Medication disposal within reach: Assessing implementation of permanent disposal receptacles in community pharmacies

Dustin K Miracle; Laura Stinson; Monica F Roberts; Douglas R Oyler; Adrienne Matson; Hannah K Knudsen; Sharon L Walsh; Patricia R Freeman

doi:10.1016/j.drugalcdep.2024.112500

Medication disposal within reach: Assessing implementation of permanent disposal receptacles in community pharmacies

Drug Alcohol Depend. 2024 Nov 16:266:112500. doi: 10.1016/j.drugalcdep.2024.112500. Online ahead of print.

Authors

Dustin K Miracle¹, Laura Stinson², Monica F Roberts³, Douglas R Oyler⁴, Adrienne Matson⁵, Hannah K Knudsen⁶, Sharon L Walsh⁷, Patricia R Freeman⁸

Affiliations

¹ Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, 789 South Limestone, Lexington, KY 40508, United States. Electronic address: [email protected].
² Substance Use Priority Research Area, University of Kentucky, 845 Angliana Avenue, Lexington, KY 40508, United States. Electronic address: [email protected].
³ Substance Use Priority Research Area, University of Kentucky, 845 Angliana Avenue, Lexington, KY 40508, United States. Electronic address: [email protected].
⁴ Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, 789 South Limestone, Lexington, KY 40508, United States. Electronic address: [email protected].
⁵ Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, 789 South Limestone, Lexington, KY 40508, United States; Center for the Advancement of Pharmacy Practice, University of Kentucky College of Pharmacy, 789 South Limestone, Lexington, KY 40508, United States. Electronic address: [email protected].
⁶ Department of Behavioral Science, University of Kentucky, 845 Angliana Avenue, Lexington, KY 40508, United States; Center for Drug and Alcohol Research, University of Kentucky, 845 Angliana Avenue, Lexington, KY 40508, United States. Electronic address: [email protected].
⁷ Department of Behavioral Science, University of Kentucky, 845 Angliana Avenue, Lexington, KY 40508, United States; Center for Drug and Alcohol Research, University of Kentucky, 845 Angliana Avenue, Lexington, KY 40508, United States. Electronic address: [email protected].
⁸ Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, 789 South Limestone, Lexington, KY 40508, United States; Center for the Advancement of Pharmacy Practice, University of Kentucky College of Pharmacy, 789 South Limestone, Lexington, KY 40508, United States; Center for Drug and Alcohol Research, University of Kentucky, 845 Angliana Avenue, Lexington, KY 40508, United States. Electronic address: [email protected].

PMID: 39642784
DOI: 10.1016/j.drugalcdep.2024.112500

Abstract

Background: Availability of medication disposal receptacles is critical to curbing nonmedical opioid use and diversion; however, availability in community pharmacies is sparse. The objective of this study was to describe implementation of the community pharmacy medication disposal program offered by the HEALing Communities Study in Kentucky (HCS-KY) using the EPIS (Exploration, Preparation, Implementation, and Sustainment) framework.

Methods: Sixteen counties participated in the HCS-KY from 1/1/2020-12/31/2023. Exploration and Preparation included gathering and review of evidence-based literature, state/community data, and key opinion leader input to develop a detailed implementation plan. Implementation and Sustainment were assessed using implementation outcome data collected (e.g., number of receptacles placed, amount of drug returned) and semi-structured qualitative interviews to evaluate common themes, including barriers and facilitators related to implementation and sustainment.

Results: Disposal receptacles were placed in 59 pharmacies within the 16 HCS-KY counties. Following implementation, the median number of receptacles per participating county increased significantly from 2.5 to 4.5 (p<0.001). A total of 8019.9 pounds of drug were returned during the study period, with a median per-county return rate of 230.5 pounds per year. Twenty-one pharmacy representatives participated in qualitative interviews. Most (70.0 %) reported weekly receptacle usage; however, few (35.0 %) reported routinely discussing disposal with patients. While 42.9 % reported no barriers, the most frequently reported barrier (33.3 %) was receptacle limitations (e.g., only available during business hours, dosage form restrictions).

Conclusions: Implementation of the HCS-KY community pharmacy medication disposal program led to notable increases in disposal locations that were highly utilized by communities.

Keywords: Barriers and facilitators; Controlled substances; Implementation strategies; Medication disposal; Opioid epidemic; Prescription drug diversion.