{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T19:08:40Z","timestamp":1788808120636,"version":"build-2803163510"},"reference-count":30,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Pharmaceutical waste poses increasing environmental and public health risks, particularly in low- and middle-income countries where regulatory systems are often weak. In Lebanon, little is known about the work undertaken by community pharmacists in managing such waste, despite their accessibility and central role in medication distribution. This study aimed to investigate and quantify the knowledge, attitudes, and practices of community pharmacists in Lebanon regarding pharmaceutical waste disposal, and to identify perceived challenges and recommendations for improvement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional survey, administered via a structured online questionnaire, was completed by 470 community pharmacists across Lebanon between July and September 2025 using convenience snowball sampling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key findings<\/jats:title>\n                    <jats:p>Three hundred thirty-one community pharmacists completed the survey. A total of 70% of pharmacists were aware of the environmental hazards of inappropriate drug disposal, and 42.7% reported returning unwanted medications to manufacturers or warehouses as their primary disposal method. However unsafe practices, such as disposing of drugs in household waste, persisted (48.3%). Awareness was high, but formal training was limited (58.3% had never received related education). Nearly all respondents (91.5%) supported the need for a national take-back system, and most favored funding by public authorities and pharmaceutical companies. Major barriers included a lack of infrastructure, regulatory clarity, and enforcement. Training and pharmacy-based return schemes were the most favored interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Lebanese community pharmacists demonstrate strong knowledge and willingness to implement safer pharmaceutical waste management practices, but are hindered by existing challenges. Establishing a national disposal network, enhancing regulatory control, and providing focused training are essential to facilitate effective pharmaceutical waste management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>Not applicable.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ijpp\/riag130","type":"journal-article","created":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T11:34:47Z","timestamp":1787484887000},"source":"Crossref","is-referenced-by-count":0,"title":["Assessment of Lebanese community pharmacists\u2019 perceptions and practices towards pharmaceutical waste disposal"],"prefix":"10.1093","author":[{"given":"Rajaa","family":"Al-Qudah","sequence":"first","affiliation":[{"name":"Faculty of Pharmacy, Applied Private Science University , Amman 11937 ,","place":["Jordan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7966-1172","authenticated-orcid":false,"given":"Muna","family":"Barakat","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy, Applied Private Science University , Amman 11937 ,","place":["Jordan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katia","family":"Iskandar","sequence":"additional","affiliation":[{"name":"School of Pharmacy, Lebanese International University , PO Box 146404, Beirut ,","place":["Lebanon"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Malaeb","sequence":"additional","affiliation":[{"name":"College of Pharmacy, Gulf Medical University , PO Box 4184, Ajman ,","place":["United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6918-5689","authenticated-orcid":false,"given":"Souheil","family":"Hallit","sequence":"additional","affiliation":[{"name":"School of Medicine and Medical Sciences, Holy Spirit University of Kaslik , PO Box 446, Jounieh ,","place":["Lebanon"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,7]]},"reference":[{"key":"2026090714522606000_ref1","volume-title":"Health-care Waste","author":"World Health Organization"},{"key":"2026090714522606000_ref2","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1016\/j.det.2025.08.011","article-title":"The environmental impact of biologic therapy","volume":"44","author":"Leung","year":"2026","journal-title":"Dermatol Clin"},{"key":"2026090714522606000_ref3","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-323-90909-9.00006-X","volume-title":"360-Degree Waste Management","author":"Kawade","year":"2023"},{"key":"2026090714522606000_ref4","doi-asserted-by":"publisher","first-page":"595","DOI":"10.1002\/etc.5528","article-title":"Do pharmaceuticals in the environment pose a risk to wildlife?","volume":"43","author":"Bean","year":"2024","journal-title":"Environ Toxicol Chem"},{"key":"2026090714522606000_ref5"},{"key":"2026090714522606000_ref6","author":"Return Unwanted Medicines (RUM)"},{"key":"2026090714522606000_ref7"},{"key":"2026090714522606000_ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.ssmqr.2024.100421","article-title":"Financial barriers, facilitators, and strategies among syringe services programs in the U.S., and their impact on implementation and health outcomes","volume":"5","author":"Akiba","year":"2024","journal-title":"SSM\u2014Qual Res Health"},{"key":"2026090714522606000_ref9","doi-asserted-by":"publisher","first-page":"e0259160","DOI":"10.1371\/journal.pone.0259160","article-title":"Pharmaceuticals wastage and pharmaceuticals waste management in public health facilities of Dessie town, North East Ethiopia","volume":"16","author":"Mohammed","year":"2021","journal-title":"PLoS One"},{"key":"2026090714522606000_ref10","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1186\/s40545-019-0174-1","article-title":"Assessment of disposal practices of expired and unused medications among community pharmacies in Anambra State southeast Nigeria: a mixed study design","volume":"12","author":"Michael","year":"2019","journal-title":"J Pharm Policy Pract"},{"key":"2026090714522606000_ref11","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph192315798","article-title":"Household pharmaceutical waste disposal as a global problem\u2014a review","volume":"19","author":"Rogowska","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"2026090714522606000_ref12","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1093\/ijpp\/riaf010","article-title":"Awareness