A University-Led Take-Back Program for Pharmaceutical Waste Management: Eleven Years of Real-World Evidence on Medication Non-Use and Disposal Patterns

BACKGROUND/OBJECTIVES: Improper medication use, premature treatment discontinuation, and inadequate disposal contribute to irrational drug consumption and environmental contamination. Although pharmaceutical take-back programs have expanded globally, real-world evidence on household medication accumulation in academic and community settings remains limited. This study aimed to describe longitudinal patterns of medication collection during an eleven-year university-based take-back campaign, with detailed pharmacological characterization available for selected post-pandemic years. METHODS: Real-world data were analyzed from a sustainable medication take-back campaign conducted annually at the University of Colima between 2015 and 2025. Expired or unused medications were voluntarily returned by students and community members. Total collected weight was recorded for all years, while detailed classification by dosage form, Anatomical Therapeutic Chemical (ATC) group, and Mexican regulatory fraction (Fractions II, IV, V, and VI) was performed for years with complete records (2023-2025). All materials were disposed of through an authorized hazardous-waste company in compliance with NOM-052-SEMARNAT-2005. Descriptive analyses were performed using SPSS version 29.0. RESULTS: Approximately 3.9 tons of pharmaceutical products were collected over eleven years, reflecting persistent household accumulation of unused or expired medicines. In the years with detailed analysis, oral solid dosage forms predominated. In 2025, ATC groups M, A, and C were most frequently returned, consistent with medications used for chronic conditions. Therapeutic composition varied annually, with NSAIDs/analgesics predominating in 2023-2024 and antibiotics in 2025. Across analyzed years, 5-7% of collected items corresponded to non-medication products. CONCLUSIONS: This long-term campaign provides valuable real-world evidence on medication non-use and disposal, highlighting ongoing challenges in rational medicine use, treatment continuity, and environmentally responsible pharmaceutical waste management.