Assessment of Lebanese community pharmacists' perceptions and practices towards pharmaceutical waste disposal.

OBJECTIVES: Pharmaceutical waste poses increasing environmental and public health risks, particularly in low- and middle-income countries where regulatory systems are often weak. In Lebanon, little is known about the work undertaken by community pharmacists in managing such waste, despite their accessibility and central role in medication distribution. This study aimed to investigate and quantify the knowledge, attitudes, and practices of community pharmacists in Lebanon regarding pharmaceutical waste disposal, and to identify perceived challenges and recommendations for improvement. METHODS: A cross-sectional survey, administered via a structured online questionnaire, was completed by 470 community pharmacists across Lebanon between July and September 2025 using convenience snowball sampling. KEY FINDINGS: Three hundred thirty-one community pharmacists completed the survey. A total of 70% of pharmacists were aware of the environmental hazards of inappropriate drug disposal, and 42.7% reported returning unwanted medications to manufacturers or warehouses as their primary disposal method. However unsafe practices, such as disposing of drugs in household waste, persisted (48.3%). Awareness was high, but formal training was limited (58.3% had never received related education). Nearly all respondents (91.5%) supported the need for a national take-back system, and most favored funding by public authorities and pharmaceutical companies. Major barriers included a lack of infrastructure, regulatory clarity, and enforcement. Training and pharmacy-based return schemes were the most favored interventions. CONCLUSIONS: Lebanese community pharmacists demonstrate strong knowledge and willingness to implement safer pharmaceutical waste management practices, but are hindered by existing challenges. Establishing a national disposal network, enhancing regulatory control, and providing focused training are essential to facilitate effective pharmaceutical waste management. TRIAL REGISTRATION: Not applicable.