Medicine Waste at Hospice Southwest Jutland

The project aims to map out the extent and underlying causes of medicine waste from patients admitted to Hospice Southwest Jutland.

Purpose

The project aims to map out the extent and underlying causes of medicine waste from patients admitted to Hospice Southwest Jutland who pass away due to life-threatening illnesses. Specifically, the project will obtain knowledge about the extent of medication waste at Hospice Southwest Jutland and investigate the sources of medication waste.

The results will be used to:

Identify initiatives that can reduce medication waste within Hospice Southwest Jutland.
Contribute to reducing Region of Southern Denmark’s overall medication waste, thereby reducing environmental impacts within the pharmaceutical sector.

In addition to environmental benefits, reducing unnecessary medication for patients with life-threatening illnesses can improve their quality of life by decreasing their medication intake and thereby minimizing the risk of side effects.

Furthermore, optimizing the use of medication can reduce pharmaceutical expenses, benefiting patients, the region, and society as a whole. The insights gained from this project may also be applied in other regions, as well as in cross-sectoral settings where patients are treated with palliative care in both the primary and secondary sector.

Background

When patients with life-threatening illnesses are admitted to Hospice Southwest Jutland, they are encouraged to bring all their medications with them. Following the patient’s passing, this medication must be discarded due to practical and legislative restrictions.

Hospice Southwest Jutland submits leftover medications from deceased patients for destruction at Esbjerg Hospital Pharmacy. Large quantities are destructed each week, which suggests significant levels of waste annually from this group of patients.

A preliminary review of the discarded medicines from just one week showed that they consisted of:

Prescription medications, likely prescribed by general practitioners and specialist departments at hospitals prior to hospice admission.
Medications aimed at treating chronic diseases and their symptoms (e.g., heart medications, inhalation preparations, diabetes treatments, and pain relievers).
Preventive medications (e.g., cholesterol-lowering drugs, osteoporosis prevention medications, vitamin and mineral supplements).

Thus, most of the medication waste originates from previous interactions with the healthcare system, rather than from the hospice admission itself.

Consequently, the project's recommendations will focus on reducing unnecessary prescriptions before hospice admission.

Medication waste from the hospice is included in the overall waste quantity from Esbjerg and Grindsted Hospital and is disposed of as pharmaceutical waste, alongside other hospital-generated waste.

Based on this knowledge, the project will:

Create a detailed mapping of medication waste. Over a three-month period, data will be collected on medicines submitted to the hospital pharmacy from Hospice Southwest Jutland.
Assess the type of pharmaceutical consumption (i.e., types of medicines found on patients’ current medication lists upon admission to the hospice), along with various patient characteristics such as gender, age, performance status, length of admission, and referral source. The goal is to identify areas for targeted waste reduction efforts.

The project is aligned with Odense University Hospital’s sustainable medicine initiative, which aims to reduce medication waste to lower the environmental footprint of pharmaceuticals.

Expected Impact

Reducing medication waste can:

Decrease the volume of discarded medicines classified as environmentally harmful hazardous waste.
Lower CO2 emissions associated with medication waste from hospitals in Region of Southern Denmark.
Reduce costs related to the purchase of pharmaceuticals, benefiting both patients and the region.

Partners

Project Owner: Mette Marie Hougaard Christensen, Medical Director, Pharmacology, Odense University Hospital
Project Manager: Sidsel Arnspang Pedersen, Medical Specialist in Clinical Pharmacology, Odense University Hospital
Hospital Pharmacy, Esbjerg Hospital
Palliative Care Unit, Esbjerg Hospital
Hospice Southwest Jutland
Region of Southern Denmark, Department of Green Transition
Health Innovation Centre of Southern Denmark