Assessment of Medication Return Pattern in a Tertiary Care Teaching Hospital

Medication return is reverse logistics associated with many complexities due to an imbalance between the medical needs and demands. It imposes a significant financial burden on public health systems, due to the cost of the drugs returned & disposing of the items. Henceforth Medication wastage is a considerable shock faced by the health care system thought the world. Medicines returned within the hospital setting, disrupt and divert the standard functions and operations of pharmacy routine activities. These returns can ultimately potentiate the risk of medication error. Hence the present study was carried out in inpatients of the rural population. Method: A prospective observational study carried out in 190 inpatients, from October 2018 to May 2019 in Medicine, Orthopedics, and Surgery department. Patient case sheets were reviewed and assessed daily. Types of Medication returned the reason for the return, the cost of medication returned, and disposal methods documented. The obtained data is subject to descriptive statistics. Result: Among 190 inpatients, 133 cases had medication returns. In which, 24.28% and 22.85% of the drugs returned classes were anti-hypertensive and antibiotics in the medicine department. In the orthopedic, 33.33% and 31.74% of the medicines were analgesics and proton pump inhibitors. In the surgery department, 31.57% and 24.56% of the drugs returned were analgesics and antibiotics;Amongst three departments, the total cost of returned medication found to be more in the surgery department, amounting to an average of 124.18±134.31 INR, followed by medicine and orthopedics amounting to 110.9±219.8 INR and 108.66±162.89 INR respectively. The majority of drug form returned in the department of medicine (42.85%), orthopedics (80.95%) was IV, and the dominant type of drug returned in the surgery department was tablets (61.40%). Out of the returned medication,the primary reason for returns was medication discontinuation (42.16%), followed by patient discharge (24.69%). The disposal methods used by the patients in their homes for excess medication found to be throwing away (95.18%) and multiple ways (66.84%). Conclusion: Medicines returned from wards to pharmacy usually happen because of irrational prescribing and uncontrolled dispensing practices. For controlling the medications returned, knowledge of its reason is essential. Therefore, knowing about the frequencies and contributing ctors of medicine returned to aid in the formulation of new drug prescribing and dispensing policies in hospitals. These will ultimately reduce the pharmacy workload and medication dispensing errors. Hence the clinical Pharmacist's daily activities help minimize drug return and helps in proper drug usage/Optimum drug usage in the inpatients. Key words: Medication returns, BMI: Body mass Index, INR: International normalized ratio, PPI: proton pump Inhibitors".