DOOP Kit, Domestic Bin Or Watery Grave? A Study Investigating Disposal Practices Of Transdermal Drug Delivery Products In Care Homes

Abstract

Background The issue of opioid use and misuse is current and topical at present with reports of opioid epidemics in the USA and the increasing use of opioids in other parts of the world. The New Scientist asserted that America was in the throes of an opioid epidemic with reports of fatalities linked to physical contact with fentanyl. Discussions have progressed from an American focus to speculating on the spread of this issue to UK cities, Glasgow in particular. Safety issues have more recently come to light regarding the physical application and management of specific drug forms e.g. opioid transdermal patches (OTPs). The prescribing, application and safe disposal of OTPs within both healthcare settings and personal dwellings is critical to the effective use of these products. Healthcare professionals have a duty of care and responsibility to ensure the safe application and disposal of OTPs. Aims The aims of this study were to 1) gain insight into current practices of healthcare professionals regarding OTPs (fentanyl and buprenorphine) disposal practices and 2) identify Abstract knowledge and system awareness surrounding the disposal of these products in care home settings. Methods We decided to focus on care homes due to the estimated high prevalence of prescribing of OTPs in these care settings. The study was undertaken by the University of Bradford School of Pharmacy in 2015 and the participant sample focussed on the North of England (UK). Results The findings (based on 56 survey responses) displayed a significant variation in current disposal practices and a lack of specific working policies. We unearthed anomalies in the participants’ knowledge of the active ingredient volume held in depleted patches which, if not disposed of correctly, can lead to harm. This has highlighted the need for more thorough training and education on the safe and effective management of OTPs. Conclusions Further education and training is needed regarding safe disposal practices of OTPs, with the suggestion of pharmacist-led interventions. This will minimise confusion and reinforce safe disposal practices (denaturing products) and support the reduction of unsafe disposal practices (domestic waste or flushing).