RxMEDS Dr. Sterling W. Hayden, ARCHS Nicole M. Gattas, Pharm.D., BCPS Regional eXcess MEdication Disposal Service Partnership

Goal of RxMEDS Partnership: Create an efficient regional model that removes and disposes of unwanted medications and informs the citizens of related health and environmental issues.

St. Louis: Missouri & Mississippi Rivers converge MO and IL 5 counties

RxMEDS’ Partners Area Resources for Community and Human Services (ARCHS) Area Resources for Community and Human Services (ARCHS) Schnuck Markets, Inc. Cintas Corporation St. Louis College of Pharmacy Missouri AARP Mid-East Area Agency on Aging St. Louis OASIS Senior Services Plus

Partnerships Growing WK Health Stericycle St. Louis City on Aging Metropolitan Sewer District STL County Waste Management Program MO Environmental Water Ass’n Living Lands and Waters American Water Company PhRMA Saint Louis University

Time Line Determine feasibility of on-going take-back programs 12 months of take- back programs: provide the service and educate the public 6 months of planning set-up: Controls, policies and procedures, marketing, scheduling Phase 1 Phase 2 Phase 3

Goal: Create an efficient regional model that removes and disposes of unwanted medications and informs the citizens of related health and environmental issues. Objectives:  Identify 25 regional supermarkets that will serve as collection centers.  Establish an environment friendly methodology to dispose of unwanted medications.  Plan and present a major regional workshop for seniors through our senior services partners.  Provide educational programs to regional schools on drug safety, etc.  Conduct relevant research on the topic. Such as:  Demographics of patrons  What types of medications are being turned in  Previous disposal methods Measurement Methodology:  Surveys at point of collection  Data collected at point of collection  Feedback from involved parties  Attendance at Regional Senior Workshop(s)  Pre/post senior survey on knowledge gained  # of school programs conducted  # of students in the programs  Pre/post student survey on knowledge gained Outcomes: Immediate  Public awareness of an issue that affects the region but until now has not been addressed on a major scale. Intermediate  Removal of medications that harm the environment and pose a health hazard. Long Term  An attitudinal change of the general public that currently accepted and promoted means of medication disposal are not correct.  A shift in the advertising by major pharmaceutical companies towards an improved disposal method for unused medications.

Hurdle #1: Control Medication EPA and federal DEA approved plan of separate bins, multiple person check off, and officer picks up immediately following the drop off period. –Specifically for this grant State BNDD would not agree Therefore, we will not accept control medications –Ambien to Methylphenidate to Xanax –Pseudoephedrine

Approvals √ US EPA √ US EPA Human Subjects Review & St. Louis University IRB Board √ IL EPA √ MO EPA √ Hazardous Materials Information Center (US Dept of Transportation) √ MO Bureau of Narcotics and Dangerous Drugs (BNDD) √ US DEA, MO & IL √ MO Board of Pharmacy

Unwanted Medication Disposal Program Set-up 20 locations, 3 hour drop off time once a month Accept non-controls unwanted medications, document controls but do not accept Inform patrons what to do with non- returnable materials Only collect medications during collection times

Personnel Greeter Tech Student Extern Pharmacist Show location Manage flow Market Ready materials Assist with workflow Document Determine drug Discuss drug related problems Check drug documentation Feedback Liability/reliability of information

Policies and Procedures Greet and explain purpose Background Facts & Comparisons 4.0 drug database on students laptop for quick tablet identification Form may be printed out for patron Educational materials offered Incentive offered

Public Education 20 school age presentations Presentations at Area Agencies on Aging Marketing the disposal program

RxMEDS Community Partners: Schnuck Markets, Inc., St. Louis College of Pharmacy Cintas, AARP Missouri Chapter, Senior Services Plus OASIS & Mid-East Area Agency on Aging stlarchs.org