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Medicines Reuse Edited by Parastou Donyai Printed Edition of the Special Issue Published in Pharmacy www.mdpi.com/journal/pharmacy Medicines Reuse Medicines Reuse Editor Parastou Donyai MDPI‚Basel‚Beijing‚Wuhan‚Barcelona‚Belgrade‚Manchester‚Tokyo‚Cluj‚Tianjin Editor ParastouDonyai Pharmacy UniversityofReading Reading UnitedKingdom EditorialOffice MDPI St. Alban-Anlage66 4052Basel,Switzerland ThisisareprintofarticlesfromtheSpecialIssuepublishedonlineintheopenaccessjournalPharmacy (ISSN 2226-4787) (available at: www.mdpi.com/journal/pharmacy/special issues/Medicines Reuse). For citation purposes, cite each article independently as indicated on the article page online and as indicatedbelow: LastName, A.A.; LastName, B.B.; LastName, C.C. Article Title. Journal Name Year, Volume Number, PageRange. ISBN978-3-0365-4090-0(Hbk) ISBN978-3-0365-4089-4(PDF) CoverimagecourtesyofParastouDonyai © 2022 by the authors. Articles in this book are Open Access and distributed under the Creative Commons Attribution (CC BY) license, which allows users to download, copy and build upon publishedarticles,aslongastheauthorandpublisherareproperlycredited,whichensuresmaximum disseminationandawiderimpactofourpublications. ThebookasawholeisdistributedbyMDPIunderthetermsandconditionsoftheCreativeCommons licenseCCBY-NC-ND. Contents AbouttheEditor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii Prefaceto”MedicinesReuse” . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix AbdullahAlshemari,LizBreen,GemmaQuinnandUthayasankarSivarajah CanWeCreateaCircularPharmaceuticalSupplyChain(CPSC)toReduceMedicinesWaste? Reprintedfrom: Pharmacy2020,8,221,doi:10.3390/pharmacy8040221. . . . . . . . . . . . . . . . 1 HamzaAlhamad,NileshPatelandParastouDonyai TowardsMedicinesReuse:ANarrativeReviewoftheDifferentTherapeuticClassesandDosage FormsofMedicationWasteinDifferentCountries Reprintedfrom: Pharmacy2020,8,230,doi:10.3390/pharmacy8040230. . . . . . . . . . . . . . . . 23 SuHakLeeandJonC.Schommer MedicationUseandStorage,andTheirPotentialRisksinUSHouseholds Reprintedfrom: Pharmacy2022,10,27,doi:10.3390/pharmacy10010027 . . . . . . . . . . . . . . . 63 ParastouDonyai,RachelMcCrindle,TerenceK.L.HuiandR.SimonSherratt StakeholderViewsontheIdeaofMedicinesReuseintheUK Reprintedfrom: Pharmacy2021,9,85,doi:10.3390/pharmacy9020085 . . . . . . . . . . . . . . . . 83 David McRae, Abigail Gould, Rebecca Price-Davies, Jonathan Tagoe, Andrew Evans and DelythH.James Public Attitudes towards Medicinal Waste and Medicines Reuse in a ‘Free Prescription’ HealthcareSystem Reprintedfrom: Pharmacy2021,9,77,doi:10.3390/pharmacy9020077 . . . . . . . . . . . . . . . . 91 HamzaAlhamadandParastouDonyai The Validity of the Theory of Planned Behaviour for Understanding People’s Beliefs and IntentionstowardReusingMedicines Reprintedfrom: Pharmacy2021,9,58,doi:10.3390/pharmacy9010058 . . . . . . . . . . . . . . . . 107 HamzaAlhamadandParastouDonyai Intentions to “Reuse” Medication in the Future Modelled and Measured Using the Theory of PlannedBehavior Reprintedfrom: Pharmacy2020,8,213,doi:10.3390/pharmacy8040213. . . . . . . . . . . . . . . . 119 MonicaChauhan,HamzaAlhamad,RachelMcCrindle,TerenceK.L.Hui,R.SimonSherratt andParastouDonyai MedicinesasCommonCommoditiesorPowerfulPotions? WhatMakesMedicinesReusablein People’sEyes Reprintedfrom: Pharmacy2021,9,88,doi:10.3390/pharmacy9020088 . . . . . . . . . . . . . . . . 139 Terence K. L. Hui, Bilal Mohammed, Parastou Donyai, Rachel McCrindle and R. Simon Sherratt Designofpharmaceuticalpackagingtofacilitatethereuseofmedicinesandreducemedicinal waste Reprintedfrom: Pharmacy2020,8,58,doi:10.3390/pharmacy8020058 . . . . . . . . . . . . . . . . 151 YasminLam,RachelMcCrindle,TerenceK.L.Hui,R.SimonSherrattandParastouDonyai TheEffectofQualityIndicatorsonBeliefsaboutMedicinesReuse: AnExperimentalStudy Reprintedfrom: Pharmacy2021,9,128,doi:10.3390/pharmacy9030128. . . . . . . . . . . . . . . . 169 v About the Editor ParastouDonyai Prof. Parastou Donyai is Professor of Social and Cognitive Pharmacy in the Department of Pharmacy at the University of Reading. She is a qualified pharmacist and registrant of the General PharmaceuticalCouncil(GPhC),amemberoftheRoyalPharmaceuticalSociety(RPS),afellowofthe HigherEducationAcademy,agraduatememberoftheBritishPsychologicalSocietyandanassociate memberoftheCollegeofMentalHealthPharmacy. ShestudiedpharmacyatKing’sCollegeLondon (1990-1993), andafterherpre-registrationtraininginhospitalreturnedtoKing’stocompleteaPhD in pharmacy (1994-1998). Inspired by her experiences as a pharmacist, she began studying people withinhealthcaresettings.Shecompletedapostgraduatediplomainpsychologicalresearchmethods in 2007 and obtained a second full degree in psychology