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. 2022 Dec 30:2022:7674701.
doi: 10.1155/2022/7674701. eCollection 2022.

Drug Disposal and Ecopharmacovigilance Practices in the Krowor Municipality, Ghana

Affiliations

Drug Disposal and Ecopharmacovigilance Practices in the Krowor Municipality, Ghana

Yvonne Yirenkyiwaa Esseku et al. J Toxicol. .

Abstract

Introduction: The use of medicines is a ubiquitous practice for the management of healthcare conditions. In the delivery of healthcare, medicines may remain unused and may expire within the various stakeholders in the pharmaceutical value chain. If these unused and expired medicines are not disposed of properly, they may result in the concentration of pharmaceuticals in environmental media contaminating food sources for humans and animals. Implementation of ecopharmacovigilance strategies will reduce the quantities of pharmaceuticals in the environmental media, reduce the potential for inadvertent consumption by humans and animals, and reduce potential pharmacological effects on the environment, humans, and animals. The drug disposal flow diagram (DDFD) provides an effective way of assessing the most cost-effective strategies to reduce environmental contamination.

Method: A combined method of desk study and questionnaires, both structured and unstructured was used. The desk study reviewed the institutional arrangements for the regulation of disposal of pharmaceutical waste in Krowor. The questionnaires were used to gather information from community members, community pharmacies, and pharmaceutical manufacturers in Krowor.

Results: The drug disposal flow diagram shows that up to 96% of pharmaceuticals are handled and disposed of in ways that are harmful to the environment with only 4% being handled in ways that are environmentally friendly. Forty-nine percent (49%) of generated pharmaceutical waste ends up in the local and surrounding areas, 21% contaminates the drainage system and 25% is discharged into receiving waters. Discussion. The DDFD for Krowor shows that engagement with community members and institutional healthcare service providers and strategies that result in separation of pharmaceutical waste from general household waste will reduce the quantities of pharmaceuticals that end up in the environmental media.

Conclusion: The DDFD will support the effective implementation of ecopharmacovigilance (EPV) strategies.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Map of Ghana and communities in the Krowor municipality (by nordnordwest and manny 9455 licensed under CC BY-SA 3.0 and 4.0).
Figure 2
Figure 2
Educational background of the survey respondents in the Krowor municipality comparing gender differences. Data represent the means for each group (n = 400). (PhD: doctor of philosophy; HND: higher national diploma; SHS: senior high school; and JHS: junior high school).
Figure 3
Figure 3
Major types of medications consumers in the Krowor municipality admit to having at home for emergency use. Data represent the means for each group (n = 400).
Figure 4
Figure 4
Methods of disposal used by community members in Krowor municipality for different drug dosage forms. Data represent the means for each group (n = 400).
Figure 5
Figure 5
The percentage of pharmacies holding medicines requiring disposal in the Krowor municipality. Data represent the means for each group (n = 35).
Figure 6
Figure 6
Flow of medicines during regulated disposal–from source to sink. Source: author (from KII with FDA).
Figure 7
Figure 7
Drug disposal flow diagram showing the likely pathways for disposal of drugs within the Krowor municipality.

References

    1. World Health Organization. Medicines . Geneva, Switzerland: World Health Organization; 2012. https://www.who.int/health-topics/medicines#tab=tab_1 .
    1. Esseku Y. Y. Ecopharmacovigilance in Practice: Design of an Intervention - the Drug Disposal Flow Diagram . Okhla Industrial Estate, New Delhi: manakin press; 2016. http://dspace.knust.edu.gh:8080/jspui/handle/123456789/9354 .
    1. Deziel N. Pharmaceuticals in wastewater treatment plant effluent waters. Scholarly horizons: university of Minnesota, Morris Undergraduate Journal . 2014;1(2):p. 12.
    1. Kummerer K. Pharmaceuticals in the Enviornment: Source, Fate, Effects and Risks . Berlin, Germany: Springer; 2008.
    1. Velo G. Pharmacovigilance and Ecopharmacology. Proceedings of the 1st International Conference on Sustainable Pharmacy; April 2008; Osnabruck, Germany.

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