Views, Barriers and Facilitators  of Policymakers, Pharmacists and Health Community Representative in Managing Unused Medicine in a Socioeconomically Diverse District in Indonesia

Views, Barriers and Facilitators of... | F1000Research "use strict";function _typeof(t){return(_typeof="function"==typeof Symbol&&"symbol"==typeof Symbol.iterator?function(t){return typeof t}:function(t){return t&&"function"==typeof Symbol&&t.constructor===Symbol&&t!==Symbol.prototype?"symbol":typeof t})(t)}!function(){var t=function(){var t,e,o=[],n=window,r=n;for(;r;){try{if(r.frames.__tcfapiLocator){t=r;break}}catch(t){}if(r===n.top)break;r=r.parent}t||(!function t(){var e=n.document,o=!!n.frames.__tcfapiLocator;if(!o)if(e.body){var r=e.createElement("iframe");r.style.cssText="display:none",r.name="__tcfapiLocator",e.body.appendChild(r)}else setTimeout(t,5);return!o}(),n.__tcfapi=function(){for(var t=arguments.length,n=new Array(t),r=0;r 3&&2===parseInt(n[1],10)&&"boolean"==typeof n[3]&&(e=n[3],"function"==typeof n[2]&&n[2]("set",!0)):"ping"===n[0]?"function"==typeof n[2]&&n[2]({gdprApplies:e,cmpLoaded:!1,cmpStatus:"stub"}):o.push(n)},n.addEventListener("message",(function(t){var e="string"==typeof t.data,o={};if(e)try{o=JSON.parse(t.data)}catch(t){}else o=t.data;var n="object"===_typeof(o)&&null!==o?o.__tcfapiCall:null;n&&window.__tcfapi(n.command,n.version,(function(o,r){var a={__tcfapiReturn:{returnValue:o,success:r,callId:n.callId}};t&&t.source&&t.source.postMessage&&t.source.postMessage(e?JSON.stringify(a):a,"*")}),n.parameter)}),!1))};"undefined"!=typeof module?module.exports=t:t()}(); dataLayer = dataLayer || []; // Standard GTM initialization - Google Consent Mode handles consent automatically (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start': new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0], j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src= 'https://www.googletagmanager.com/gtm.js?id='+i+dl+ '>m_auth=hzk0Vc3qFsQYhCrIoHz68A>m_preview=env-1>m_cookies_win=x';f.parentNode.insertBefore(j,f); })(window,document,'script','dataLayer','GTM-MWFK8L5J'); ;window.NREUM||(NREUM={});NREUM.init={distributed_tracing:{enabled:true},privacy:{cookies_enabled:true},ajax:{deny_list:["bam.nr-data.net"]}}; ;NREUM.loader_config={accountID:"438030",trustKey:"438030",agentID:"772317073",licenseKey:"97f8f67f26",applicationID:"772317073"} ;NREUM.info={beacon:"bam.nr-data.net",errorBeacon:"bam.nr-data.net",licenseKey:"97f8f67f26",applicationID:"772317073",sa:1} ;/*! For license information please see nr-loader-spa-1.236.0.min.js.LICENSE.txt */ (()=>{"use strict";var e,t,r={5763:(e,t,r)=>{r.d(t,{P_:()=>l,Mt:()=>g,C5:()=>s,DL:()=>v,OP:()=>T,lF:()=>D,Yu:()=>y,Dg:()=>h,CX:()=>c,GE:()=>b,sU:()=>_});var n=r(8632),i=r(9567);const o={beacon:n.ce.beacon,errorBeacon:n.ce.errorBeacon,licenseKey:void 0,applicationID:void 0,sa:void 0,queueTime:void 0,applicationTime:void 