of the appropriate handling and disposal of unused medicines in Jordan: a cross-sectional study","volume":"33","author":"Alhamad","year":"2025","journal-title":"Int J Pharm Pract"},{"key":"2026090714522606000_ref13","doi-asserted-by":"publisher","first-page":"103","DOI":"10.3390\/pharmacy9020103","article-title":"Disposal practices of unused and leftover medicines in the households of Dhaka metropolis","volume":"9","author":"Begum","year":"2021","journal-title":"Pharmacy"},{"key":"2026090714522606000_ref14","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-021-11676-x","article-title":"Disposal practice and factors associated with unused medicines in Malaysia: a cross-sectional study","volume":"21","author":"Wang","year":"2021","journal-title":"BMC Public Health"},{"key":"2026090714522606000_ref15","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1186\/s40545-020-00273-9","article-title":"Prescription and dispensing guidelines in Lebanon: initiative of the Order of Pharmacists of Lebanon","volume":"13","author":"Hajj","year":"2020","journal-title":"J Pharm Policy Pract"},{"key":"2026090714522606000_ref16","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1186\/s40545-022-00506-z","article-title":"Assessment of knowledge, attitude, and practice regarding the disposal of expired and unused medications among the Lebanese population","volume":"15","author":"Hajj","year":"2022","journal-title":"J Pharm Policy Pract"},{"key":"2026090714522606000_ref17","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1007\/978-3-030-18350-9_11","volume-title":"Waste Management in MENA Regions","author":"Halwani","year":"2020"},{"key":"2026090714522606000_ref18","doi-asserted-by":"publisher","first-page":"2003","DOI":"10.18549\/PharmPract.2020.2.2003","article-title":"Primary health care policy and vision for community pharmacy and pharmacists in Lebanon","volume":"18","author":"Hallit","year":"2020","journal-title":"Pharm Pract (Granada)"},{"key":"2026090714522606000_ref19"},{"key":"2026090714522606000_ref20","doi-asserted-by":"publisher","first-page":"1035","DOI":"10.1186\/s12913-023-09888-5","article-title":"Assessment of practices and awareness regarding the disposal of unwanted pharmaceutical products among community pharmacies: a cross-sectional study in Palestine","volume":"23","author":"Nairat","year":"2023","journal-title":"BMC Health Serv Res"},{"key":"2026090714522606000_ref21","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1016\/j.jsps.2012.04.001","article-title":"Practice, awareness and opinion of pharmacists toward disposal of unwanted medications in Kuwait","volume":"20","author":"Abahussain","year":"2012","journal-title":"Saudi Pharm J"},{"key":"2026090714522606000_ref22","doi-asserted-by":"publisher","first-page":"823","DOI":"10.3390\/healthcare9070823","article-title":"Community pharmacists\u2019 practice, awareness, and beliefs about drug disposal in Saudi Arabia","volume":"9","author":"Alghadeer","year":"2021","journal-title":"Healthcare"},{"key":"2026090714522606000_ref23","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1093\/ijpp\/riac101","article-title":"Knowledge, attitude and practice of community pharmacists towards household pharmaceutical waste disposal","volume":"31","author":"Low","year":"2023","journal-title":"Int J Pharm Pract"},{"key":"2026090714522606000_ref24","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1007\/s00267-019-01174-7","article-title":"Pharmaceutical household waste practices: preliminary findings from a case study in Poland","volume":"64","author":"Rogowska","year":"2019","journal-title":"Environ Manag"},{"key":"2026090714522606000_ref25","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1016\/j.hydres.2022.11.001","article-title":"The pharmaceutical disposal practices and environmental contamination: a review in East African countries","volume":"5","author":"Karungamye","year":"2022","journal-title":"HydroResearch"},{"key":"2026090714522606000_ref26","doi-asserted-by":"publisher","DOI":"10.1016\/j.rcsop.2026.100799","article-title":"Disposal of unnecessary and expired medicines in households: practices and factors associated with proper medicine disposal using the extended theory of planned behavior","volume":"23","author":"Leskinen","year":"2026","journal-title":"Explor Res Clin Soc Pharm"},{"key":"2026090714522606000_ref27","article-title":"A systematic review of the knowledge, attitude and practice of healthcare professionals and healthcare professional students towards household pharmaceutical waste disposal","volume":"17","author":"Hiew","year":"2025","journal-title":"Explor Res Clin Soc Pharm"},{"key":"2026090714522606000_ref28","doi-asserted-by":"publisher","DOI":"10.1177\/20503121241290968","article-title":"Pharmacists perspectives on challenges and facilitators in initiating medications take-back program in Indonesia: a qualitative study","volume":"12","author":"Alfian","year":"2024","journal-title":"SAGE Open Med"},{"key":"2026090714522606000_ref29","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1071\/HC11197","article-title":"Disposal practices for unused medications in New Zealand community pharmacies","volume":"3","author":"Tong","year":"2011","journal-title":"J Prim Health Care"},{"key":"2026090714522606000_ref30","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1016\/j.jsps.2017.11.006","article-title":"Assessment of the association between drug disposal practices and drug use and storage behaviors","volume":"26","author":"Akici","year":"2018","journal-title":"Saudi Pharm J"}],"container-title":["International Journal of Pharmacy Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ijpp\/advance-article-pdf\/doi\/10.1093\/ijpp\/riag130\/70985133\/riag130.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ijpp\/advance-article-pdf\/doi\/10.1093\/ijpp\/riag130\/70985133\/riag130.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T18:52:33Z","timestamp":1788807153000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ijpp\/advance-article\/doi\/10.1093\/ijpp\/riag130\/8787458"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,7]]},"references-count":30,"URL":"https:\/\/doi.org\/10.1093\/ijpp\/riag130","relation":{},"ISSN":["2042-7174"],"issn-type":[{"value":"2042-7174","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,7]]},"article-number":"riag130"}}