# From Policy to Practice: Community Pharmacists’ Self-Reported Counseling Role in Pharmaceutical Waste Management

## TL;DR

Community pharmacists in Romania are aware of pharmaceutical waste issues and have positive attitudes, but they mostly provide disposal advice only when asked by patients.

## Contribution

This study reveals that despite high awareness and training, counseling on pharmaceutical waste remains reactive rather than proactive.

## Key findings

- 98.2% of pharmacists are aware of current pharmaceutical waste legislation.
- Proactive counseling increases when patients frequently ask about disposal.
- Only 55.4% of pharmacists provide disposal information unless requested.

## Abstract

What are the main findings?
Most community pharmacists report providing disposal counseling, but routine counseling is often reactive.Respondents reported high levels of awareness and generally positive attitudes toward pharmaceutical waste prevention.

Most community pharmacists report providing disposal counseling, but routine counseling is often reactive.

Respondents reported high levels of awareness and generally positive attitudes toward pharmaceutical waste prevention.

What are the implications of the main findings?
The frequency of patient inquiries was associated with differences in self-reported counseling practices.Community pharmacists continue to have a communication role within the hospital-centered medication take-back system.

The frequency of patient inquiries was associated with differences in self-reported counseling practices.

Community pharmacists continue to have a communication role within the hospital-centered medication take-back system.

Background/Objectives: Safe disposal of unused medicines represents an increasing public health and environmental concern. Until 2024, Romanian community pharmacies collected expired medicines from the public, though implementation was inconsistent. Using a knowledge–attitude–practice (KAP) framework, this study assessed community pharmacists’ self-reported involvement in pharmaceutical waste prevention in Bihor County, Romania, one year after new legislation transferred collection responsibilities to hospital-based centers. Methods: A cross-sectional survey was conducted in May 2025 using a self-administered questionnaire comprising 22 items covering socio-demographics, professional practices, knowledge, and attitudes. Eligible participants were community pharmacists (N = 285). Results: Respondents reported high awareness and favourable attitudes toward pharmaceutical waste management: 98.2% indicated awareness of current legislation, 94.4% reported receiving training on the new regulations, 99.6% acknowledged health and environmental risks, and 98.9% expressed agreement that patient education is important. However, 55.4% reported providing disposal information only when patients requested it, while 89.8% indicated that patients rarely asked about medicine disposal. Self-reported proactive counseling increased with patient request frequency (χ2(3) = 7.914, p = 0.048), with pharmacists in the high-request group reporting substantially higher proactive counseling than those in the low-request group (83.3% vs. 42.9%). In an adjusted logistic regression, low request frequency was associated with lower odds of proactive counseling (aOR = 0.21, 95% CI: 0.05–0.98, p = 0.047). Most respondents (94.6%) perceived waste-related responsibilities, though these perceptions were only weakly related to reported counseling behaviors. Conclusions: Pharmacists reported high awareness and positive attitudes toward pharmaceutical waste management, but counseling remained reactive. Patient demand was a key correlate of counseling proactivity, underscoring the need for structured education within Romania’s hospital-based take-back system.