in 2014. She researches the practical and behaviouralaspectsofmedicinesuse,fromthetimeoftheirprescribingtotheirdisposalandpotential for reuse, including patient and practitioner education and training. She has explored medication usageinarangeofconditionsincludingdementia,psychosis,attentiondeficithyperactivitydisorder, and following myocardial infarction and breast cancer. Her research on Continuing Professional DevelopmentprovidedthebasisforrevalidatingpharmacyprofessionalsinGreatBritainandshehas alsodevelopedtrainingforpre-registrationpharmacists. Sheisaco-directoroftheInterdisciplinary Research Centre for Health Humanities at the University of Reading, promoting projects on health and illness that combine the traditional and social sciences with the humanities. Her research on reducing medicines wastage has created in-depth understandings of the psychology of drug holidays,medicationusereviewsandbeliefsaboutmedicationreuse,facilitatingtheinterdisciplinary ReMINDS(ReuseofMedicinesthoughInformatics,NetworksandDigitalSensors)collaboration. vii Preface to ”Medicines Reuse” This is a book about ’medicines reuse’. In a pharmacy setting, medicines reuse is about re- dispensing unused medication returned by one patient for use by another. The ’reuse’ of dispensed medicines instead of the disposal of the medication as waste is preferable where possible. Disposal as waste is the current practice that takes place in many parts of the world, including in the UK. A number of related or alternative terminologies also exist to describe the concept of medicines reuse, including re-dispensing, recycling, redistributing and reverse flow. Medicines reuse is gaining popularity around the world, either as an existing scheme or as an idea to be explored for implementation in the future. The contributing authors were motivated to write this book because medicines reuse has the potential to help reduce the waste and environmental pollution created by unused medicines, reduce the depletion of material resources and/or help save money and provide medicines to people who cannot otherwise afford them. Medicines reuse might also help deal with the problem of drug shortages or assist with the creation of new medicines using extracted and repurposed pharmaceutical ingredients. This can facilitate greater responsiveness and recovery in times of supply chain disruption when shortages occur. Yet, perhaps for historical reasons, this subject remains under-investigated. Our aim was to bring together leading authors in the field to help create a comprehensive and contemporary account of medicines reuse research. The intended audience for this book includes academics, health professionals, policy-makers, researchers and students, and indeed anyone else with an interest in making medicines use more sustainable by learning from research within the emerging field of medicines reuse. This book brings together over 20 authors from graduate students to Professors from the UK and the US working within a breadth of specialisms including Biomedical Engineering, Biosensors, Computer and Human Interaction, Health Psychology, Health Service Operations, Pharmacy Practice, and Technology Management and Circular Economy. Paper one outlines a Circular Pharmaceutical Supply Chain and explains how it could be considered and tested as a sustainable supply chain proposition. Paper two examines the different therapeutic classes and dosage forms making up medication waste around the world, to inform potential reuse practice. Paper three describes medications stored in US households, gauging their risk to minors, pets, and the environment, while estimating the costs of unused medications. Paper four draws on stakeholder meetings to detail the range of views expressed on medication waste and the potential for medicines reuse within a UK context. Paper five reports on public attitudes towards medicinal waste and medicines reuse within a ‘free prescription’ healthcare system in Wales, UK. Paper six examines the validity of the Theory of Planned Behaviour (TPB) for understanding people’s intentions to engage in medicines reuse as a behaviour. Paper seven reports on a TPB model which predicts behavioural intentions showing how people could embrace medicines reuse via practical measures. Paper eight illustrates people’s perceptions of medicines as common commodities to explain their pro-medicines-reuse beliefs and desire for these to be recycled. Paper nine shows how sensing technologies applied to pharmaceutical packaging could enlist medicines to the Internet of Things to facilitate medicines reuse. Paper ten gauges the effect of quality indicators, including sensing technology applied to packaging, on people’s beliefs about medicines reuse in an experiment. ix