0,ttGuid:void 0,user:void 0,account:void 0,product:void 0,extra:void 0,jsAttributes:{},userAttributes:void 0,atts:void 0,transactionName:void 0,tNamePlain:void 0},a={};function s(e){if(!e)throw new Error("All info objects require an agent identifier!");if(!a[e])throw new Error("Info for ".concat(e," was never set"));return a[e]}function c(e,t){if(!e)throw new Error("All info objects require an agent identifier!");a[e]=(0,i.D)(t,o),(0,n.Qy)(e,a[e],"info")}var u=r(7056);const d=()=>{const e={blockSelector:"[data-nr-block]",maskInputOptions:{password:!0}};return{allow_bfcache:!0,privacy:{cookies_enabled:!0},ajax:{deny_list:void 0,enabled:!0,harvestTimeSeconds:10},distributed_tracing:{enabled:void 0,exclude_newrelic_header:void 0,cors_use_newrelic_header:void 0,cors_use_tracecontext_headers:void 0,allowed_origins:void 0},session:{domain:void 0,expiresMs:u.oD,inactiveMs:u.Hb},ssl:void 0,obfuscate:void 0,jserrors:{enabled:!0,harvestTimeSeconds:10},metrics:{enabled:!0},page_action:{enabled:!0,harvestTimeSeconds:30},page_view_event:{enabled:!0},page_view_timing:{enabled:!0,harvestTimeSeconds:30,long_task:!1},session_trace:{enabled:!0,harvestTimeSeconds:10},harvest:{tooManyRequestsDelay:60},session_replay:{enabled:!1,harvestTimeSeconds:60,sampleRate:.1,errorSampleRate:.1,maskTextSelector:"*",maskAllInputs:!0,get blockClass(){return"nr-block"},get ignoreClass(){return"nr-ignore"},get maskTextClass(){return"nr-mask"},get blockSelector(){return e.blockSelector},set blockSelector(t){e.blockSelector+=",".concat(t)},get maskInputOptions(){return e.maskInputOptions},set maskInputOptions(t){e.maskInputOptions={...t,password:!0}}},spa:{enabled:!0,harvestTimeSeconds:10}}},f={};function l(e){if(!e)throw new Error("All configuration objects require an agent identifier!");if(!f[e])throw new Error("Configuration for ".concat(e," was never set"));return f[e]}function h(e,t){if(!e)throw new Error("All configuration objects require an agent identifier!");f[e]=(0,i.D)(t,d()),(0,n.Qy)(e,f[e],"config")}function g(e,t){if(!e)throw new Error("All configuration objects require an agent identifier!");var r=l(e);if(r){for(var n=t.split("."),i=0;i {r.d(t,{D:()=>i});var n=r(50);function i(e,t){try{if(!e||"object"!=typeof e)return(0,n.Z)("Setting a Configurable requires an object as input");if(!t||"object"!=typeof t)return(0,n.Z)("Setting a Configurable requires a model to set its initial properties");const r=Object.create(Object.getPrototypeOf(t),Object.getOwnPropertyDescriptors(t)),o=0===Object.keys(r).length?e:r;for(let a in o)if(void 0!==e[a])try{"object"==typeof e[a]&&"object"==typeof t[a]?r[a]=i(e[a],t[a]):r[a]=e[a]}catch(e){(0,n.Z)("An error occurred while setting a property of a Configurable",e)}return r}catch(e){(0,n.Z)("An error occured while setting a Configurable",e)}}},6818:(e,t,r)=>{r.d(t,{Re:()=>i,gF:()=>o,q4:()=>n});const n="1.236.0",i="PROD",o="CDN"},385:(e,t,r)=>{r.d(t,{FN:()=>a,IF:()=>u,Nk:()=>f,Tt:()=>s,_A:()=>o,il:()=>n,pL:()=>c,v6:()=>i,w1:()=>d});const n="undefined"!