Unused medications

[jaysay]

Was having a debate with a friend this morning regarding unused medication. Its a well known fact that lots of meds are over prescribed in the NHS, especially in cases where a certain med is stopped or changed. I know I'm not the only one on this site who are and lots of daily meds and from time to time I have had one med stopped and put on another, I manage my meds quite well and never allow anything to run out so I a certain med is stop I may have a full box in hand. I know we have people on here who work in pharmacy and I'm sure they will back me up when I say that if any unused meds are returned they are just destroyed and cannot be re issued. I could understand this in the years when tabs were dispensed in bottles, but today virtually all meds come in sealed containers so why can these medications not be recycled and re issued, they could be removed from there original boxes and dispensed in small boxes which even now happens from time to time. I don't know what anybody else feels on this subject, but with the cost of these new meds costing more and more money, merely to flush unused meds down the loo is a nonsense to me

[Neil]

No thank you.
I don't want any pills that someone else has had before.
How do you know what they did to them?

Have you forgotten the problems with contaminated foods and why jars etc have tamper proof seals?

[Margaret Pilkington]

Most pills today are 'blister' packed so if the 'blister' is intact you know it has not been touched.
Yes, you are right Jaysay, if you return drugs to the pharmacy unused they are destroyed even if they are in date.
This is because the pharmacy cannot guarantee what conditions they have been kept in...temperature etc.....so they figure it is safer to destroy them.

A great bugbear of mine was always..... when people go into hospital and they already have a supply of perfectly good meds that they were taking at home......why can't they continue to take their own meds in hospital? After all, they are told to bring all their current medications into hospital with them.
That would save hospitals an untold amount of money.

[Less]

Originally Posted by Margaret Pilkington

A great bugbear of mine was always..... when people go into hospital and they already have a supply of perfectly good meds that they were taking at home......why can't they continue to take their own meds in hospital? After all, they are told to bring all their current medications into hospital with them.
That would save hospitals an untold amount of money.

perhaps it is to make sure the patient is getting what the hospital doctor prescribes?
After all, if for some reason the patients tablets are from home & haven't been kept correctly who will they sue if they get worse instead of better?

[Margaret Pilkington]

The point is Less, they would have been taking these medications at home.

Most people are quite sensible about the storage of their medicines too.....
I did say most but not all....some patients have bottles of mixed medications.....where they have popped all the pills out of their blister packs and put them all in one bottle......how on earth some of them didn't kill themselves was beyond me.
We would take these from the patient, then make sure they knew how dangerous it was to mix the medicines in one container.
The hospital invariably dispense exactly the same medications to be given during the stay.
But yes, you are right....that was the reason a pharmacist gave me when I asked.

It just seems to me to be an unnecessary expense...especially now the pills are blister packed, well labelled and boxed.
I can't imagine many of the pills have been stored in excess of 25 degrees C.

[Margaret Pilkington]

Oh yes.....a point I forgot to mention......I am pretty sure the current documentation could be amended to fit something in that says the patient is taking their own medication, brought in from home....then they would have no claim against the hospital.

For every problem....there is a solution of one description or another.....it is just not always right to take the line of least resistance...especially when we are so strapped for cash.....allegedly.

[jaysay]

Originally Posted by Margaret Pilkington

Most pills today are 'blister' packed so if the 'blister' is intact you know it has not been touched.
Yes, you are right Jaysay, if you return drugs to the pharmacy unused they are destroyed even if they are in date.
This is because the pharmacy cannot guarantee what conditions they have been kept in...temperature etc.....so they figure it is safer to destroy them.

A great bugbear of mine was always..... when people go into hospital and they already have a supply of perfectly good meds that they were taking at home......why can't they continue to take their own meds in hospital? After all, they are told to bring all their current medications into hospital with them.
That would save hospitals an untold amount of money.

