Background Drugs returned by patients have to be managed properly.
Purpose To analyse drugs returned by patients and the associated financial impact after the implementation of a quality system (corrective action to ensure traceability of these drugs).
Materials and methods Retrospective descriptive study of returns recorded after implementation of the improved procedure for ‘return of drugs for the patient’, from March 2011 to June 2013. The auxiliary records the return in formalised form indicating date, name of the patient, drug, number of units, batch and expiry date. The pharmacist validates the return based on a decision algorithm allowing the acceptance or rejection of the drug, taking into account whether it is in date, the physical appearance of the product and the storage conditions at home. If the drug is accepted, it is recorded back in the APD-Prism software and is labelled with ‘Return accepted drug’ so it can be traced to the patient to whom the returned medicine is dispensed. WE analysed the number of patients who returned drugs, units of returned drugs, therapeutic group of returned drugs (according to ATC classification), causes of the return and the financial impact associated with returned drugs.
Results During the study period, 132 patients out of 1811 returned 77 different drugs corresponding to 400 lines of returns and 10,377 returned units. The main therapeutic groups and amounts of returned units were: J05 antivirals (44.7%), L01 antineoplastics (23%), J01 anti-infectives for systemic use (5.7%), C02 antihypertensives (4.4%), L04 immunosuppressants (4.3%), L03 immunomodulators (3.8%) and L02 endocrine drugs (3.3%). Returned drugs were accepted for the following reasons: end of treatment (31%), change of treatment (21.8%), death (12%), less than the expected treatment duration (11.8%), change of dose (11.3%), adverse reactions (10.3%), did not start the treatment (1.3%) and patient transfer (0.5%). The total value of returns was 188,862 € (0.77% of total), of which 4.6% were not accepted due to being expired (30%), defective (30%), badly stored (20%) and to opening of the primary multi-dose container (abiraterone) (20%).
Conclusions A standard procedure for return of drugs facilitates the traceability of drugs and optimises the use of resources allocated to the budget line of drugs. It should inform patients of the importance of returning drugs no longer needed and their proper storage. The cost opportunity in the repackaging of drugs dispensed in the outpatient area should be discussed.
No conflict of interest.
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