=typeof window&&!!window.document,i="undefined"!=typeof WorkerGlobalScope&&("undefined"!=typeof self&&self instanceof WorkerGlobalScope&&self.navigator instanceof WorkerNavigator||"undefined"!=typeof globalThis&&globalThis instanceof WorkerGlobalScope&&globalThis.navigator instanceof WorkerNavigator),o=n?window:"undefined"!=typeof WorkerGlobalScope&&("undefined"!=typeof self&&self instanceof WorkerGlobalScope&&self||"undefined"!=typeof globalThis&&globalThis instanceof WorkerGlobalScope&&globalThis),a=""+o?.location,s=/iPad|iPhone|iPod/.test(navigator.userAgent),c=s&&"undefined"==typeof SharedWorker,u=(()=>{const e=navigator.userAgent.match(/Firefox[/\s](\d+\.\d+)/);return Array.isArray(e)&&e.length>=2?+e[1]:0})(),d=Boolean(n&&window.document.documentMode),f=!!navigator.sendBeacon},1117:(e,t,r)=>{r.d(t,{w:()=>o});var n=r(50);const i={agentIdentifier:"",ee:void 0};class o{constructor(e){try{if("object"!=typeof e)return(0,n.Z)("shared context requires an object as input");this.sharedContext={},Object.assign(this.sharedContext,i),Object.entries(e).forEach((e=>{let[t,r]=e;Object.keys(i).includes(t)&&(this.sharedContext[t]=r)}))}catch(e){(0,n.Z)("An error occured while setting SharedContext",e)}}}},8e3:(e,t,r)=>{r.d(t,{L:()=>d,R:()=>c});var n=r(2177),i=r(1284),o=r(4322),a=r(3325);const s={};function c(e,t){const r={staged:!1,priority:a.p[t]||0};u(e),s[e].get(t)||s[e].set(t,r)}function u(e){e&&(s[e]||(s[e]=new Map))}function d(){let e=arguments.length>0&&void 0!==arguments[0]?arguments[0]:"",t=arguments.length>1&&void 0!==arguments[1]?arguments[1]:"feature";if(u(e),!e||!s[e].get(t))return a(t);s[e].get(t).staged=!0;const r=[...s[e]];function a(t){const r=e?n.ee.get(e):n.ee,a=o.X.handlers;if(r.backlog&&a){var s=r.backlog[t],c=a[t];if(c){for(var u=0;s&&u {let[t,r]=e;return r.staged}))&&(r.sort(((e,t)=>e[1].priority-t[1].priority)),r.forEach((e=>{let[t]=e;a(t)})))}function f(e,t){var r=e[1];(0,i.D)(t[r],(function(t,r){var n=e[0];if(r[0]===n){var i=r[1],o=e[3],a=e[2];i.apply(o,a)}}))}},2177:(e,t,r)=>{r.d(t,{c:()=>f,ee:()=>u});var n=r(8632),i=r(2210),o=r(1284),a=r(5763),s="nr@context";let c=(0,n.fP)();var u;function d(){}function f(e){return(0,i.X)(e,s,l)}function l(){return new d}function h(){u.aborted=!0,u.backlog={}}c.ee?u=c.ee:(u=function e(t,r){var n={},c={},f={},g=!1;try{g=16===r.length&&(0,a.OP)(r).isolatedBacklog}catch(e){}var p={on:b,addEventListener:b,removeEventListener:y,emit:v,get:x,listeners:w,context:m,buffer:A,abort:h,aborted:!1,isBuffering:E,debugId:r,backlog:g?{}:t&&"object"==typeof t.backlog?t.backlog:{}};return p;function m(e){return e&&e instanceof d?e:e?(0,i.X)(e,s,l):l()}function v(e,r,n,i,o){if(!1!==o&&(o=!0),!u.aborted||i){t&&o&&t.emit(e,r,n);for(var a=m(n),s=w(e),d=s.length,f=0;fn,p:()=>i});var n=r(2177).ee.get("handle");function i(e,t,r,i,o){o?