Analysis and Management of Unused Medications Problem in Urban Living Area Wanaporn Charoenchokthavee

Abstract

Faculty of Medicine Vajira hospital during December 2010 - February 2012. Pharmacists received unusedmedications and recorded data into the research-derived specific electronic database.Results: 1,092 patients returned their 4,624 unused medications items to the hospital. These medications consisted of722 different trade names. Total amount of the medications were 321,193 units. Total cost of the medicationswas 3,430,358.85 THB. Prevalence of unused medications problem was 0.14% of total dispensing medications,0.22% of total patients and 0.21% of total medication cost. Average of unused medication was 4.23 items,294.13 units and 3,141.35 THB per patient. The most frequently returned unused medications were simvastatin,omeprazole and enalapril. The most returned unused medications by their numbers were hydralazine 25 mg,isosorbide mononitrate 20 mg and doxazosin 2 mg but metformin, ferrous sulfate and hydralazine were themost returned unused medications by frequency and numbers. Erythropoietin 4000 U, abacavir 300 mg andpramipexole 250 mcg were the most returned unused medications by total cost (sorted by tradenames).Clopidogrel 75 mg, erythropoietin 4000 U and salmeterol/fluticasone accuhaler 50/250 mcg were the mostreturned unused medications by total cost (sorted by generic names). Main causes of returning unusedmedications were patient death, medications changes, patients stopped using them by themselves, adverse drugreactions, patients received the medications more than their needed, medication non-adherent, patients receivedmedications from more than one hospital and passed expired date.Conclusions: Unused medications problem in urban living area impacts medication system both numbers and cost ofmedication items. Causes of returning the unused medications reveal the solutions and chance of improvingmedication system in many dimensions.