Centre for Pharmaceutical Pricing and Reimbursement Policies, Health Economics Department, Gesundheit Österreich GmbH/Geschäftsbereich ÖBIG - Austrian Health Institute, Vienna, Austria.
authors.forename: Christine
authors.initials: C
authors.lastname: Leopold
authors.affiliation: WHO Collaborating Centre for Pharmaceutical Pricing and Reimbursement Policies, Health Economics Department, Gesundheit Österreich GmbH/Geschäftsbereich ÖBIG - Austrian Health Institute, Vienna, Austria ; WHO Collaborating Centre for Pharmaceutical Policy and Regulation, Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.
authors.forename: Christel
authors.initials: C
authors.lastname: Zuidberg
authors.affiliation: WHO Collaborating Centre for Pharmaceutical Pricing and Reimbursement Policies, Health Economics Department, Gesundheit Österreich GmbH/Geschäftsbereich ÖBIG - Austrian Health Institute, Vienna, Austria.
authors.forename: Claudia
authors.initials: C
authors.lastname: Habl
keywords: Austria; Medical waste disposal; Medication adherence; Medicines utilization; Pharmacy services
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