[Pharmwaste] Pharmacy Receptacle Experience Update

[Jaramillo, Jeanie]

Hello All,

As promised, here is my update on how our pharmacy-based medication disposal receptacle experience is going.

Recap: The Texas Panhandle Poison Center is part of Texas Tech's School of Pharmacy. The School of Pharmacy runs a retail pharmacy in the School of Medicine/Allied Health building next door (this building houses multiple practice clinics.) Our poison center has run a periodic, twice annually medication take back event as a poison prevention measure of one of our grants. We were recently awarded a community grant for the events, thus freeing up poison funding. We are using this funding to support a permanent pharmacy-based collection receptacle at the pharmacy next door.

The DEA authorized collector registration was simple. It took approximately 5 minutes and we had the printable PDF certificate in hand. For the disposal service, we are utilizing RxReturnBox (a division of RedBag service). With RxReturn, we are provided with boxes and inner liners per DEA specifications. The boxes are pre-paid for shipping when full, utilizing UPS. So, when a box is full, we take it out of the receptacle, secure the inner liner closed, seal the shipping box, place the pre-paid shipping label on it, notify UPS that it's ready, and place it in the University's secure outbound package pickup room.

We installed our first 40 gallon liner in the receptacle on 9/14. We removed it for shipping on 10/01. The process has been relatively smooth. We developed our own forms for keeping the DEA required documentation. (I'll attach to this email.) We have promoted the box very little at this point. The PIC at the pharmacy felt that the box would be inundated, so we are taking it slow in terms of getting the word out. Customers at the pharmacy are inquiring regarding what it is and seem to be eager to use it.

Challenges:

*         Since this is a relatively new process with UPS, they've made adjustments. The initial boxes/inner liners were "downsized." My guess is that they were too bulky and difficult to handle when full, as even the smaller boxes we have now are bulky and heavy when full.

*         We ordered the stainless still version of the receptacle rather than the powder-brushed white model. When we installed it, we realized how much space was available on the front and thought we'd order large magnets with our current desired message to place on the front. As it turns out, magnets don't stick to it! Thankfully, we tried it out before we ordered the magnets. So, now, we design our desired message in Word or PowerPoint, laminate it, and tape it to the front. Of note, the vendor does offer the capability for interchangeable messaging "windows" on the units.  Basically, a hard plastic sleeve where you can slide in your info and change it out as needed.

*         According to the DEA, no liquids or inhalers or sharps should be inserted in the receptacle. We've placed a sign on it to reflect this directive, but we really can't monitor what people are placing in there close enough to control this. When the pharmacy staff is standing at their counter, they can try to keep an eye on what is going in, but they are usually busy and I don't feel that it's appropriate to expect them to monitor this on top of their other duties.

*         Today the receptacle stank!!!! I could smell it when I was about 2 feet away from it. I think someone must of put shark oil or something in there! The unit is well-contained, but it doesn't block against odors.

Other notes:

*         We can't tell if the box is full without opening the unit. We need a peep hole or something. For now, we have made a log sheet for "visual checks". We note how full the box is to guide us as to when we need to check again. When we get it all settled, I think we'll have a better idea of how frequently to change it out and this won't really be an issue.

*         Since we hold the twice annual take back events, we often have stragglers come to the SOP thinking they can "drop off" their meds. This box now gives us somewhere close to send them. (See our map attached.)

Surprises:

*         Now that our pharmacy is an "authorized collector," we've had several LTCFs in the area ask about us setting up receptacles at their locations. This is not something we're doing just yet, but definitely something we're considering.

Next steps:

*         Begin active promotion of use of the receptacle.

[cid:image003.jpg at 01D10500.A6BDF1E0]


Jeanie Jaramillo-Stametz, PharmD
Managing Director, Texas Panhandle Poison Center
Asst. Professor, Texas Tech UHSC School of Pharmacy
Director, Medication Cleanout
1300 S. Coulter St., Suite 105
Amarillo, TX 79106
(office): (806)414-9299
(mobile): (806)376-0039

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