Characterizing medication waste from a palliative care unit in Denmark – A descriptive study

Production, transport, use, and disposal of medication is associated with high levels of CO 2 emissions, which negatively affects environmental sustainability. Reduction of the carbon footprint can be addressed by various strategies including focus on sustainability in the procurement and supply chains of medication, substitution or reduction of medication use, and reduction in medication disposal. To reduce medication waste, insights into the types of medications and volumes disposed are required. A significant research gap regarding the prevalence, management, and implications of medication waste remains within the hospice setting. This study aimed to categorize the medication waste and calculate the corresponding carbon emissions from a hospice in Denmark. All disposed medication from March to May 2024 from HospiceSønderjylland was collected, totaling 638 items, which amounts to 42.1 kg. This corresponds to an estimated annual medication waste rate of 168 kg assuming constant disposal over the year. Of the manually counted items, 31% were found in unopened packages. The waste was predominantly composed of medication for pain relief. The cost of the medication waste was 56,923 DKK (US$8,778) for a period of three months, which corresponds to 227,691 DKK (US$35,110) per year. The cost for disposal of the medication waste was 1,013 DKK (US$156) for the 42.1 kg, corresponding to 4,054 DKK (US$625) per year. The carbon footprint of the disposal of medication waste was estimated at 45.2 kg CO 2 e, corresponding to 180.8 kg CO 2 e per year. This study showed a substantial economic and environmental burden from disposal of medication from one hospice in Denmark. More research is needed on the proportions of unnecessary medication waste and ways to avoid it. • Medication waste from a Danish hospice amounted to 168 kg annually. • This corresponds to a cost of 35,110 US$ and 180.8 kg CO 2 e in carbon emissions. • Patient needs are unpredictable and rapidly changing in palliative care. • This leads to unique medication patterns, making waste reduction especially difficult. • Discussions are needed about which types of medication waste are avoidable.