Why do Aussies hoard medicines?

Dr Sara McMillan with the poster.
Dr Sara McMillan with the poster.

Australians are engaging in inappropriate storage, use and disposal of medicines – even those who are aware of safety and environmental risks

A poster study presented at the recent National Medicines Symposium looked at the quantity and nature of unwanted or when-required medicines in the home, and self-reported practices relating to their storage, accumulation, use and disposal.

“This poster looked at the qualitative interviews of a sub-population of survey responses, so the initial survey, we surveyed 4,202 Australian adults and 80% of them were unaware of the national Return Unwanted Medicines program, it’s unknown,” said Dr Sara McMillan, a co-author of the study.

“We assume, it’s been around so long, that people know. We do need to have that greater conversation with consumers, particularly newer consumers into the health system that may not be familiar with the fact that they can return their unwanted medicines.”

In this study, 608 of the participants in the initial study were eligible, and 166 completed an interview with one of three pharmacists.

A total of 1424 unwanted and/or when required medicines were stored, most commonly in the kitchen, bedroom and then bathroom of participants. Multiple household storage locations were common, and measures to restrict access to children or pets were not.

Most participants (117/130) did not collect prescribed medicines “just in case” but they did describe storing unused medicines for later use.

Medicines expiry was associated with reduced efficacy, rather than safety concerns, and participants reported using medicines that had recently expired, a year past expiry or even longer, especially if they were topical medicines.

Ointments, liquids, CAMs, or unscheduled medicines were more likely to be thrown in the rubbish or down the drain, while prescription medicines were more likely to be returned to the pharmacy.

The researchers say it’s important to explore the underlying reasons why people engage in inappropriate storage, use and disposal of medicines.

“We came up with a number of reasons as to why people store them and usually it’s for later use – which could be quite appropriate for maybe analgesics if their a migraine sufferer,” Dr McMillan told the AJP.

The researchers observed that some participants were storing antibiotics for later use.

“Medications change regularly and they just forget that they actually have them in their home,” Dr McMillan said.

“And a lot of people, when you talk to them about, well, can you get all your medicines out and all the other items that you store in your home that could be considered a medicine, that a lot of them weren’t expecting to find anything expired.

“Some of them were actually really surprised that they were, because when you look at a medicines box sometimes expiry dates are really hard to find, particularly if a label is put over it or if you’re an elderly consumer and don’t have really great vision.

“And what does that expiry mean? Does that mean that it’s not safe to use, or that it’s not effective, or what are the perceptions of expiry dates?

“There’s definitely individual risk assessments that go on as to whether people keep a medicine when they no longer use it, or if they use it after expiry, and we don’t really talk much about that.”

She encouraged pharmacists to talk to patients about these issues, particularly young consumers who may be presenting with one of their first scripts.

“And let people know, we can’t make assumptions that people know about Nat RUM.”

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