台北市居家廢棄藥物檢收調查研究

Investigation of the Disposal of Expired and Unused Medicines in Households in Taipei

10.6288/TJPH2012-31-03-03

陳怡靜(I-Chin Chen)；姜郁美(Yu-Mei Chiang)；陳立奇(Lih-Chi Chen)

剩藥 ； 廢棄藥物檢收 ； unused medicines ； disposal medicine return

台灣公共衛生雜誌

31卷3期（2012 / 06 / 01）

228 - 235

繁體中文

目標：民眾普遍遇有剩餘藥品不知如何處理之現況，潛藏用藥安全、環境污染、及醫療資源浪費等問題，本研究針對民眾對於廢棄藥物認知及剩餘藥品原因進行分析及探討，據以參考改進及減少民眾家中剩餘之藥品。方法：在全市十二行政區內的社區藥局及醫院藥局設置「居家廢棄藥物檢收站」，由專業藥師協助市民進行居家廢棄藥物的分類與檢收，同時抽樣進行問卷調查。結果：於2010年4月1日至12月31日，共有2,012名民眾完成問卷調查，統計廢棄藥物主要來源是「看診領藥」（80.6%），產生剩藥的主要原因是「自覺病情或症狀改善」（23.7%）及忘記服藥（19.3%）。廢棄藥品主要種類為口服藥品（91.8%），依藥理分類區分則以「腸胃道用藥」（15.8%）及「心血管用藥」（13.4%）最多。結論：研究結果顯示大多數民眾服藥依順性仍有待改善，且多數藥品應為未服用放在家中放到過期才檢收。建議藥師對民眾多加宣導應依醫囑用藥，如為慢性病用藥不可自行停藥，非慢性病用藥若不須開藥可與醫師溝通，避免浪費健保資源。

Objectives: The aim of this study was to determine the reasons why households kept unwanted medicines. Methods: A questionnaire was completed by patients or their families when they returned unused medicines for disposal to pharmacies in the community or to hospitals in Taipei. The reasons why medications were unused and the ways in which they were disposed were recorded and analyzed. Results: A total of 2,012 people completed the questionnaire. The way that they knew about returning unwanted medications was, ”walked by and saw the return box” (30.1%). The way they had previously disposed of unwanted medicines was to ”dispose in the trash can” (61.8%). The reasons for possessing unused medication were: ”felt well already” (35.7%) and ”forgot to take the medicines” (19.3%). The most commonly returned items were medications for ”gastrointestinal” (15.8%) and ”cardiovascular” (13.4%) problems. Conclusions: The results showed that medication adherence could be better. We suggest that pharmacists could do more patient education about chronic illness, following orders, not stopping the medication without asking the doctor; and, if they don't need medications for common illnesses, patients should discuss this with their doctor in order not to waste health insurance resources.

1. Illinois-Indiana Sea Grant. Disposal of unwanted medicines: a resource for action in your community. Chapter 2: unwanted medicine take-back programs: case studies, programs in other countries: European Union. Available at: http://www.iisgcp.org/unwantedmeds/toolkit/europeanunion.pdf. Accessed May 24, 2011.
2. The Teleosis Institute. National programs and resources. Available at: http://www.teleosis.org/gppnational.php. Accessed May 24, 2011.
3. The National Return & Disposal Unwanted Medicines Limited. Return your unwanted medicines to your pharmacy. Available at: http://www.returnmed.com.au/. Accessed May 24, 2011.
4. Al-Mehza, A. M.,Al-Muhailije, F. A.,Khalfan, M. M.,Al-Yahya, A. A.(2009).Drug compliance among hypertensive patients; an area based study.Eur J Gen Med,6,6-10.
5. Braund, R.,Chuah, F.,Gilbert, R.(2008).Identification of the reasons for medication returns.NZFP,35,248-52.
6. Ekedahl, A. B.(2006).Reasons why medicines are returned to Swedish pharmacies unused.Pharm World Sci,28,352-8.
7. Kolpin, D. W.,Furlong, E. T.,Meyer, M. T.(2002).Pharmaceuticals, hormones, and other organic wastewater contaminants in U.S. streams, 1999-2000: a national reconnaissance.Environ Sci Technol,36,1202-11.
8. Kuspis, D. A.,Krenzelok, E. P.(1996).What happens to expired medications? A survey of community medication disposal.Vet Hum Toxicol,38,48-9.
9. 吳奕璋、林珍芳、黃上真、廖淑眉、王春玉(2006)。某醫學中心門診病患服藥順從性相關因素調查。醫院藥學雜誌，23，6-12。
10. 林正芳、林郁真、余宗賢(2008)。,台北=Taipei:行政院環境保護署=Environmental Protection Administration, Executive Yuan, R.O.C. (Taiwan)。
11. 陳怡靜、陳珮甄、姜郁美、陳立奇(2010)。居家廢棄藥物檢收─從公共衛生角度之探討。醫院藥學雜誌，27，116-20。

1. 鄧雪妹、黃淑娟、郭美玲、張惠珍、邱子菁(2016)。降低中醫病房病人中藥廢棄發生率之改善專案。長庚護理，27(4)，559-572。
2. 管玉娟、陳漢瑛、胡益進(2013)。臺北市某國中學生正確用藥知識、態度與行為之研究。學校衛生，62，93-116。
3. 張鳳琴、紀雪雲、林陳麗蓉、李景美(2016)。臺灣某國小學生正確用藥教育介入成效之探討。學校衛生，69，87-111。
4. (2024)。藥師多元策略介入門診多重用藥糖尿病病人之成效研究。台灣公共衛生雜誌，43(5)，501-512。