Disposal of Unused and Expired Medicines in a Take-Back-Unwanted-Medicines (TBUM) Site in Ghana: A Cross-Sectional Study

Background and Aim: Medicines form a major component of Ghana's healthcare delivery system. However, stockpile of unwanted medicines in many Ghanaian homes and lack of proper disposal system results in indiscriminate disposal of unwanted medicines. Improper disposal affects the environment and economy. The study aims to assess disposal of unwanted medicines within the past 12 months, methods of disposal, and associated factors. Methods: A cross-sectional analytic survey involving 426 randomly selected households in the Ga Central municipality was conducted using structured questionnaires. The primary outcome was disposal of expired/unused medicines within the past 12 months measured categorically as yes disposal versus no disposal. The secondary outcome was type of disposal method, measured as home disposal versus organized disposal. Prevalence of expired/unused medicines at home, knowledge, attitude and awareness of disposal programs were assessed. Descriptive, logistic regression and post-estimation analyses were performed using Stata 16 at an alpha of 0.05. Results: The mean age of respondents was 29.5 years (+/−11.9), 226 (53.1%) were females and 37.1% (95% CI: 32.48–41.87) disposed of expired/unused medicines, out of which majority (91.8%; CI: 86.34–95.54) disposed of their expired/unused medicines at home. The prevalence of unwanted medicines at homes was 56.6% (95% CI: 51.7–61.3). Knowledge of disposal practices (14.5%; 95% CI: 11.34–18.27) and awareness of Take-Back-Unwanted-Medicine (9.4%; 95% CI: 6.79–12.57) were low. Attitude (67.1%; 95% CI: 62.5–71.6) towards good disposal was high. Elderly individuals in households (AOR = 0.50; 95% CI: 0.29–0.84), adverse drug reactions (AOR = 2.03; 95% CI: 1.05–3.9), knowledge (AOR = 3.01; 95% CI: 1.53–6.30), and awareness (AOR = 2.91; 95% CI: 1.17–7.24) were associated with expired/unused medicines disposal. Conclusion: Majority disposed of unwanted medicines at home, thus Food and Drugs Authority should create awareness on safe medicines disposal through community outreach, integration into healthcare training programs and scaling up of the TBUM program to other districts.