PRESCRIPTION medicine waste is a serious issue for the NHS as a whole and the launch of our wasted medicines campaign aims to raise awareness among everybody – patients, carers, pharmacists and prescribers – to highlight the situation.
It is diffi
cult to quantify the actual amount of medicines wasted, but our estimates – and these are likely to be low – suggest that in NHS Lothian around £3 million each year is spent on medicines which are not actually taken. Our pharmacists are seeing more and more medicines being collected in and returned for disposal.
The medicines returned in most quantities tend to be painkillers, possibly where the patient does not need or is not taking the full dose but orders the same amount every time. Other medicines such as calcium and iron preparations are also not taken because of side-effects but are still ordered as people feel they should be taking them.
As you can imagine there are many reasons why medicine waste exists and it is impossible to rule it out completely, particularly when there will always be changes in medical conditions and changing medication due to side-effects. However, with an increase in chronic diseases and increased prescribing for preventative care, alongside a growing elderly population, we are seeing an increase in prescribing volumes, a likely contributory factor in medicine waste.
We do find that when patients are re-ordering on their repeat prescription form, there is a tendency to order all the medicines listed. The thrust of the campaign is to get people to "think before they tick" the form, so that they only order the prescriptions they need, rather than those they already have. This leads to stockpiling. Medications prescribed to be taken when required can accumulate when only taken occasionally and ordered regularly. This can be kept to a minimum.
Also, and I'm sure we are all guilty of it, sometimes you stop taking a medication because you feel better or think you don't need to take it any longer. Again this leads to waste, but as long as that product is not reordered, that waste is minimal. It is also likely that most people don't realise it is illegal for a pharmacist to re-use a returned medicine, even if unopened.
Unused medicines also pose a safety risk. The more medicines kept at home, the greater the risk of children and others taking them when they shouldn't.
This campaign is not about trying to reduce the amount of medicines patients receive, but ensuring they are only receiving the medicines they need.
While there is an onus on patients to be aware of the issue, there is also a responsibility among our staff, those who prescribe, such as GPs, nurse prescribers and pharmacists to do all they can to minimise waste. There have been a number of small, local campaigns in recent years, encouraging patients to return unused medicines to their pharmacists and a rough estimate in north-west Edinburgh indicated that the potential estimated cost of returned medicines was around £170,000 a year in that area alone. These events show that there are a range of measures that need to be taken to prevent the stockpiling of medication that will not be used.
We are encouraging our NHS staff to engage even more with patients in relation to reviewing their medication. The new role of the community pharmacist, particularly with the minor ailments service launched in 2006 and the forthcoming introduction of the chronic medication service, should allow for increased engagement with patients and carers over medicine requirements.
We want to get the message out that "wasted medicines, wastes money". This is money that could pay for more nurses, hip replacements or heart bypass operations.
We have already taken steps to minimise medicine waste in hospitals with our one-stop dispensing initiative. As well as reducing patient waiting times on discharge from hospital, it importantly helps to reduce medicine waste. Patients are encouraged to bring all their medicines into hospital with them which are then put into a lockable bedside cabinet. Changes to medication and further supplies from the hospital pharmacy ensures the correct medication goes home with the patient and there is no duplication.
This is an issue that is not going to go away, but there are steps that can be taken to help and NHS Lothian's wasted medicine campaign is one of them. I hope that everyone will understand now to "think before they tick". That way we can all make a difference.
• Pat Murray is director of pharmacy at NHS Lothian. For more information visitwww.nhslothian.scot.nhs.uk/wastedmedicines The full article contains 803 words and appears in Edinburgh Evening News newspaper.
