dr. amy tiemeier, pharm.d., bcps st. louis college of pharmacy regional excess medication disposal...
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Dr. Amy Tiemeier, Pharm.D., BCPS
St. Louis College of Pharmacy
RRegional egional eeXXcess cess MEMEdication dication DDisposal isposal SServiceervicePartnershipPartnership
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 patronso What types of medications
are being turned in o Previous disposal methods
MeasurementMethodology: 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 atAARP Health
Fair
Educating atAARP Health
Fair
Area Resources for Community and Human Services (ARCHS)
Area Resources for Community and Human Services (ARCHS)
Schnuck Markets, Inc. Schnuck Markets, Inc. Cintas Corporation Cintas Corporation
St. Louis College of Pharmacy St. Louis College of Pharmacy
Missouri AARP Missouri AARP
Mid-East Area Agency on Aging Mid-East Area Agency on Aging
St. Louis OASISSt. Louis OASIS
Senior Services Plus Senior Services Plus
WK Health WK Health
Stericycle Stericycle
St. Louis City Agency on Aging St. Louis City Agency on Aging
Metropolitan Sewer District Metropolitan Sewer District
STL County Waste Management Program STL County Waste Management Program
MO Environmental Water Association MO Environmental Water Association
Living Lands and Waters Living Lands and Waters
American Water Company American Water Company
PhRMA PhRMA
Saint Louis University Saint Louis University
Phase 1Phase 1
Phase 2Phase 2
Phase 3Phase 3
√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 TechStudent Extern Pharmacist
•Show location•Manage flow
•Market •Ready materials• Assist with workflow
•Document •Determine drug •Discuss drug related problems
•Check drug documentation •Feedback
Liability/reliability of information 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)
RxMEDSCommunity 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
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