Yes / The purpose of this paper is to determine how best to reduce, reuse and dispose of household waste medicines in the National Health Service (NHS) (UK). Through a combination of literature review and empirical work, this research investigates the existing household waste medicines reverse logistics (RL) system and makes recommendations for improvement by benchmarking it against household waste batteries RL. The viability and feasibility of these recommendations are evaluated through in-depth interviews with healthcare professionals and end user surveys. The batteries RL system appears to be a more structured and effective system with more active engagement from actors/stakeholders in instigating RL practices and for this very reason is an excellent comparator for waste medicines RL practices. Appropriate best practices are recommended to be incorporated into the waste medicines RL system, including recapturing product value, revised processing approaches, system cooperation and enforcement, drivers and motivations and system design and facilitation. This study offers academics and professionals an improved insight into the current household waste medicines RL system and provides a step towards reducing an existing gap in this under-researched area. A limitation is that only a small sample of healthcare professionals were involved in subjectively evaluating the feasibility of the recommendations, so the applicability of the recommendations needs to be tested in a wider context and the cost effectiveness of implementing the recommendations needs to be analysed. Reducing, reusing and properly disposing of waste medicines contribute to economic sustainability, environmental protection and personal and community safety. The information retrieved from analysing returned medicines can be used to inform prescribing practice so as to reduce unnecessary medicine waste and meet the medicine optimisation agenda. This paper advocates learning from best practices in batteries RL to improve the waste medicines RL design and execution and supports the current NHS agenda on medicine waste reduction (DoH, 2012). The recommendations made in the paper not only aim to reduce medicine waste but also to use medicines effectively, placing the emphasis on improving health outcomes.

Submitted by admin tede (tede@pucgoias.edu.br) on 2018-05-03T13:45:46Z No. of bitstreams: 1 Kassia Francielly Soares de Oliveira Martins.pdf: 958685 bytes, checksum: 60adb1481bf27e06f4cbd2789e7a42a6 (MD5) / Made available in DSpace on 2018-05-03T13:45:46Z (GMT). No. of bitstreams: 1 Kassia Francielly Soares de Oliveira Martins.pdf: 958685 bytes, checksum: 60adb1481bf27e06f4cbd2789e7a42a6 (MD5) Previous issue date: 2018-03-15 / As a consequence of the population growth, was obtained the increase the percentage of Urban Solid Waste (USW) generated in the country; in 2008 about 409,530 tons of USW were generated and in 2015, were 495,528 tons approximately. In the state of Goiás and in Goiânia, the same trend followed. In Goiânia, much of the USW is disposed in the Landfill of Goiânia, among these residues are the batteries; instituted in the National Solid Waste Policy (Law n°12.305 of 2010), which imposes the implementation of the reverse logistics system. Having as a starting point the inappropriate disposal of batteries in the USW of the municipality of Goiânia, this work has as general objective to evaluate the toxic potential of metals from batteries in the Landfill of Goiânia and to diagnose the way of disposal of this residue. Thereby, it was approached in this study the results obtained using the parameters cadmium, lead and mercury - established by the pertinent legislation and resolutions - based on the analyzes of the slurry of the Landfill of Goiânia and the ETE e uent Dr. Hélio Seixo de Brito, in addition to the estimated amount of batteries recycled in Brazil and in Goiás. Finally, there is a demonstration of applied researches in several regions of the country presenting the form of disposal of the batteries in the respective localities. The results evidence a future problem, since, batteries decompose from 100 years to 35 years, the area of the Landfill of Goiânia is used at the disposal of USW. Therefore, these residues are in the process of decomposition and the tenor of these parameters tend to increase. As this question is the e ect of a cause, environmentally inappropriate disposal, evidenced in the recycling estimates of batteries, between 2012 and 2016, in Brazil and the state of Goiás, being 55.45% and 0.65% respectively. All this scope highlights the importance of extending the environmental education programs to solve the problem of disposal of batteries. / Em consequência ao crescimento populacional obteve-se a elevação no percentual de Resíduos Sólidos Urbanos (RSU) gerados no país; em 2008 gerou-se cerca de 409.530 toneladas de RSU e em 2015, 495.528 toneladas aproximadamente. No estado de Goiás e em Goiânia, seguiu-se a mesma tendência. Em Goiânia, grande parte do RSU é disposto no Aterro Sanitário de Goiânia, dentre estes resíduos estão as pilhas e baterias; instituídas na Política Nacional de Resíduos Sólidos (Lei n°12.305 de 2010) que impõe a implantação do sistema de logística reversa. Tendo como ponto de partida o descarte inadequado de pilhas e baterias no RSU do município de Goiânia, este trabalho tem como objetivo geral, avaliar o potencial tóxico dos metais provenientes de pilhas e baterias descartadas no Aterro Sanitário de Goiânia e diagnosticar a forma de descarte destes resíduos. Com isso, abordou-se nesta pesquisa os resultados obtidos através dos parâmetros cádmio, chumbo e mercúrio — estabelecidos pela legislação e resoluções pertinentes — em função das análises do chorume do Aterro Sanitário de Goiânia e do efluente da ETE Dr. Hélio Seixo de Brito, além da estimativa da quantidade de pilhas e baterias recicladas no Brasil e em Goiás. Por fim, tem-se um demonstrativo de pesquisas aplicadas em diversas regiões do país apresentando a forma de descarte das pilhas e baterias nas respectivas localidades. Os resultados evidenciam a problemática futura, porquanto, pilhas e baterias decompõe-se a partir de 100 anos e a 35 anos a área do Aterro Sanitário de Goiânia é utilizada à disposição de RSU. Portanto, estes resíduos estão em processo de decomposição e os teores destes parâmetros tendem a se elevarem. Sendo essa questão o efeito de uma causa, descarte ambientalmente inadequado, evidenciada nas estimativas de reciclagem de pilhas e baterias, no período de 2012 a 2016, no Brasil e no estado de Goiás, sendo, 55,45% e 0,65%, respectivamente. Todo este escopo aponta a importância de se ampliar os programas de educação ambiental para solucionar a problemática do descarte de pilhas e baterias.