Evaluation of the causes and cost impact of returned intravenous medications at a tertiary care hospital in Riyadh, Saudi Arabia

Purpose: To evaluate the main reasons for returning intravenous (IV) medications and to determine its cost impact in an in-patient setting in a Saudi tertiary care hospital.
Methods: The study was conducted over a one-month period at the central IV room of the in-patient pharmacy unit at King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia. All returned IV medications were evaluated in terms of frequency, causes and cost.
Results: The total number of IV medications returned was 2,061 items. The most common reasons for returning IV medications were drug discontinuation (933 items, 45.3 %), dispensing of an extra quantity (396 items, 19.2 %), patient deaths (173 items, 8.4 %), dose changes (171 items, 8.3 %) and drugs being held (150 items, 7.3 %). The total cost of all the returned IV medications was US$26,805.80), which accounts for (13.65 %) of the total pharmacy’s budget. Wasted medication cost was US$13,877.80) which constitute 51.77 % of returned medication cost.
Conclusions: The results of this study indicate that IV medication wastage is a serious problem with significant cost impact, with drug discontinuation and dispensing of an extra quantity of medication being the two main reasons for returning IV medications. Effective communication among health care professionals, pharmacist training, and adherence to standard practice guidelines might be the most vital strategies to reduce medication wastage.

Keywords
Medication wastage; In-patient; Cost impact; Intravenous medications; Tertiary care