Analysis of Unused Medicines and Cost among Patients in Tanglin Health Clinic, Malaysia

Introduction:  
Unused medicines among patients have been a critical problem in the Malaysia's healthcare system, contributing to drug wastage, increased national financial burden and decreased treatment cost-effectiveness. This descriptive, cross-sectional study at Tanglin Health Clinic aims to identify the unused medicines, its cost, contributing factors and patients' medication adherence.    

Methodology:  
Unused/remaining medications brought by patients to pharmacy prior medications refill were listed and the cost was calculated in Phase 1, using cost price from Lembah Pantai District Health Office, Kuala Lumpur. During Phase 2, questionnaires were distributed to assess adherence and to identify factors contributing to having many remaining medications. Study was conducted from October 2020 to May 2021. Data collected were analyzed using SPSS v22.    

Results:  
A total of 72520 tablets/capsules and 397 insulin vials were found unused by patients, accounting for a total cost of RM8926.91, with an average cost of RM21.25 per patient. The top 3 quantities of unused medicines were Metformin, Perindopril and Simvastatin. The top 3 highest costs of unused medicines were Metformin, Insulin Insulatard and Insulin Actrapid. 57.8% of patients with many unused medications were incompliant to medications. Common reasons of incompliance were: not taking medicines when "started feeling better" and "taking supplements/traditional/herbal medicines concurrently". Main reason of being compliant but having many unused medications was "pharmacy has supplied extra quantity of medicines".   
 
Conclusion:   
A vast quantity of unused medicines among patients exists, which markedly increase the national financial burden. Measures shall be taken to avoid medication wastage.    

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