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Meta-Analysis
. 2021 Jun 12;21(1):1127.
doi: 10.1186/s12889-021-11100-4.

Medicine storage, wastage, and associated determinants among urban households: a systematic review and meta-analysis of household surveys

Adineh Jafarzadeh  1 , Alireza Mahboub-Ahari  2   3 , Moslem Najafi  4 , Mahmood Yousefi  5 , Koustuv Dalal  6   7
Affiliations
Meta-Analysis

Medicine storage, wastage, and associated determinants among urban households: a systematic review and meta-analysis of household surveys

Adineh Jafarzadeh et al. BMC Public Health. .

Abstract

Background: Irrational household storage of medicines is a world-wide problem, which triggers medicine wastage as well as its associated harms. This study aimed to include all available evidences from literature to perform a focused examination of the prevalence and factors associated with medicine storage and wastage among urban households. This systematic review and meta-analysis mapped the existing literature on the burden, outcomes, and affective socio-economic factors of medicine storage among urban households. In addition, this study estimated pooled effect sizes for storage and wastage rates.

Methods: Household surveys evaluating modality, size, costs, and affective factors of medicines storage at home were searched in PubMed, EMBASE, OVID, SCOPUS, ProQuest, and Google scholar databases in 2019. Random effect meta-analysis and subgroup analysis were used to pool effect sizes for medicine storage and wastage prevalence among different geographical regions.

Results: From the 2604 initial records, 20 studies were selected for systematic review and 16 articles were selected for meta-analysis. An overall pooled-prevalence of medicine storage and real wastage rate was 77 and 15%, respectively. In this regard, some significant differences were observed between geographical regions. Southwest Asia region had the highest storage and wastage rates. The most common classes of medicines found in households belonged to the Infective agents for systemic (17.4%) and the Nervous system (16.4%). Moreover, income, education, age, the presence of chronic illness, female gender, and insurance coverage were found to be associated with higher home storage. The most commonly used method of disposal was throwing them in the garbage.

Conclusions: Factors beyond medical needs were also found to be associated with medicine storage, which urges effective strategies in the supply and demand side of the medicine consumption chain. The first necessary step to mitigate home storage is establishing an adequate legislation and strict enforcement of regulations on dispensing, prescription, and marketing of medicines. Patient's pressure on excessive prescription, irrational storage, and use of medicines deserve efficient community-centered programs, in order to increase awareness on these issues. So, hazardous consequences of inappropriate disposal should be mitigated by different take back programs, particularly in low and middle income countries.

Keywords: Expired; Home storage; Household; Medicine; Not in use; Wastage.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA Chart describing systematic review search process
Fig. 2
Fig. 2
Rank of stored and wasted medicines by ATC category (average %)
Fig. 3
Fig. 3
Comparison of stored medicines in Asia and Africa (average %)
Fig. 4
Fig. 4
Storage conditions of medicine products found in households (% medicine)
Fig. 5
Fig. 5
Disposal method of medicine (% household)
Fig. 6
Fig. 6
Forest plot assessing the prevalence of medicine storage among households, using data from 16 studies
Fig. 7
Fig. 7
Forest plot assessing the prevalence of medicine real wastage among households, using data from 16 studies
See this image and copyright information in PMC

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