Exploring accredited pharmacists’ work processes regarding the return of unwanted medicines during Home Medicines Reviews in Australia

Background: Globally, there is a growing emphasis on appropriate removal of unwanted medicines for safe destruction from community, hospital(1) and other settings. Pharmacists play a vital role in the safe and effective practice of choosing, using and removing medicines in society.(2) Objectives: To explore accredited pharmacists’ (APs’) perspectives on removal of unwanted, unused and expired medicines from patients’ homes as part of Home Medicines Review (HMR) service delivery in Australia. Methodology: An extended exploratory project examining APs’ HMR work processes in Australia utilised 2 focus groups, 15 semi-structured interviews, a national survey (n=255) and non-participatory observation of the patient-pharmacist home consultation (n=5). The data was explored for themes around the return of unwanted medicines (RUM) as part of HMR practice. Results: HMR work practice themes around (RUM) identified across the studies included: barriers such as lack of interest, lack of time, concerns around the medicines remaining in their car for extended periods, perceptions around “the patient can return it themselves to the community pharmacy”, poor relationships with community pharmacists, and lack of use of the Australian RUM project approved plastic bags intended for appropriate removal of medicines from patients’ homes as part of best practice.(3) Discussion: The home visit presents an ideal opportunity for visiting APs to safely and appropriately remove unwanted medicines, to minimise the impact of pharmaceuticals on the environment and to maximise patient safety. Further education and exploration of APs’ work processes for the more sustainable use and disposal of medicines is warranted