Abstract:
BACKGROUND: Medicines wastage is a common problem in many health care delivery systems. It refers to medicines remaining without being administered to any patient. Improper management of medicines leads to medicine wastage. In many health care settings, the extent of medicine wastage is less known.
STUDY OBJECTIVES: General objective of this study was to assess medicines wastage and its associated factors at Muhimbili National Hospital. The specific objectives were to determine major types of medicines that were wasted, to identify factors contributing towards the wastage and finally to estimate the financial implication of medicines which were wasted.
METHODOLOGY: The study was a cross sectional carried out in medical wards of internal medicine department and one OPD dispensing unit. The study population involved patient medical files, tracer medicines, nurses and pharmacists. Four hundred fifty nine patient files where analyzed for last inpatient treatment information for the year 2012. Furthermore 49 health care workers (nurses and pharmacists) who consented to participate were self-administered with a questionnaire to find out their medicine wastage awareness. Medicines remained in medical wards stated to be leftovers were observed, whereas physical inventories and ledger balance of twenty tracer medicines was carried out in outpatient dispensing unit. Finally the data were analyzed using SPSS version 20 to identify major types of medicines wasted, contributing factors and financial implications.
RESULTS: About 56.3% of medicines prescribed were dispensed to patients. Out of the dispensed medicines, 730 medicines were wasted. Anti-infective medicines wastage was 18.9%, cardiovascular medicines (8.9%) and the other categories was 23.7% of the total medicines dispensed (p=0.0001). The factors identified for the medicines wastage were excess amount provided to patients (44%), pilferage (26.5%), patient death (24%) and change/stop of medicines due to various factors was 5.5%. The value of medicines sold to patients was 7,828,370.20 Tsh. out of which a sum of 1,804,686.40 Tsh. corresponding to 23.1% of the value of dispensed medicines was wasted.
CONCLUSION: Wastage of medicine was observed in medical wards. The major underlying factors were excess amount of medicines provided to patients, patient death, change/stop order from prescribers and pilferage. There is a need to contain medicine wastage in medical wards in order to improve medicines management.
