Public Knowledge, Attitudes, and Practices on Unused and Expired Drugs Disposal for Health Promotion in Indonesian Primary Health Care

  • Woro Supadmi Fakultas Farmasi, Universitas Ahmad Dahlan
  • Devi Indri Alvian Universitas Ahmad Dahlan Yogyakarta
  • Larasati Aprita Nanda Setyawan Universitas Ahmad Dahlan Yogyakarta
  • Della Friska Andani Universitas Ahmad Dahlan Yogyakarta
  • Muhammad Muhlis Universitas Ahmad Dahlan Yogyakarta
  • Muhammad Thesa Ghozali School of Pharmacy, Faculty of Medicine and Health Science, Universitas Muhammadiyah Yogyakarta, Brawijaya Street, Tamantirto, Kasihan, Bantul, Yogyakarta
DOI: https://doi.org/10.56338/mppki.v9i3.9182
Keywords: attitude, drug disposal, expired drugs, health promotion, knowledge, primary health care, unused drugs

Abstract

Introduction: The accumulation and inappropriate disposal of unused and expired drugs leads to significant risks to public health and the environment. Unsafe disposal behaviors contribute to the water and soil contamination and increase the potential for drug misuse. Recognizing community knowledge, attitudes, and practices (KAP) is essential for developing effective health promotion strategies to improve pharmaceutical waste management at primary care level. This study primarily aimed to assess the public’s KAP toward disposal of unused and expired drugs and its implications for health promotion in Indonesian primary health care settings.

Methods: A cross-sectional survey was conducted among 358 participants selected through purposive sampling at Banguntapan II, Danurejan II, and Mlati II primary healthcare centers in the Special Region of Yogyakarta, Indonesia. Data were technically collected using a prior validated questionnaire and analyzed by using descriptive statistics, Chi-square, and Spearman correlation tests to identify relationships between socio-demographic characteristics and KAP variables.

Results: Most participants (88.3%) reported storing unused or expired drugs at home, primarily due to improved health or excess medication. While 64% reported good knowledge and 98.3% showed positive attitudes, only 27.7% practiced proper disposal. Education, income, and medical history significantly influenced knowledge and attitudes (p < 0.05). Moreover, knowledge and attitude were positively correlated with disposal practices (p < 0.05).

Conclusion: Although public knowledge and attitudes were generally favorable, disposal practice aspects remained inadequate. Strengthening the pharmacist-led education, implementing the drug take-back programs, and integrating health promotion within primary care services are highly essential to enhance community awareness, ensure safe drug disposal, and protect environmental and public health.

