Abstract
BACKGROUND: Improper disposal of medications is a growing global concern, leading to environmental contamination and public health risks, including accidental poisoning and antimicrobial resistance. This study assessed public knowledge, attitudes, and practices regarding disposing of unused and expired medications among community pharmacy visitors in Kathmandu, Nepal. METHODS: A cross-sectional study was conducted using the Return and Disposal of Unused Medication questionnaire among 395 randomly selected participants, and a 100% response rate was achieved. Descriptive and inferential statistics, including chi-square tests, were used to identify significant associations with the Statistical Package for Social Sciences version 23. RESULTS: Over half of the respondents (n = 247, 62%) understood the proper disposal methods for unused and expired medication. Additionally, a majority of participants (n = 366, 92%) exhibited a positive attitude, while more than two-thirds (88.1%) were aware of the detrimental effects of incorrect medicine disposal on the environment. Approximately 43% (n = 171) of respondents reported having unused medicines stored at home, with analgesics (46%) and antibiotics (42%) being the most common types. Most participants disposed of expired medicines in household garbage bins and retained unused medications at home until their expiration. Furthermore, a significant association was identified between respondents' knowledge levels and their actual practices in medicine disposal (p < 0.001). CONCLUSION: Despite positive attitudes, gaps in practice highlight the urgent need for awareness campaigns and structured disposal programs. The findings suggest actionable measures, including national guidelines and pharmacy-led take-back programs, to mitigate improper disposal of unused and expired medicines.