By Ruth Elzer, RN, MS

Hospitals across the country continue to struggle with the issue of how to dispose of medication patches in a manner that is both safe for patients and families and convenient for caregivers.

Advocacy campaigns, including SMARxT Disposal* have attempted to enlighten caregivers and the public about the potential impact that discarded drugs can have on the environment. The White House’s Office of National Drug Control Policy has also issued general guidelines on the disposal of prescription drugs for consumers and professionals. Yet, regulatory agencies have few regulations applicable to hospitals regarding the disposal of medication patches.

Meanwhile, emerging information suggests that some medication patches are being misused and even abused. Lingering and unpredictable levels of medications are still contained in medication patches at the time of scheduled removal, and they can represent a risk to patients or caregivers if not disposed of properly. In addition, medication patches containing pain control substances hold a potential for abuse, adding further importance to the issue of properly securing medication patches upon removal.

Some hospitals have implemented home-like policies, such as disposal of patches in trash receptacles. Others have implemented policies for disposal of patches in medical sharps bins, which are later incinerated. This strategy holds unknown risks for individuals involved in the disposal process. Flushing patches down the toilet – another disposal option – sends medications into the municipal waste system with little-known effects.

In short, there is no certain best practice that applies to hospitals.

To provide some clarity, the following table has been compiled to assist organizations in establishing a policy that meets manufacturer’s recommendations for the most common patches used in hospitals. Please follow the “Source/More Info” links for further information. If your server disables links, visit www.hospital-accreditation.com, to explore this table further.

As with all medications, it is recommended that all used patches be kept out of the reach of children and pets.

Establishing Policy
To establish a policy regarding disposal of medication patches in your organization, consider the following steps:

• Evaluate which medication patches are commonly used in your organization.
• Review diversion reports for any risks associated with medication patches.
• Review the manufacturer’s recommendations for each medication patch used in the organization.
• Consider any local requirements for municipal disposal of medications.
• Review current practice with frontline caregivers to determine options for compliance and gain insight into common use.

Finally, pilot test the new policy to assure that sufficient safeguards have been taken to protect patients, their families, and other caregivers from the effects of discarded patches.

For information regarding disposal of medications in general, click here.
To see the publication from the Office of Drug Control Policy, click here.

*SMARxT Disposal is a public awareness campaign that targets medication consumers to provide guidance on proper disposal of unused and or expired prescription and over-the-counter medications. SMARxT Disposal also raises awareness about the potential environmental impacts from improperly disposed medications. SMARxT Disposal is a unique public-private partnership between the U.S. Fish and Wildlife Service, the American Pharmacists Association, and the Pharmaceutical Research and Manufacturers of America.

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