Management of pharmaceutical waste in hospitals in Serbia – challenges and the potential for improvement

Background: Left over medication widely used in hospitals for the treatment of various diseases including malignant illnesses, stand to represent a hazardous form of healthcare waste. According to regulations in the Republic of Serbia dating back to 2009, all healthcare facilities are obligated to separate, label and safely put away said leftover medication, i.e. forward it to authorised operators in order to be securely shipped and properly taken care of abroad. Pharmaceutical waste can lead to dire consequences on a patient’s or medical employee’s health, as well as cause simultaneous damage to the environment, both work and not. The main aim of this research is the assessment of the state of Serbian hospitals as is, from the perspective of dealing with pharmaceutical waste. Also, the research’s objective is to examine the factors that affect the way healthcare waste is handled and the respectful aftermath of their alterations in healthcare institutions. Methods: For the realization of this survey, a special questionnaire was developed, concocted with regard to the margins set out by WHO, in order to promptly assess the management of healthcare waste in hospitals, which had beforehand been pretested. The research was carried out as a cross-sectional study of the representative hospital sample of the secondary and tertiary level of healthcare facilities in the public domain, in November 2014. Results: The questionnaire was completed by 60 hospitals, which typifies a representative number of said facilities in the Republic of Serbia and which covers more than 85% of inpatient capacity within the public sector’s network of healthcare hospitals defined by the Bylaw (referred to as the Network of healthcare facilities in Serbia). Conclusion: Tertiary level hospitals, meaning clinical centres, clinical medical centres and institutes that offer highly specialized healthcare services and have an admittedly larger number of hospital beds, have a more evolved system of sorting pharmaceutical waste and do away with grander amounts of it on a yearly basis. Establishing a safe and law-abiding management of pharmaceutical waste in hospitals will come to wholly enhance the management of hazardous waste in the healthcare system.