Healthcare professional's knowledge, and practices regarding disposal of medicines in primary healthcare facilities in South Africa: impacts and implications

Objective: Professional nurses, pharmacists and medical practitioners are responsible for the disposal of medicines within healthcare facilities. South African regulations stipulate that medicines should not be disposed of through sewage systems in view of the potential impact on patients and the environment. Consequently, our objective was to determine knowledge and practices among healthcare professionals (HCPs) in South Africa, and the information they provide to patients, regarding the safe disposal of unused/expired/damaged medicines to provide future guidance with identified concerns. Methods: Descriptive study conducted amongst 165 HCPs at 16 primary healthcare clinics in two sub-districts of the City-of-Tshwane in Gauteng Province via self-administered questionnaires. Findings: 23.5% of HCPs stated they participated in the destruction of medicines within their facilities. 57.8% reported they always counsel patients regarding the safe storage of their medicines in their homes, with 27.9% indicating they counsel patients on the safe disposal of their medicines during consultations. 65.1% reported that patients never asked about disposal of medicines. Of concern is that incineration (31.9%), flushing down the toilet (20.6%) and flushing down the sink (9.9 %) were regarded by HCPs as correct disposal methods, while 9.6% stated they did now the correct methods. 71.1% reported never receiving training regarding safe disposal of medicine. Conclusion: There is an urgent need to educate HCPs regarding appropriate waste disposal of medicines in South Africa. This can start with including this topic in the curriculum of HCPs including pharmacists, and continuing post qualification.