(o.buffer([e],i),o.emit(e,t,r)):(n.buffer([e],i),n.emit(e,t,r))}},4322:(e,t,r)=>{r.d(t,{X:()=>o});var n=r(5546);o.on=a;var i=o.handlers={};function o(e,t,r,o){a(o||n.E,i,e,t,r)}function a(e,t,r,i,o){o||(o="feature"),e||(e=n.E);var a=t[o]=t[o]||{};(a[r]=a[r]||[]).push([e,i])}},3239:(e,t,r)=>{r.d(t,{bP:()=>s,iz:()=>c,m$:()=>a});var n=r(385);let i=!1,o=!1;try{const e={get passive(){return i=!0,!1},get signal(){return o=!0,!1}};n._A.addEventListener("test",null,e),n._A.removeEventListener("test",null,e)}catch(e){}function a(e,t){return i||o?{capture:!!e,passive:i,signal:t}:!!e}function s(e,t){let r=arguments.length>2&&void 0!==arguments[2]&&arguments[2],n=arguments.length>3?arguments[3]:void 0;window.addEventListener(e,t,a(r,n))}function c(e,t){let r=arguments.length>2&&void 0!==arguments[2]&&arguments[2],n=arguments.length>3?arguments[3]:void 0;document.addEventListener(e,t,a(r,n))}},4402:(e,t,r)=>{r.d(t,{Ht:()=>u,M:()=>c,Rl:()=>a,ky:()=>s});var n=r(385);const i="xxxxxxxx-xxxx-4xxx-yxxx-xxxxxxxxxxxx";function o(e,t){return e?15&e[t]:16*Math.random()|0}function a(){const e=n._A?.crypto||n._A?.msCrypto;let t,r=0;return e&&e.getRandomValues&&(t=e.getRandomValues(new Uint8Array(31))),i.split("").map((e=>"x"===e?o(t,++r).toString(16):"y"===e?(3&o()|8).toString(16):e)).join("")}function s(e){const t=n._A?.crypto||n._A?.msCrypto;let r,i=0;t&&t.getRandomValues&&(r=t.getRandomValues(new Uint8Array(31)));const a=[];for(var s=0;s {r.d(t,{Bq:()=>n,Hb:()=>o,oD:()=>i});const n="NRBA",i=144e5,o=18e5},7894:(e,t,r)=>{function n(){return Math.round(performance.now())}r.d(t,{z:()=>n})},7243:(e,t,r)=>{r.d(t,{e:()=>o});var n=r(385),i={};function o(e){if(e in i)return i[e];if(0===(e||"").indexOf("data:"))return{protocol:"data"};let t;var r=n._A?.location,o={};if(n.il)t=document.createElement("a"),t.href=e;else try{t=new URL(e,r.href)}catch(e){return o}o.port=t.port;var a=t.href.split("://");!o.port&&a[1]&&(o.port=a[1].split("/")[0].split("@").pop().split(":")[1]),o.port&&"0"!==o.port||(o.port="https"===a[0]?"443":"80"),o.hostname=t.hostname||r.hostname,o.pathname=t.pathname,o.protocol=a[0],"/"!==o.pathname.charAt(0)&&(o.pathname="/"+o.pathname);var s=!t.protocol||":"===t.protocol||t.protocol===r.protocol,c=t.hostname===r.hostname&&t.port===r.port;return o.sameOrigin=s&&(!t.hostname||c),"/"===o.pathname&&(i[e]=o),o}},50:(e,t,r)=>{function n(e,t){"function"==typeof console.warn&&(console.warn("New Relic: ".concat(e)),t&&console.warn(t))}r.d(t,{Z:()=>n})},2587:(e,t,r)=>{r.d(t,{N:()=>c,T:()=>u});var n=r(2177),i=r(5546),o=r(8e3),a=r(3325);const s={stn:[a.D.sessionTrace],err:[a.D.jserrors,a.D.metrics],ins:[a.D.pageAction],spa:[a.D.spa],sr:[a.D.sessionReplay,a.D.sessionTrace]};function c(e,t){const r=n.ee.get(t);e&&"object"==typeof e&&(Object.entries(e).forEach((e=>{let[t,n]=e;void 0===u[t]&&(s[t]?s[t].forEach((e=>{n?