Pharmacists' activities to reduce medication waste: An international survey

Background and Objective: Pharmacists are key players for reducing the undesirable economic and environmental burden of medication waste. Previously, we identified 14 activities that indi-vidual pharmacists undertake to reduce medication waste, divided over different stages of the pharmaceutical supply chain (prescribing, dispensing [pharmacy-and patient-related] and leftover stage). However, to what extent these activities are implemented in clinical practice across Western countries is unknown. The objective was to assess the frequency that activities to reduce medication waste are implemented by community and hospital pharmacists of Western countries, the importance of the activities for reducing waste and the feasibility for implementing the activities in clinical practice. Setting and Method: The 14 pre-defined activities were used to construct a questionnaire that was distributed among community and hospital pharmacists working in Western countries who participated in the 45th ESCP congress in 2016. Pharmacists were asked to report if the activity was implemented in their country (yes/no), to rank the importance of the activity to reduce waste and the feasibility to implement in practice (from 1 [not] to 5 [very important/feasible]). Data was descriptively analysed using STATA13. Main outcome measures: The proportion of countries that has implemented the different waste reducing activities, and the impor-tance and feasibility of these activities ranked by the pharmacists. Results: 89 pharmacists from 22 countries participated. On average 5.7 of the pre-defined activities (standard deviation 2.4) were implemented per country. Most activities were implemented in less than half of the countries. Reducing the amount of medicines in stock at the pharmacy (dispensing stage-pharmacy related) was most frequently implemented, (n = 19, 86%), followed by collecting unused medicines (77%, leftover stage) and performing medication review (68%, dispensing stage-patient related). Waste reducing activities in the dispensing stage were both considered most important to reduce waste and most feasible activities to implement in practice (ranked '4′). Overall, the activities scored higher on importance than on feasibility. Conclusion: Pharmacists have various opportunities to reduce med-ication waste throughout the pharmaceutical supply chain. However, not all activities are implemented. Although pharmacists consider medication waste reducing activities important, they doubt the feasibility for implementation in clinical practice.