References

1. Chattu VK, Singh B, Pattanshetty S, Reddy S. Access to medicines through global health diplomacy. Health Promot Perspect [Internet]. 2023 [cited 2025 Nov 5];13:40. doi: 10.34172/HPP.2023.05. Cited: in: : PMID: 37309432.
2. Ling JY, Ng PY, Shamsuddin AS, Zulkifli A, Lee KE. Medication Disposal Patterns and Practices with Awareness of Environmental Contamination Caused by Pharmaceuticals among the General Public in Malaysia. Asian Pac J Cancer Prev [Internet]. 2024 [cited 2025 Nov 5];25:2723. doi: 10.31557/APJCP.2024.25.8.2723. Cited: in: : PMID: 39205570.
3. Freitas L de AA, Radis-Baptista G. Pharmaceutical pollution and disposal of expired, unused, and unwanted medicines in the Brazilian context. J Xenobiot [Internet]. 2021 [cited 2025 Nov 5];11:61–76. doi: 10.3390/JOX11020005/S1.
4. Rogowska J, Zimmermann A. Household Pharmaceutical Waste Disposal as a Global Problem—A Review. Int J Environ Res Public Health [Internet]. 2022 [cited 2025 Nov 5];19:15798. doi: 10.3390/IJERPH192315798. Cited: in: : PMID: 36497873.
5. Ghozali MT, Murni IW. Knowledge and Attitude among Community Pharmacists regarding Pharmacovigilance – A Cross Sectional Survey. Indonesian Journal of Pharmacy. 2023;34:686–694. doi: 10.22146/IJP.5814.
6. Sinaga CR, Elvinda E, Annafiatuzakiah. Relationship Between Knowledge Level And Behavior Of Disposing Damaged And Expired Medicine In The Community Of Marga Mulia Village, Kutai Timur Regency. PHARMACON [Internet]. 2025 [cited 2025 Nov 5];14:937–953. doi: 10.35799/PHA.14.2025.61319.
7. Alfian SD, Insani WN, Halimah E, Qonita NA, Jannah SS, Nuraliyah NM, Supadmi W, Gatera VA, Abdulah R. Lack of Awareness of the Impact of Improperly Disposed Of Medications and Associated Factors: A Cross-Sectional Survey in Indonesian Households. Front Pharmacol [Internet]. 2021 [cited 2025 Nov 5];12:630434. doi: 10.3389/FPHAR.2021.630434/FULL.
8. Pramestutie HR, Hariadini AL, Ebtavanny TG, Illahi RK, Ilmi SN. Managing unused, damaged, and expired medications: Knowledge and attitudes among people of Malang, Indonesia. J Appl Pharm Sci [Internet]. 2021 [cited 2025 Nov 5];11,:102–109. doi: 10.7324/JAPS.2021.110912.
9. Samal K, Mahapatra S, Hibzur Ali M. Pharmaceutical wastewater as Emerging Contaminants (EC): Treatment technologies, impact on environment and human health. Energy Nexus. 2022;6:100076. doi: 10.1016/J.NEXUS.2022.100076.
10. Rahmadani MA, Kristina SA. A Scoping Review of Disposal of Unused Medicines in Take-Back Programs. Jurnal Manajemen dan Pelayanan Farmasi (Journal of Management and Pharmacy Practice) [Internet]. 2021 [cited 2025 Nov 5];11:73–90. doi: 10.22146/JMPF.61343.
11. Insani WN, Qonita NA, Jannah SS, Nuraliyah NM, Supadmi W, Gatera VA, Alfian SD, Abdulah R. Improper disposal practice of unused and expired pharmaceutical products in Indonesian households. Heliyon [Internet]. 2020 [cited 2025 Nov 5];6. doi: 10.1016/J.HELIYON.2020.E04551. Cited: in: : PMID: 32760838.
12. Rahayu AP, Rindarwati AY. Pengelolaan Obat yang Tidak Terpakai Dalam Skala Rumah Tangga di Kota Bandung. Majalah Farmaseutik [Internet]. 2021 [cited 2025 Nov 5];17:238–244. doi: 10.22146/FARMASEUTIK.V17I2.64389.
13. Gidey MT, Birhanu AH, Tsadik AG, Welie AG, Assefa BT. Knowledge, Attitude, and Practice of Unused and Expired Medication Disposal among Patients Visiting Ayder Comprehensive Specialized Hospital. Biomed Res Int [Internet]. 2020 [cited 2025 Nov 5];2020:9538127. doi: 10.1155/2020/9538127. Cited: in: : PMID: 32908927.
14. Pramestutie HR, Hariadini AL, Ebtavanny TG, Illahi RK, Ilmi SN. Managing unused, damaged, and expired medications: Knowledge and attitudes among people of Malang, Indonesia. J Appl Pharm Sci [Internet]. 2021 [cited 2025 Nov 5];11,:102–109. doi: 10.7324/JAPS.2021.110912.
15. Al Dweik R, Ajaj R, Hafez W. Public awareness of medication disposal and its impact on environmental and public health: A cross-sectional study in the United Arab Emirates. Inform Med Unlocked. 2024;50:101580. doi: 10.1016/J.IMU.2024.101580.
16. Rokayah, Puspitasari HP, Nita Y. Evaluation of rational drug use in primary healthcare centres of Probolinggo District, Indonesia. Pharmacy Education [Internet]. 2024 [cited 2025 Nov 5];24:401–405. doi: 10.46542/PE.2024.243.401405.
17. Sari O, Anwar K, Putri I. Tingkat Pengetahuan Dalam Penyimpanan dan Pembuangan Obat di Rumah pada Masyarakat Kota Banjarbaru Kalimantan Selatan. Cendekia Journal of Pharmacy. 2021;5.
18. Friedemann ML, Buckwalter KC. Family Caregiver Role and Burden Related to Gender and Family Relationships. J Fam Nurs [Internet]. 2014 [cited 2025 Nov 5];20:313. doi: 10.1177/1074840714532715. Cited: in: : PMID: 24777069.
19. Aisyah DN, Setiawan AH, Mayadewi CA, Lokopessy AF, Kozlakidis Z, Manikam L. Understanding Health Information Systems Utilization Across Public Health Centers in Indonesia: Cross-Sectional Study. JMIR Med Inform [Internet]. 2025 [cited 2025 Nov 5];13:e68613. doi: 10.2196/68613. Cited: in: : PMID: 40902076.
