The impact of type of delivery method on medicine waste in households: a questionnaire-based study on outpatients receiving cost-free medicine in the North Denmark Region.

Objectives: The increasing number of patients challenges healthcare and drives demand for home-based treatments. In the North Denmark Region, outpatients can acquire their hospital medication as 'cost-free medicine' through home delivery or medication pickup lockers. With a focus on home-based treatments and limited household medicine tracking, investigating medicine waste is crucial for resource optimisation. This study aimed to investigate the prevalence of excess medication among outpatients in the North Denmark Region, whether there was an association between excess cost-free medicine and type of delivery method, and reasons for the excess.

Methods: This study included outpatients from the Department of Neurology or Department of Gastroenterology at Aalborg University Hospital receiving cost-free medication from March to October 2023. Eligible outpatients received a questionnaire via Digital Post. As medicine waste is difficult to measure directly, excess medication was used as a surrogate measure. Patient data were acquired through Apovision and stored in REDCap. Pearson's χ² test was performed to examine the difference in excess medicine between medication pickup locker and home delivery.

Results: 52.8% (233/441) of outpatients reported excess cost-free medication at home. Medication pickup lockers, where 58.9% (132/224) reported an excess, were associated with larger medicine stocks at home compared with home delivery where 46.5% (101/217) reported excess (p=0.009). For 45.5% (106/233) of medicine pickup locker users and 24% (56/233) of home delivery users, the excess was planned with the hospital department. If the excess was not planned with the department, most users reported receiving too much medicine (23/76) or 'Other' (42/76).

Conclusions: Over half of the outpatients reported excess cost-free medication, with the largest excess linked to medication pickup lockers. Patients managing their own pickup tend to accumulate more. To minimise accumulation of medicine for personal use, it may be worth investigating whether deliveries through medication pickup lockers should be scheduled at fixed intervals.