Household Drug-Storing Practices

Among Community Residents In

Paknaan, Mandaue City, Philippines,

2010 “A Clear and Present

Danger . . . .”

Background• *Global increase in drug consumption • *In 1998, Philippines ranked second to Singapore

in terms of per capita drug consumption • *Drug prices are 600% more expensive• Unrestricted drug availability and use:

• Inappropriate drug use• Drug resistance• Drug-drug interactions• Waste of resources

• Inappropriate disposal of expired medications* Valera, M. Experiences with Insurance Coverage of Medicines in the Philippines: Philippine Health Insurance Coverage. WHO, 2005.

• What is the epidemiology (prevalence, nature

and determinants) of the practice of household

drug-storing among the residents in Paknaan,

Mandaue City, Philippines?

• Household storage refers to the practice of

keeping drugs at home

Research Question

• Study Design: Analytical Cross Sectional Survey

• Study Setting: Paknaan, Mandaue City, Philippines, April-July 2010

• Study Population: Caregivers, household heads or any adult family member of household units

• Sampling Procedure: Proportionate sampling• Sample Size: 80% of the total number of

households within each zone

Methodology

Methodology• Maneuvers: - house-to-house survey

- structured data collection form - questionnaire

- focus group discussion – for questionnaire development and validation of responses in filled questionnaire

• Data Analysis: - Data were entered with Microsoft Excel Spread

sheet and analyzed with SPSS ver. 16.0

- P value < 0.05 defined statistical significance

• A total of 1,209 household units (80% of total households in community)

• Respondent characteristics:• Median age: 34 years (IQR: 26 – 44)• Majority of respondents were females (77.3%)• Educational attainment: 52.9% High School• Only 21.9% were employed

• Household medication storage was high (81%)• More prevalent in households with a family

member with chronic illness - HPN, arthritis• Medications stored in non-child proof containers

Results

Results• Most commonly stored drugs: symptom relief,

vitamins, antibiotics, anti-hypertensive agents• Stored expired drugs: 433 (44.2%)• Stored medicines without expiry dates: 306 (31.3%) • Stored unlabelled medications: 126 (12.9%)• High prevalence of OTC drug purchases (86.1%)• Non-compliance from a prescription (29.5%)• Mostly stored in dining room/ kitchen (53.7%)• Most commonly thrown in garbage bin in original

formulation (86.5%)

Characteristic Home Medication Storage Practice Status

P Value

Positive NegativeAge (Yrs.) 34 (IQR: 25-44) 34 (IQR: 26.8-45) 0.33Gender (%) 0.14 Males 21.8 26.5 Females 78.2 73.5Employment Status (%) 0.33 Employed 28.3 31.7 Unemployed 71.7 68.3Illness in the Family (%) < 0.001 With chronic illness 65.1 31.7 Without chronic illness 34.9 68.3Educational Attainment 0.05 Vocational (%) 2.3 0.9 College (%) 27.5 20.9

Results

Why do you store medicines at home?- “Intended for future use, in case of emergency”

- “Left over from previous prescription”- “For remedy of common illness”- “To avoid consulting physicians to save money”- “Maintenance medications”

Why do you keep in kitchen/ dining room?- “Most doses are taken with meals”

Why do you store or give expired medications to others?

- “Still effective” Why do you throw expired medications in the

garbage? - “Don’t know any other method of disposal”

Conclusion• Prevalence of household drug storage was high at

81%• Most commonly stored drugs were symptom

relievers, vitamins, antibiotics and antihypertensive medications

• Practice of household drug storage was significantly associated with presence of family member with chronic disease and level of educational attainment

• Drug storage patterns and disposal increase risk of harm to family members and community

• Patient education regarding indications and potential adverse effects of prescribed drugs

• Caution patients against medication-sharing: symptoms may be similar for many diseases of varying etiology

• Restrict and monitor Over-The-Counter (OTC) antimicrobial drug sales and drug dispensing

• Warn against potential for toxicity in children due to improper storage of medications at home

• Monitor drug advertisements in media

• Implement community drug-disposal program

Implications & Recommendations

Daghan Salamat