(0,i.p)("feat-"+t,[],void 0,e,r):(0,i.p)("block-"+t,[],void 0,e,r),(0,i.p)("rumresp-"+t,[Boolean(n)],void 0,e,r)})):n&&(0,i.p)("feat-"+t,[],void 0,void 0,r),u[t]=Boolean(n))})),Object.keys(s).forEach((e=>{void 0===u[e]&&(s[e]?.forEach((t=>(0,i.p)("rumresp-"+e,[!1],void 0,t,r))),u[e]=!1)})),(0,o.L)(t,a.D.pageViewEvent))}const u={}},2210:(e,t,r)=>{r.d(t,{X:()=>i});var n=Object.prototype.hasOwnProperty;function i(e,t,r){if(n.call(e,t))return e[t];var i=r();if(Object.defineProperty&&Object.keys)try{return Object.defineProperty(e,t,{value:i,writable:!0,enumerable:!1}),i}catch(e){}return e[t]=i,i}},1284:(e,t,r)=>{r.d(t,{D:()=>n});const n=(e,t)=>Object.entries(e||{}).map((e=>{let[r,n]=e;return t(r,n)}))},4351:(e,t,r)=>{r.d(t,{P:()=>o});var n=r(2177);const i=()=>{const e=new WeakSet;return(t,r)=>{if("object"==typeof r&&null!==r){if(e.has(r))return;e.add(r)}return r}};function o(e){try{return JSON.stringify(e,i())}catch(e){try{n.ee.emit("internal-error",[e])}catch(e){}}}},3960:(e,t,r)=>{r.d(t,{K:()=>a,b:()=>o});var n=r(3239);function i(){return"undefined"==typeof document||"complete"===document.readyState}function o(e,t){if(i())return e();(0,n.bP)("load",e,t)}function a(e){if(i())return e();(0,n.iz)("DOMContentLoaded",e)}},8632:(e,t,r)=>{r.d(t,{EZ:()=>u,Qy:()=>c,ce:()=>o,fP:()=>a,gG:()=>d,mF:()=>s});var n=r(7894),i=r(385);const o={beacon:"bam.nr-data.net",errorBeacon:"bam.nr-data.net"};function a(){return i._A.NREUM||(i._A.NREUM={}),void 0===i._A.newrelic&&(i._A.newrelic=i._A.NREUM),i._A.NREUM}function s(){let e=a();return e.o||(e.o={ST:i._A.setTimeout,SI:i._A.setImmediate,CT:i._A.clearTimeout,XHR:i._A.XMLHttpRequest,REQ:i._A.Request,EV:i._A.Event,PR:i._A.Promise,MO:i._A.MutationObserver,FETCH:i._A.fetch}),e}function c(e,t,r){let i=a();const o=i.initializedAgents||{},s=o[e]||{};return Object.keys(s).length||(s.initializedAt={ms:(0,n.z)(),date:new Date}),i.initializedAgents={...o,[e]:{...s,[r]:t}},i}function u(e,t){a()[e]=t}function d(){return function(){let e=a();const t=e.info||{};e.info={beacon:o.beacon,errorBeacon:o.errorBeacon,...t}}(),function(){let e=a();const t=e.init||{};e.init={...t}}(),s(),function(){let e=a();const t=e.loader_config||{};e.loader_config={...t}}(),a()}},7956:(e,t,r)=>{r.d(t,{N:()=>i});var n=r(3239);function i(e){let t=arguments.length>1&&void 0!==arguments[1]&&arguments[1],r=arguments.length>2?arguments[2]:void 0,i=arguments.length>3?arguments[3]:void 0;return void(0,n.iz)("visibilitychange",(function(){if(t)return void("hidden"==document.visibilityState&&e());e(document.visibilityState)}),r,i)}},1214:(e,t,r)=>{r.d(t,{em:()=>v,u5:()=>N,QU:()=>S,_L:()=>I,Gm:()=>L,Lg:()=>M,gy:()=>U,BV:()=>Q,Kf:()=>ee});var n=r(2177);const i="nr@original";var o=Object.prototype.hasOwnProperty,a=!1;function s(e,t){return e||(e=n.ee),r.inPlace=function(e,t,n,i,o){n||(n="");var a,s,c,u="-"===n.charAt(0);for(c=0;c 2?n-2:0),o=2;o {r(A[T],e,w),r(E[T],e,w)})),r(l._A,"fetch",y),t.on(y+"end",(function(e,r){var n=this;if(r){var i=r.headers.get("content-length");null!