Things may have changed a little Margaret, when I was last in I used all my own meds that I took in with me, in fact they actually asked if a certain drug could be brought from home

[setayas]

It's to do with chain of evidence, just like the police. Everything must be signed for at every handover. It was originally brought in for use with controlled drugs such as opiates but is now used for all medications. Mainly because of adulteration and storage problems.

[Margaret Pilkington]

I know that sometimes we used to use patients own medication...especially if it was something unusual(didn't happen often)......and as for signing for everything, at handover, I don't see how using patients own medication would hinder that.
The patient hands over their medications on admission. The medications are placed in the ward medicine trolley, and administered by the nursing staff at medicine rounds.....I would imagine that at handover the nurses taking over do not physically check every medication in the round trolley.

And what has happened to the self medication system? This was being done on some wards(usually long term patients).....patients had their own locked medicine cabinet beside their bed.....they took the medications themselves at the time they would normally take them at home.

[jaysay]

Originally Posted by Margaret Pilkington

I know that sometimes we used to use patients own medication...especially if it was something unusual(didn't happen often)......and as for signing for everything, at handover, I don't see how using patients own medication would hinder that.
The patient hands over their medications on admission. The medications are placed in the ward medicine trolley, and administered by the nursing staff at medicine rounds.....I would imagine that at handover the nurses taking over do not physically check every medication in the round trolley.

And what has happened to the self medication system? This was being done on some wards(usually long term patients).....patients had their own locked medicine cabinet beside their bed.....they took the medications themselves at the time they would normally take them at home.

The med cabinets are virtually standard now Margaret (well on the medical wards I've been on) but they are locked and the nurse on med rounds still give them out, maybe (in my case) with the exception of nebulisers which are usually written up as when needed

[grego]

I work in hospital pharmacy as some of you know so here's what happens now. Medications returned to pharmacy from patients homes have to be destroyed because we cannot 100% guarantt they are fit to use, storage, tampered with etc. However we now do use patients own drugs in the hospital, all patients are asked to bring in their own supply, which we check and assess for "fit for use". It means that the patients dont miss doses, we dont have to change their brands and we can make sure that the correct medications are prescribed on their In-patient charts, we check if patients have further supplies at home and only supply on discharge if we need to which helps to cut down on waste, hope that answers some of the questions.
I agree it sometimes seems a real shame to throw things away, but can you imagine the uproar if they were used and they'd been contaminated in some way....

[Margaret Pilkington]

When Ma was in last June they were still doing the medicine round with the trolley.......I really, really wanted to take my coat off rollup my sleeves and get stuck in.

[grego]

All wards now have patients own drug lockers fixed or already part of the bedside cabinet, well certainly at Royal Blackburn. I think the only exception are the day case unit and escalation ward.

[Margaret Pilkington]

Originally Posted by grego

I work in hospital pharmacy as some of you know so here's what happens now. Medications returned to pharmacy from patients homes have to be destroyed because we cannot 100% guarantt they are fit to use, storage, tampered with etc. However we now do use patients own drugs in the hospital, all patients are asked to bring in their own supply, which we check and assess for "fit for use". It means that the patients dont miss doses, we dont have to change their brands and we can make sure that the correct medications are prescribed on their In-patient charts, we check if patients have further supplies at home and only supply on discharge if we need to which helps to cut down on waste, hope that answers some of the questions.
I agree it sometimes seems a real shame to throw things away, but can you imagine the uproar if they were used and they'd been contaminated in some way....

Hooray, hooray........I am really glad about that.
When I was Ward Sister I was always banging on about how it could save lots of money....also patients would say that we weren't giving them the right meds, because they were getting different brands to what they used themselves.....or were getting generic versions(unbranded) which were either different shapes or different colours.

Thanks for that info Grego.....I know this may sound really sad, but you have made my day!

[wallop79]

They did when I was in back in June last year, I was kept waiting over 1/2 a day to be discharged waiting for the pharmacy to bring up some meds for me to be sent home with, as the nurses used my tablets and so I had virtually run out by the time I could go home.