Tamper-Proofing Multidose Medications in Hospitals: High-Value, Low-Effort Interventions to Reduce Medication Waste

The Canadian health care sector contributes 4.6% of national greenhouse gas emissions, with medications accounting for 25% of that amount. Reducing waste from high-cost multidose items such as eye drops and inhalers can lower environmental and health care costs.

To evaluate tamper-proofing practices in hospital pharmacy departments in British Columbia and to explore opportunities for standardization to reduce medication waste.

Site visits were conducted at 13 hospitals across 3 health authorities in British Columbia-Vancouver Coastal Health, Providence Health Care, and Fraser Health-to gather data on tamper-proofing practices in hospital pharmacy departments.

Methods of tamper-proofing varied across departments. Key recommendations for improvement include the implementation of adhesive stickers or other tamper-evident features, standardization of the placement of tamper-evident adhesive stickers, prioritization of patient-specific medications for tamper-proofing, and development of and adherence to policies/procedures for most multidose medications before they leave the pharmacy.

Standardizing tamper-proofing practices can reduce medication waste and environmental impact, with potential for broader adoption across hospitals.