Medication waste and disposal behaviors among Iranian households: A Cross-sectional study

Abstract

Improper use and disposal of medications pose substantial risks to both public health and the environment. Although medication take-back programs are recognized as effective solutions to address these concerns, public awareness remains low, and such programs are currently unavailable in Iran. The study, conducted between February and May 2024, used a validated 40-item questionnaire to assess the Knowledge, Attitudes, and Practices (KAP) of households regarding the disposal of unused and expired medications. The study revealed moderate knowledge levels (median = 58.82, interquartile range [IQR] = 88.2) and relatively positive attitudes (median = 85.71, IQR = 51.7) among participants. However, a notable discrepancy was observed between positive attitudes and actual practice, with 51.1% of households reporting disposal of unused medications in household waste. A weak negative correlation was found between older age and knowledge score (r = -0.129, p = 0.001), and a very weak negative correlation was observed between older age and attitude score (r = -0.078, p = 0.049). Higher knowledge scores were observed among participants with middle monthly incomes, those with post-secondary education (including Secondary education and students), and those living in three-member households. More positive attitudes were associated with Post-secondary education and households consisting of three or four members. To improve medication disposal practices, public health interventions should focus on raising awareness about the environmental and health risks of improper disposal and promoting proper disposal methods. This includes organizing community medication collection events and advocating for the establishment of nationwide medication take-back programs. The negative correlation between age and knowledge suggests that these interventions should specifically target older adults and individuals with lower levels of education.

Keywords: Attitude; Disposal behaviors; Environmental pollution; Knowledge; Medication waste.

Fig. 1

Geographical distribution of municipal districts in Tabriz, Iran.

Fig. 2

Flowchart of the sampling process.

Fig. 3

Disposal practices of unused and expired medications among households (n = 633).