Published: 2018-04-23

Medication waste disposal practices among patients attending selected out patient departments in a tertiary care institution: a cross sectional survey

Vipula R. Bataduwaarachchi, Rameshkumar Thevarajah, Chamari L. Weeraratne


Background: Medication waste has major implications on human and animal health, environmental safety and the health economy. Low and middle income countries have paid less attention to proper medication waste disposal at household and community level. This is the first baseline assessment on medication waste disposal practices among the general public in Sri Lanka.

Methods: This was a descriptive, cross-sectional survey, conducted via face to face interviews using a structured questionnaire among selected outpatient clinics at the National Hospital of Sri Lanka. A non-probability sampling technique was used to achieve a representative sample from each clinic. The data collectors were trained prior to administering the questionnaire. Data was presented as descriptive statistics using percentages. Chi-square test was used to find associations.

Results: From the total number of participants (n=200) majority were females 135 (67.5%). Majority of the participants (78%) stated that they have unused medicines at home. Among them, tablet form was the commonest (78%) followed by topical preparations (49%). Commonest reason for having unused medicines at home were self-discontinuation as illness resolved (57.5%). There was a significant difference between the knowledge and practices when disposing tablet form (<0.001), syrups (0.002), topical preparations (0.04) and sharps (<0.001). Majority (23%) discarded sharp to rubbish bins. Rubbish bin was the commonest mode of disposal for all dosage forms as well as devices.

Conclusions: In this sample majority had unused medicines at home which was compatible with the pattern seen in other countries and need proper attention.


Medication waste, Pharmaceutical waste disposal

Full Text:



World Health Organisation. Safe management of wastes from health-care activities, 2014. Available at: Accessed 27 Nov 2017.

Natural Resources Defense Council. Dosed Without Prescription: Preventing Pharmaceutical Contamination of Our Nation’s Drinking Water, 2010. Available at: Accessed 29 Nov 2017.

Grenni P, Ancona V, Barra Caracciolo A. Ecological effects of antibiotics on natural ecosystems: A review. Microchemical Journal. 2018;136:25-39.

Vellinga A, Cormican S, Driscoll J, Furey M, O’Sullivan M, Cormican M. Public practice regarding disposal of unused medicines in Ireland. Sci. Total Environ. 2014;478:98-102.

Ahmed A, Mushtaq N, Tariq M, Durrani M, Akhtar S, Arif M, Yasmeen G. Disposal practices of unused and expired pharmaceuticals in Karachi and their impact on health and environment. JUMDC. 2013;2007(4):2.

Law AV, Sakharkar P, Zargarzadeh A, Tai BW, Hess K, Hata M, et al. Taking stock of medication wastage: Unused medications in US households. Research in Social and Administrative Pharmacy. 2015 Jul 1;11(4):571-8.

University College of London. Evaluation of the scale, causes and costs of waste medicines. Report of DH funded national project, 2010. Available at: Accessed 29 Nov 2017.

Ministry of Health. Sri Lanka National Health Accounts, 2013. Available at: Lanka National Health Accounts 2013.pdf. Accessed 27 Nov 2017.

Bundunee L, Athapattu C, Masafumi T. Waste Management Practices of Government Hospitals in Colombo, Sri Lanka. Int. J. Waste Resour. 2015;5:178.

Abahussain EA, Ball DE, Matowe WC. Practice and opinion towards disposal of unused medication in Kuwait. Med. Princ. Pract. 2006;15:352-7.

Jāmiʻah al-Urdunīyah. Imādat al-Baḥth al-ʻIlmī. S, Khader Y, Rawashdeh S, Hijazi S. An assessment of the extent of medication wastage among families in Jordan. Jordan J. Pharm. Sci. 2008;5(1):65-73.

Braund R, Peake BM, Shieffelbien L. Disposal practices for unused medications in New Zealand. Environ. Int. 2009;35:952-5.

Sonowal S, Desai C, Kapadia JD, Desai MK. A Survey of Knowledge, Attitude, and Practice of Consumers at a Tertiary Care Hospital Regarding the Disposal of Unused Medicines. J. basic Clin. Pharm. 2016;8:4-7.

Bashaar M, Thawani V, Hassali MA, Saleem F. Disposal practices of unused and expired pharmaceuticals among general public in Kabul. BMC Public Health. 2017;17:45.

Kusturica PM, Tomas A, Tomic Z, Bukumiric D, Corac A, Horvat O, et al. Analysis of expired medications in Serbian households. Zdr. Varst. 2016;55:195-201.

Boxall ABA. The environmental side effects of medication. EMBO Rep. 2004;5:1110-6.

World Health Organisation. Guidelines for Safe Disposal of Unwanted Pharmaceuticals in and after Emergencies Ordering Information Guidelines for the Safe Disposal of Unwanted Pharmaceuticals in and after Emergencies Interagency Guidelines, 1999. Available at: Accessed 27 Nov 2017.

Persson M, Sabelström E, Gunnarsson B. Handling of unused prescription drugs--knowledge, behaviour and attitude among Swedish people. Environ. Int. 2009;35:771-4.

European Medicines Agency. Guideline on the environmental risk assessment of medicinal products for human use, 2006. Available at: Accessed 27 Nov 2017.

World Health House Indraprastha Estate Mahatma Gandhi Marg New Delhi, India Report on health-care waste management status in countries of the South-East Asia Region, 2017. Available at: Accessed 27 Nov 2017.