title: Comparison of the knowledge, attitude, and practices of doctors, nurses, and pharmacists regarding the use of expired and disposal of unused medicines in Delhi.
abstract: OBJECTIVE
  The use of out-of-date medicines and improper disposal of pharmaceutical products harm consumers and environment. To limit pharmaceutical load on the environment, it is important that healthcare professionals (HCPs) are aware of and have good practices toward their disposal.
  
  
  METHODS
  A pretested instructor administered questionnaire containing 21 questions was used to assess knowledge, attitude, and practices (KAP) of 300 HCPs toward use and disposal of unwanted/expired medicines.
  
  
  RESULTS
  Nurses (76%) had significantly (P< 0.01) better knowledge over doctors regarding the methods of drug disposal, whereas both doctors (63%) and nurses (64%) knew significantly (P< 0.05) more than pharmacists about type of formulations not to be incinerated. The majority (88%) of overall respondents were unaware of validity of dispensing medicines before 15 days of mentioned expiry date. A large proportion of HCPs had a positive attitude toward checking the expiry date of medicines (96%), and a significant proportion of doctors and nurses believed that drug disposal is everyone's responsibility. Only 8% of the HCPs received unused/expired drugs back from the consumers. Nurses (59%) had better (P< 0.01) practice than pharmacists regarding the disposal of expired medicines. Nearly half (44%) of all HCPs agreed that there existed a system for removing expiry and unused medicines from the inventory.
  
  
  CONCLUSIONS
  The KAP of HCPs toward use and disposal of out-of-date and unused medicines need upgrading. The existing guidelines should be implemented to ensure patients' safety and to preserve the ecosystem.
authors.affiliation: Department of Pharmacology, Lady Hardinge Medical College, New Delhi, India.
authors.forename: Kriti
authors.initials: K
authors.lastname: Bhayana
authors.affiliation: Department of Pharmacology, Lady Hardinge Medical College, New Delhi, India.
authors.forename: Harmeet Singh
authors.initials: HS
authors.lastname: Rehan
authors.affiliation: Department of Pharmacology, Lady Hardinge Medical College, New Delhi, India.
authors.forename: Tarun
authors.initials: T
authors.lastname: Arora
mesh_terms: D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D009726:Nurses / Q000523:psychology / Q000592:standards*; D010595:Pharmacists / Q000523:psychology / Q000592:standards*; D010820:Physicians / Q000523:psychology / Q000592:standards*; D055553:Prescription Drugs / Q000592:standards*; D012037:Refuse Disposal / Q000379:methods / Q000592:standards*
chemical_list: D055553:Prescription Drugs
keywords: Disposal of unwanted medicines; expiry medicines use; healthcare professionals; unused medicine disposal