Pharmaceutical waste in public pharmacies in Serbia: Practices, challenges and needs for a sustainable and standardized management system

Abstract

Environmental pollution and public health risks make improper medicine disposal a significant environmental and health prob lem. Pharmaceutical waste is a key challenge, and pharmacies are an important point for its collection from citizens. However, practice shows different behavior of public pharmacies, which indicates the need to improve the system. The aim of this work is to examine the current practices of pharmaceutical waste collection and problems pharmacists encoun ter in its management in public pharmacies in Serbia. A cross-sectional study was conducted among pharmacists employed in public pharmacies in Serbia using an anonymous on line questionnaire. Descriptive indicators and chi-square test were used, with a significance level of p<0.05. The survey included 334 pharmacists, of whom 34.6% reported that their pharmacy collects pharmaceutical waste from cit izens. Almost all respondents (94.4%) supported a national system for the collection and destruction of pharmaceutical waste. Significant differences were found between branches of the Pharmaceutical Chamber of Serbia regarding collection practices (p=0.001), with the lowest percentage in Belgrade (20.0%) and the highest in Kragujevac (47.2%). Pharmacists in pharmacies that collect waste more often reported a moderate or high financial burden compared with those in pharmacies that do not (40.2% vs 18.4%; p=0.003). The main barriers were lack of infrastructure and containers (65.7%), lack of patient knowledge and interest (62.0%), and high costs (51.2%). It is necessary to integrate pharmacists' support for a national system into standardized pharmaceutical waste management practices, along with infrastructure provision, financial support for pharmacies, and continuous education of pharmacists and patients.