title: A cross-sectional survey of the Maltese general public on medication wastage.
abstract: BACKGROUND
  Medication wastage is a global issue, with key public health implications in terms of safety, the environment and the economy. A recently conducted systematic review of the published literature identified a lack of focus on the views of healthcare professionals and the general public.
  
  
  OBJECTIVE
  To explore awareness, attitudes and behaviours relating to medication wastage amongst the general public in Malta.
  
  
  METHODS
  Malta.
  
  
  METHODS
  Survey methodology employing a pre-piloted questionnaire was developed from theoretical frameworks of behaviour. Questionnaire items comprised open, closed and 5-point Likert scales. Medication adherence as a possible factor associated with wastage was measured using the 8-item Morisky Medication Adherence Scale. Random sample of 1920 was obtained from the Maltese electoral register 2013. Ethical approval was obtained.
  
  
  METHODS
  Awareness, attitudes and behaviours relating to medication wastage amongst the general public in Malta.
  
  
  RESULTS
  Response rate was 20.4 %. The majority (70.6 %) agreed that they were fully aware of the issue of wastage and 71.9 % disagreed that they had no interest in wastage. The following were significantly related to increased awareness of wastage: older age (p = 0.003), pensioners (p = 0.011), on regular medication (p = 0.021) and obtaining free medication (p = 0.026). Lack of interest in wastage was significantly related to obtaining free medication by government (p = 0.022), with those purchasing medication being significantly more interested (p = 0.028). While 75.1 % of respondents on regular medication self-reported not being fully adherent, there were no associations with awareness (p = 0.100) and interest in wastage (p = 0.385). Unemployed were more likely to report contribution towards wastage (p = 0.010) and the presence of a healthcare professional as family member was significantly related to confidence in ability to reduce wastage (p = 0.009). 46.2 % claimed to have unused medication at home and improvement in patient's medical condition was the main reason for this.
  
  
  CONCLUSIONS
  More effort is warranted to raise awareness of the public as an initial step in promoting behavioural change in relation to medication wastage.
authors.affiliation: School of Pharmacy and Life Sciences, Faculty of Health and Social Care, Robert Gordon University, Aberdeen, UK. l.m.west@rgu.ac.uk.
authors.forename: Lorna Marie
authors.initials: LM
authors.lastname: West
authors.affiliation: School of Pharmacy and Life Sciences, Faculty of Health and Social Care, Robert Gordon University, Aberdeen, UK.
authors.forename: Lesley
authors.initials: L
authors.lastname: Diack
authors.affiliation: Department of Clinical Pharmacology and Therapeutics, Faculty of Medicine and Surgery, University of Malta, Msida, Malta.
authors.forename: Maria
authors.initials: M
authors.lastname: Cordina
authors.affiliation: School of Pharmacy and Life Sciences, Faculty of Health and Social Care, Robert Gordon University, Aberdeen, UK.
authors.forename: Derek
authors.initials: D
authors.lastname: Stewart
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D001364:Awareness; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008319:Malta / Q000453:epidemiology; D055118:Medication Adherence / Q000523:psychology; D008875:Middle Aged; D055553:Prescription Drugs; D011639:Public Opinion; D012037:Refuse Disposal / Q000379:methods*; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D055553:Prescription Drugs
keywords: Adherence; Awareness; Behaviour; Malta; Medication wastage; Survey