20. Ong SC, Ooi GS, Shafie AA, Hassali MA. Knowledge, attitude and disposing practice of unused and expired medicines among the general public in Malaysia. Journal of Pharmaceutical Health Services Research [Internet]. 2020 [cited 2025 Nov 5];11:141–148. doi: 10.1111/JPHS.12333.
21. Yohannes L, Tegegne AA, Genet G, Workie Limenh L, Mohammed Seid A, Alemayehu TT, Ayenew W, Simegn W. Disposal practice and determinants of unused medicines among the general public in Gondar City, Northwest Ethiopia. Front Public Health. 2025;13:1516809. doi: 10.3389/FPUBH.2025.1516809/BIBTEX. Cited: in: : PMID: 40084200.
22. Ambianti N, Hardani R, Tandah MR, Putro H. Gambaran Pembuangan Obat yang Tidak Digunakan di Kalangan Masyarakat Kota Palu. PREPOTIF?: Jurnal Kesehatan Masyarakat [Internet]. 2022 [cited 2025 Nov 6];6:925–932. doi: 10.31004/PREPOTIF.V6I1.3700.
23. Rahimah, Melviani, Hateriah St. Pengelolaan Obat yang Tidak Terpakai Dalam Skala Rumah Tangga di Kecamatan Banjarmasin Timur. Health Research Journal of Indonesia [Internet]. 2022 [cited 2025 Nov 6];1:84–90. doi: 10.63004/HRJI.V1I2.86.
24. Bashaar M, Thawani V, Hassali MA, Saleem F. Disposal practices of unused and expired pharmaceuticals among general public in Kabul. BMC Public Health [Internet]. 2017 [cited 2025 Nov 6];17:1–8. doi: 10.1186/S12889-016-3975-Z/TABLES/4. Cited: in: : PMID: 28061902.
25. Jones CL, Jensen JD, Scherr CL, Brown NR, Christy K, Weaver J. The Health Belief Model as an Explanatory Framework in Communication Research: Exploring Parallel, Serial, and Moderated Mediation. Health Commun [Internet]. 2014 [cited 2025 Nov 7];30:566. doi: 10.1080/10410236.2013.873363. Cited: in: : PMID: 25010519.
26. Savira M, Ramadhani FA, Nadhirah U, Lailis SR, Ramadhan EG, Febriani K, Patamani MY, Savitri DR, Awang MR, Hapsari MW, et al. Praktik Penyimpanan dan Pembuangan Obat dalam Keluarga. Jurnal Farmasi Komunitas [Internet]. 2020 [cited 2025 Nov 7];7:38–47. doi: 10.20473/JFK.V7I2.21804.
27. Woldeyohanins AE, Adugna M, Mihret T, Kifle ZD. Knowledge, Attitude, and Practices of Unused Medications Disposal among Patients Visiting Public Health Centers in Gondar Town, Ethiopia: A Cross-Sectional Study. J Environ Public Health [Internet]. 2021 [cited 2025 Nov 7];2021:5074380. doi: 10.1155/2021/5074380. Cited: in: : PMID: 35003272.
28. Matthews JA, Matthews S, Faries MD, Wolever RQ. Supporting Sustainable Health Behavior Change: The Whole is Greater Than the Sum of Its Parts. Mayo Clin Proc Innov Qual Outcomes [Internet]. 2024 [cited 2025 Nov 7];8:263. doi: 10.1016/J.MAYOCPIQO.2023.10.002. Cited: in: : PMID: 38807973.
29. Alfian SD, Insani WN, Halimah E, Qonita NA, Jannah SS, Nuraliyah NM, Supadmi W, Gatera VA, Abdulah R. Lack of Awareness of the Impact of Improperly Disposed Of Medications and Associated Factors: A Cross-Sectional Survey in Indonesian Households. Front Pharmacol [Internet]. 2021 [cited 2025 Nov 7];12:630434. doi: 10.3389/FPHAR.2021.630434/BIBTEX.
30. Pramestutie HR, lllahi RK, Hariadini AL, Ebtavanny TG, Aprilia TE. Faktor yang Berhubungan dengan Tingkat Pengetahuan Masyarakat dalam Mengelola Obat Sisa, Obat Rusak dan Obat Kedaluarsa. Jurnal Manajemen dan Pelayanan Farmasi (Journal of Management and Pharmacy Practice) [Internet]. 2021 [cited 2025 Nov 7];11:25–38. doi: 10.22146/JMPF.58708.
31. Hiew SY, Low BY. The knowledge, attitude, and practice of the public regarding household pharmaceutical waste disposal: a systematic review (2013–2023). International Journal of Pharmacy Practice [Internet]. 2024 [cited 2025 Nov 7];32:120–132. doi: 10.1093/IJPP/RIAE001. Cited: in: : PMID: 38300734.
Published
2026-03-11
How to Cite
Supadmi, W., Alvian, D. I., Setyawan, L. A. N., Andani, D. F., Muhlis, M., & Ghozali, M. T. (2026). Public Knowledge, Attitudes, and Practices on Unused and Expired Drugs Disposal for Health Promotion in Indonesian Primary Health Care. Media Publikasi Promosi Kesehatan Indonesia (MPPKI), 9(3). https://doi.org/10.56338/mppki.v9i3.9182
Issue
Vol. 9 No. 3 (2026): March 2026
Section
Research Article

Copyright (c) 2026 Media Publikasi Promosi Kesehatan Indonesia (MPPKI)

Creative Commons License

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Authors who publish with Media Publikasi Promosi Kesehatan Indonesia retain the copyright of their work. The journal applies a Creative Commons Attribution-ShareAlike 4.0 International License (CC BY-SA 4.0), which grants the following rights:

  1. Copyright Retention: Authors retain the copyright of their work, maintaining full control over their intellectual property without restrictions.

  2. Right of First Publication: Authors grant the journal the right of first publication of their work. This ensures that the work is initially published and credited in Media Publikasi Promosi Kesehatan Indonesia.

  3. License to Share and Reuse: The work is licensed under CC BY-SA 4.0, allowing others to copy, distribute, remix, and build upon the work for any purpose, even commercially, as long as proper credit is given to the authors, and any new creations are licensed under the same terms.