Pharmacists’ awareness, readiness and practice on safe and sustainable pharmaceutical waste management: cross-sectional survey in Kuala Lumpur and Selangor, Malaysia

Pharmacists have a pivotal role in pharmaceutical waste management (PWM) but are still not completely aware of safe and sustainable PWM. This research is aimed to explore pharmacists’ awareness, readiness and practice (ARP) on PWM in Malaysia. A cross-sectional survey was conducted among 88 randomly selected Malaysian pharmacists in Kuala Lumpur and Selangor, Malaysia. One pharmacist was selected from each pharmacy randomly based on computer-generated sampling frame of pharmacies. Pharmacists having unused or expired medicines at their practice setups were included whereas those who were not willing to respond were excluded. The survey was conducted from May 2023 to September 2024 with a structured questionnaire. The content validity of instrument was ensured with seven experts, face validity was done among 5% respondents and reliability was assessed by Cronbach’s alpha. Exploratory factor analysis was performed to identify most important factors among ARP constructs. Pearson’s correlation and multiple linear regression were used to analyze correlation and statistical relationship among outcome and predictor variables considering, P < 0.05 as statistically significant. A total of 16 (18.2%) pharmacists had good level of awareness, 35 (39.8%) had good readiness and 14 (15.9%) had good practice level. Correlation values (i.e., r -values) were positive but insignificant between awareness with readiness ( r = 0.016, P = 0.884) and between awareness and practice ( r = 0.126, P = 0.241), and positive cum significant between readiness and practice ( r = 0.590, P <0.001). The correlation analysis and regression models of ARP indicate that pharmacists may not always be ready to practice but readiness correlated with practice ( r = 0.590, P <0.001). In future, actionable levers such as making takeback mandatory through regulation, instituting reimbursement mechanism for operational costs of takeback or integrating pharmacies with existing takeback programs can be feasible within Malaysia’s current health and waste governance structures.