People thinking about pharmaceutical risk – health and environment: evidence from noPILLS

Background and Objectives
As part of the INTERREG IVb Programme noPILLS the team at GCU undertook investigation of perceptions and behaviours associated with pharmaceutical use and disposal amongst the Scottish public. The aim of this work was to explore individuals’ attitudes to ‘medicine’ use; perceptions of ‘risk’; relationships with prescribers and the decision factors that came into play when disposing of unwanted medicines as well as the environmental-awareness impacts they displayed.
Methods and results
The paper explores the findings of these qualitative investigations in 5 Scottish communities where individuals demonstrated complex relationships with medicinal use influenced by a range of factors: cultural, familial, professional advice as well as by independent information searching. There is evidence of considerable variability in the associated practices resulting from these, often conditioned by the perceived ‘trustworthiness’ of key agents in the system and frustrations at confused or confusing messages about risk (side effects etc). Belief systems played an important role in determining use but also in disposal, where individuals had an acute sense of ‘safety’ with respect to both appropriate use and of (possible) human health or environmental impacts. However, there is evidence that in many cases this behaviour was misconceived or at least contrary to recommended practice. The information associated with this, in itself, was often seen to be vague or not easily accessible.
Discussion and conclusions
The paper concludes that where policy makers wish to intervene in this area their responses need to be nuanced whether they are addressing use (prescription etc) or (appropriate) disposal. Because, whilst many people appeared to demonstrate risk aversion, others showed a degree of ambivalence with respect to both use and disposal risks. Whilst there is considerable good intention evidenced in the research by members of the public there is also confusion in the minds of many as to what is ‘best practice’ in avoiding risky behaviours.