Transcript Earth Day 2008 - University of New England

Regional
eXcess
MEdication
Disposal
Service
Partnership
Dr. Amy Tiemeier,
Pharm.D., BCPS
St. Louis College of
Pharmacy
St. Louis:
Missouri &
Mississippi Rivers
converge
• MO and IL
• 5 counties
Objectives:
 Identify 25 regional
supermarkets that will serve as
collection centers.
 Establish an environment
friendly methodology to
dispose of unwanted
medications.
 Plan and present a major
regional workshop for seniors
through our senior services
partners.
 Provide educational programs
to 10-20 regional schools on
drug safety, etc.
 Conduct relevant research on
the topic. Such as:
o Demographics of patrons
o What types of medications
are being turned in
o Previous disposal methods
Measurement
Methodology:
 Surveys at point of
collection
 Data collected at
point of collection
 Feedback from
involved parties
 Attendance at
Regional Senior
Workshop(s)
 Pre/post senior
survey on knowledge
gained
 # of school programs
conducted
 # of students in the
programs
 Pre/post student
survey on knowledge
gained
Outcomes:
Immediate
 Public awareness of an issue
that affects the region but until
now has not been addressed
on a major scale.
Intermediate
 Removal of medications that
harm the environment and
pose a health hazard.
Long Term
 An attitudinal change of the
general public that currently
accepted and promoted
means of medication disposal
are not correct.
 A shift in the advertising by
major pharmaceutical
companies towards an
improved disposal method for
unused medications.
• Publications have had a circulation of 704,300 in
metropolitian area.
– Belleville News Democrat
– Schnucks Advertising Circulars
– Metropolitan Sewer District Bill Inserts
• Community outreach activities of the partners
included over 20 community based programs that
contacted an additional 2,136 area residents.
– Mideast Area Agency on Aging (MEAAA)
– OASIS
– AARP
• School based programs were offered in 15
different class settings and reached 387 students
and 15 teachers.
Educating at
AARP Health
Fair
Area Resources for Community and
Human Services (ARCHS)
Schnuck Markets, Inc.
Cintas Corporation
St. Louis College of Pharmacy
Missouri AARP
Mid-East Area Agency on Aging
St. Louis OASIS
Senior Services Plus
WK Health
Saint Louis University
Stericycle
Metropolitan Sewer District
St. Louis City Agency on Aging
PhRMA
MO Environmental Water Association
STL County Waste Management Program
Living Lands and Waters
American Water Company
Phase 3
Phase 2
Determine
feasibility
12 months of of on-going
take-back
take-back
Phase 1
programs:
programs
provide the
6 months of
planning set-up: service and
educate the
Controls,
public
policies and
procedures,
marketing,
scheduling
√US EPA
√US EPA Human Subjects Review & St. Louis
University IRB Board
√Hazardous Materials Information Center
(US Dept of Transportation)
√MO Bureau of Narcotics and Dangerous Drugs
(BNDD)
√US DEA, MO & IL
√MO Board of Pharmacy
√MO and IL EPA
• EPA and federal DEA approved plan of separate
bins, multiple person check off, and officer picks
up immediately following the drop off period.
– Specifically for this grant
• MO State BNDD would not agree
• Therefore, we did not accept
control medications
•
•
•
•
20 locations, 3 hour drop off time once a month
Document controls but do not accept
Accept non-controlled unwanted medications
Inform patrons what to do with non-returnable
materials
• Only collect medications
during collection times
Greeter
•Show
location
•Manage flow
Tech
•Market
•Ready
materials
• Assist with
workflow
Student
Extern
•Document
•Determine
drug
•Discuss
drug related
problems
Pharmacist
•Check drug
documentation
•Feedback
Liability/reliability of information
• Greet and explain purpose
• Background
• Facts & Comparisons 4.0 drug database on
students laptop for quick tablet identification
• Clinical Pharmacology used for
identifying potential controls
• Educational materials offered
• 1st contracted company did not have enough
manpower on Fridays although we were assured
by management that this could happen
• Little to no response from company when issues
brought to their attention
• Company was not invested in project
• Contract was cancelled
• Did not cost grant as there was a
breech in contract
Box
2 Plastic bags (one for backup in
case of leakage, you can double
bag the meds)
Tape roll (use every month)
Bill of Lading (“manifest”) via
email
Tie for plastic bag (not pictured)
Preprinted
shipping label
• Through September 2008
– 1,949 lbs.
– Does not include box or
container
• Completed: 547 surveys
• Demographics
– Average Age: 57
– Ethnicity
• Caucasian: 80%
– Gender: 71% female
• 72% did not bring back
any medications
• 70% preferred to bring
back to pharmacy
• Overall Participation: > 900 patients
• Store Participation: four patients per store
per event
• Average # of Meds Returned: 9
• Average age: 63.5
• Gender: 75% female
• Ethnicity: 96% Caucasian
“How did you dispose of your medications
previously?”
– Kept: 20%
– Flushed: 44%
– Trash: 20%
– Saved for future use: 1%
– Gave to friend: 1%
– Collection Program: 4%
– Other: 10%
• 8,800 individual prescriptions, OTC
and herbals collected
– ½ were tablet or capsules non-control
prescription items
– Controlled substances: 500 tablets
and capsules attempted
– OTC: 1,700 tablets and capsules
– Herbal: 24 tablets and capsules
• Tablets and Capsules
– > 190,000
• Liquids
– Over 800 bottles
• Inhalers
– 110 (MDI or DPI)
RxMEDS
Community Partners
 ARCHS (www.stlarchs.org)
 Schnuck Markets, Inc.
(www.schnucks.com/pharmacy/rxreturns.asp)
 St. Louis College of Pharmacy (www.stlcop.edu)
 Cintas (www.cintas.com)
 AARP Missouri Chapter, Senior Services Plus
 OASIS & Mid-East Area Agency on Aging