{"id":20444,"date":"2020-05-28T09:18:49","date_gmt":"2020-05-28T08:18:49","guid":{"rendered":"https:\/\/research.reading.ac.uk\/research-blog\/?p=20444"},"modified":"2023-04-24T15:01:22","modified_gmt":"2023-04-24T14:01:22","slug":"the-covid-19-pandemic-is-our-chance-to-learn-how-to-reuse-old-medicines","status":"publish","type":"post","link":"https:\/\/research.reading.ac.uk\/research-blog\/2020\/05\/28\/the-covid-19-pandemic-is-our-chance-to-learn-how-to-reuse-old-medicines\/","title":{"rendered":"The COVID-19 pandemic is our chance to learn how to reuse old medicines"},"content":{"rendered":"

It\u2019s usually illegal to reuse leftover medicines in the UK for any purpose. But as a result of the coronavirus pandemic, the government has released\u00a0guidance<\/a> that allows this to happen in care homes and hospices, under very strict guidelines.\u00a0The guidance is to be welcomed. For the past two years, we have been calling on<\/a>\u00a0the government to consider changing the rules on reuse to prevent the massive amounts of waste that takes place when we throw away medicine.<\/strong><\/p>\n

\"\"<\/p>\n

The UK wasted an estimated \u00a3300 million a year of medicines\u00a0in 2009<\/a>, \u00a3110 million of which related to medicines returned to community pharmacies for disposal.<\/p>\n

People are more likely to\u00a0dispose of their unwanted residential medication<\/a>\u00a0in the household bin or down the drain than return these to pharmacies,\u00a0contaminating<\/a>\u00a0water and soil. Prescribed medicinal waste can also harm the environment by unnecessarily inflating our\u00a0carbon footprint<\/a>.<\/p>\n

A safe, sustainable system for reusing unwanted medication could make a huge difference in addressing these problems, beyond the current pandemic.<\/p>\n

What is medicine reuse?<\/h2>\n

Medicine reuse<\/a>\u00a0is the idea that medication given to one patient can be taken back if it\u2019s no longer needed and given to someone else to use instead.<\/p>\n

Under normal circumstances, medicines dispensed in the community are not allowed to be reused, mainly because\u00a0health officials worry that\u00a0drugs that come back from people\u2019s homes will have declined in quality.<\/p>\n

Medicines, after all, are not the same as other recycled goods \u2014 to work properly, the right amount of active drug is needed, but\u00a0this could potentially decrease\u00a0if the medicine has been kept at the wrong temperature, or under too much light or moisture, away from the pharmacy.<\/p>\n

<\/figcaption><\/figure>\n

The question of whether it is safe to reuse medicine is not an easy one to answer. We know\u00a0from our own work<\/a>\u00a0on a small sample of tablets that if you take medicines out of their packaging and store them in hot and humid conditions for a month, there are at least some subtle changes.<\/p>\n

But no one has ever fully looked at where and how medicines are generally stored when they leave the pharmacy. And we don\u2019t actually know what (if anything) happens to medicines that are kept inside their original packaging. Because of this uncertainty, medicines returned to community pharmacies have to be\u00a0disposed of instead<\/a>\u00a0of being reused.<\/p>\n

Some countries including the\u00a0United States<\/a>\u00a0and\u00a0Greece<\/a>\u00a0do operate medication reuse schemes, mainly for benevolent reasons \u2013 the idea being that suitable medicines can re-enter the supply chain and be re-issued to others who might not otherwise afford them.<\/p>\n

The environmental case for reuse<\/h2>\n

Medicine shortages were a growing\u00a0global problem even before the pandemic began.\u00a0In 2019 alone, the UK\u00a0identified supply issues<\/a>\u00a0for 209 medicines, including heart medicines, anti-epilepsy tablets and treatments for cancer.<\/p>\n

Now, the pandemic has added to an existing problem, by\u00a0reducing supplies<\/a>\u00a0from overseas manufacturers while\u00a0demand for medicines has naturally increased<\/a>.\u00a0The current government\u2019s decision on the reuse of medicines, then, is a way of trying to deal with\u00a0drug shortages<\/a>.<\/p>\n

Medicine reuse in care homes<\/h2>\n

What the\u00a0government is suggesting<\/a>\u00a0now is that care homes and hospices draw up\u00a0standard operating procedures<\/a>\u00a0in case they have to reuse some medicines.<\/p>\n

The proposals are quite complex and need careful reading. If a medicine that is urgently required is out of stock, an alternative must be prescribed and dispensed if at all possible. If not, then the pharmacy can explore the possibility of reuse.<\/p>\n

Importantly, the proposed medicine should no longer be needed by the original recipient, and both parties (or their representatives) must consent to the reuse. Added to this are\u00a0measures to stop<\/a>\u00a0the possibility of cross-contamination with the coronavirus during repackaging of the reused medicine.<\/p>\n

<\/figcaption><\/figure>\n

The new guidance addresses a genuine need within care homes and hospices which are already struggling on the frontlines of the pandemic, and where\u00a0urgent demand for medication<\/a>\u00a0is likely to be for the purpose of managing someone\u2019s pain or breathlessness\u00a0at the end of their life<\/a>.<\/p>\n

Such a scenario is clearly an example where the benefit of reusing a medicine reasonably outweighs the potential risks.<\/p>\n

A more sustainable future<\/h2>\n

It is vital that we learn from our experiences reusing medicine in care homes as we dare to look beyond the current pandemic.<\/p>\n

At the moment, a registered health professional currently has\u00a0to inspect medicines<\/a>\u00a0to make sure they are suitable for reuse. But whether completed in person or virtually, these checks can only provide a physical assessment, which does not guarantee the quality or amount of the medicines inside. So it will be important to find out how these inspections work in practice.<\/p>\n

Our own ambition is to develop a\u00a0technology ecosystem<\/a>\u00a0for the packaging of pharmaceuticals that will allow for the safe reuse of medicines in the future. This would involve creating a novel digital time temperature and humidity indicator to help with quality assurance of medicines. We have already developed a prototype using smart sensors which connect to the cloud to verify safety and enable the reuse of returned medicines.<\/p>\n

This would provide an opportunity to explore medicine reuse not only during a pandemic but as a standard part of running a sustainable pharmacy.<\/p>\n

 <\/p>\n

Blog written by Parastou Donyai (Professor and Director of Pharmacy Practice), Rachel McCrindle<\/a> (Professor of Computer and Human Interaction),\u00a0R. Simon Sherratt<\/a> (Professor of Biosensors), and Terence Hui (Postdoctoral Research Associate), University of Reading. Find out more on their project website: REMINDS: Enabling Pharmaceutical Reuse<\/a> (under construction).<\/p>\n

This article is republished from The Conversation under a Creative Commons license. Read the original article<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"

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