Measures to avoid and better manage pharmaceutical household waste, including tools for health professionals to consider the environment when prescribing, have been proposed in a report.

The document, published last week by the Organisation for Economic Cooperation and Development (OECD), found the volume medication ending up as household waste has risen, as ageing populations consume more pharmaceuticals.

The authors, who are also aiming to raise awareness among the public of the risks of inappropriate disposal, warned this trend could lead an increasing amount of unused or expired medicines contaminating the environment when disposed of improperly.

They suggested including instructions for appropriate disposal on product packaging or information leaflets, as well as nudges such as ‘challenges’ or ‘saving accounts’ to return medication to pharmacies, or product ecolabelling to inform consumer choices.

Other proposals included:

· Finding ways to reduce volumes of unused or expired medicine, such as improving disease prevention, personalised and precision medicine, better dimensioning of packaging sizes, as well as marketplaces of unused, unexpired medicines.

· Ensuring the environmentally sound collection and treatment of unavoidable pharmaceutical waste.

· Campaigns to raise awareness of the importance of reducing pharmaceutical waste and on appropriate disposal routes, in particular for liquids, ointments and creams.

The report suggested that most patients in the UK tended to dispose of unused or expired medicines in household waste bins, whereas pharmacies in the UK are required to take back and sort unused medicines and return them to the NHS.

Pharmaceutical waste can contribute to adverse effects on ecosystems and the development of antimicrobial resistant bacteria, with traces of oral contraceptives causing the feminisation of fish and amphibians, and residues of psychiatric drugs altering fish behaviour. The potential waste of healthcare resources and possible public health risks were also highlighted in the report.

As many as 260 pharmacies across England and Scotland now recycle injection pens as part of a new green scheme; while in February, pharmaceutical company Chiesi launched a pilot scheme that enabled patients to dispose of and recycle their inhalers through the post.

The Primary Care Respiratory Society (PCRS) published a white paper late last year calling for better processes and information on how and where to recycle, safely dispose of and return inhalers; while the director of the Royal Pharmaceutical Society in Wales has said that pharmacy teams must further educate the public on how they can help tackle pharmaceutical pollution.

Pharmacists from Pharmacy Declares have called for the sector to focus more on clinical services than recycling. Ministers have also pledged to ‘take action’ on overprescribing after an official review concluded that 10% of medicines dispensed in primary care in England were ‘unnecessary’.

Ministers have also pledged to ‘take action’ on overprescribing after an official review concluded that 10% of medicines dispensed in primary care in England were ‘unnecessary’.