The improper disposal of unused medicines is a worldwide concern because of its impact on the environment, economy, and health. This study aims to describe the disposal practice of unused medicine and identify factors associated with unused medicines in Malaysia. This was a cross-sectional, face to face interview-based survey using a structured questionnaire. We used a convenience sampling method to recruit participants from Kuala Lumpur and Selangor in Malaysia. We interviewed 1184 participants, and the response rate was 96%. Out of the total respondents, 995 (84%) reported having unused medicines. About a quarter of respondents kept unused medicines in the cabinet, and another quarter disposed of them into the trash or toilet. Only half of the respondent who used medicines for chronic illnesses had unused medicines compared to about 90% of respondents who used medicines for acute illnesses. The main reason for having unused medicines among those who used medicines for chronic illness was non-adherence (69%, p < 0.05). Only 27% of these respondents returned unused medicines under the “Medicine Return Programme (MRP)”. The other group who used medicines for acute illnesses had unused medicines because their health conditions improved. Thus, most of the unused medicines will eventually end up in household waste. A multivariate logistic regression analysis identified respondents who used medicines for acute illnesses as the strongest predictor of having unused medicines (Odds Ratio (OR) = 29.8; p < 0.001), followed by those who pay for their medicines (OR = 6.0; p < 0.001) and those who were willing to participate the Medicine Return Programme (OR = 2.5; p = 0.009). The prevalence of unused medicines and their improper disposal were high in Malaysia. Unused medicines are associated with people who use medicines for acute illnesses, pay for their medication, and are willing to participate in an MRP. Rationale prescription and optimal dispensing practice, together with a broader MRP facilities coverage, could reduce unused medicine possession.

中文翻译：

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马来西亚未使用药物的处置实践和相关因素：横断面研究

未使用药物的不当处置因其对环境、经济和健康的影响而成为全球关注的问题。本研究旨在描述马来西亚未使用药物的处置实践，并确定与未使用药物相关的因素。这是一项使用结构化问卷的基于面谈的横断面调查。我们使用便利抽样方法从马来西亚的吉隆坡和雪兰莪招募参与者。我们采访了 1184 名参与者，回应率为 96%。在所有受访者中，995 人 (84%) 报告有未使用过的药物。大约四分之一的受访者将未使用的药物放在柜子里，另有四分之一的人将它们扔进垃圾桶或厕所。使用药物治疗慢性病的受访者中，只有一半没有使用过药物，而使用治疗急性疾病药物的受访者中，这一比例约为 90%。使用药物治疗慢性病的人未使用药物的主要原因是不依从性 (69%, p < 0.05)。这些受访者中只有 27% 的人根据“药品退货计划 (MRP)”退回了未使用的药品。另一组使用药物治疗急性疾病的人由于健康状况有所改善而未使用药物。因此，大多数未使用的药物最终都会变成家庭垃圾。多变量逻辑回归分析确定使用急性疾病药物的受访者是未使用药物的最强预测因素（优势比 (OR) = 29.8；p < 0.001），其次是那些支付药物费用的受访者（OR = 6.0；p < 0.001）和那些愿意参加药品退货计划的人（OR = 2.5；p = 0.009）。在马来西亚，未使用药物及其不当处置的流行率很高。未使用的药物与使用药物治疗急性疾病、支付药物费用并愿意参与 MRP 的人有关。合理处方和最佳配药实践，以及更广泛的 MRP 设施覆盖范围，可以减少未使用的药物持有。