A systematic review of the literature on 'medication wastage': an exploration of causative factors and effect of interventions.

INTRODUCTION: Reducing any wastage, including that of medications, is a paramount objective in promoting appropriate utilisation of finite resources. The objective was to systematically review the published literature, the possible causative factors associated with medication wastage and the effectiveness of any interventions to reduce wastage.
METHOD: A systematic review of studies published in English was identified from the following databases: Cumulative Index to Nursing and Allied Health Literature, Embase, Medline, PubMed, Science Citation Index and The Cochrane Library. Data extraction and critical appraisal was undertaken independently by two researchers. RESULTS AND DISCUSSION: Title, abstract and full paper screening reduced the 14,157 studies to 42. A general definition of medication wastage was reported in one paper only. 'Medication changed', 'patient death', 'resolution of patient's condition' and 'expired medications' were most commonly cited reasons for wastage. Only two studies were identified reporting wastage as a research outcome measure following intervention.
CONCLUSION: The systematic review has identified a limited literature on medication wastage with a lack of consistency of terms. There is a paucity of robust research focusing on the impact of healthcare interventions on outcomes around medication wastage.