==i&&(n.rxSize=i),t.emit(y+"done",[null,r],n)}else t.emit(y+"done",[e],n)})),t}const O={},j=["pushState","replaceState"];function S(e){const t=function(e){return(e||n.ee).get("history")}(e);return!l.il||O[t.debugId]++||(O[t.debugId]=1,s(t).inPlace(window.history,j,"-")),t}var P=r(3239);const C={},R=["appendChild","insertBefore","replaceChild"];function I(e){const t=function(e){return(e||n.ee).get("jsonp")}(e);if(!l.il||C[t.debugId])return t;C[t.debugId]=!0;var r=s(t),i=/[?&](?:callback|cb)=([^&#]+)/,o=/(.*)\.([^.]+)/,a=/^(\w+)(\.|$)(.*)$/;function c(e,t){var r=e.match(a),n=r[1],i=r[3];return i?c(i,t[n]):t[n]}return r.inPlace(Node.prototype,R,"dom-"),t.on("dom-start",(function(e){!function(e){if(!e||"string"!=typeof e.nodeName||"script"!==e.nodeName.toLowerCase())return;if("function"!=typeof e.addEventListener)return;var n=(a=e.src,s=a.match(i),s?s[1]:null);var a,s;if(!n)return;var u=function(e){var t=e.match(o);if(t&&t.length>=3)return{key:t[2],parent:c(t[1],window)};return{key:e,parent:window}}(n);if("function"!=typeof u.parent[u.key])return;var d={};function f(){t.emit("jsonp-end",[],d),e.removeEventListener("load",f,(0,P.m$)(!1)),e.removeEventListener("error",l,(0,P.m$)(!1))}function l(){t.emit("jsonp-error",[],d),t.emit("jsonp-end",[],d),e.removeEventListener("load",f,(0,P.m$)(!1)),e.removeEventListener("error",l,(0,P.m$)(!1))}r.inPlace(u.parent,[u.key],"cb-",d),e.addEventListener("load",f,(0,P.m$)(!1)),e.addEventListener("error",l,(0,P.m$)(!1)),t.emit("new-jsonp",[e.src],d)}(e[0])})),t}var k=r(5763);const H={};function L(e){const t=function(e){return(e||n.ee).get("mutation")}(e);if(!l.il||H[t.debugId])return t;H[t.debugId]=!0;var r=s(t),i=k.Yu.MO;return i&&(window.MutationObserver=function(e){return this instanceof i?new i(r(e,"fn-")):i.apply(this,arguments)},MutationObserver.prototype=i.prototype),t}const z={};function M(e){const t=function(e){return(e||n.ee).get("promise")}(e);if(z[t.debugId])return t;z[t.debugId]=!0;var r=n.c,o=s(t),a=k.Yu.PR;return a&&function(){function e(r){var n=t.context(),i=o(r,"executor-",n,null,!1);const s=Reflect.construct(a,[i],e);return t.context(s).getCtx=function(){return n},s}l._A.Promise=e,Object.defineProperty(e,"name",{value:"Promise"}),e.toString=function(){return a.toString()},Object.setPrototypeOf(e,a),["all","race"].forEach((function(r){const n=a[r];e[r]=function(e){let i=!1;[...e||[]].forEach((e=>{this.resolve(e).then(a("all"===r),a(!1))}));const o=n.apply(this,arguments);return o;function a(e){return function(){t.emit("propagate",[null,!i],o,!1,!1),i=i||!e}}}})),["resolve","reject"].forEach((function(r){const n=a[r];e[r]=function(e){const r=n.apply(this,arguments);return e!==r&&t.emit("propagate",[e,!0],r,!1,!1),r}})),e.prototype=a.prototype;const n=a.prototype.then;a.prototype.then=function(){var e=this,i=r(e);i.promise=e;for(var a=arguments.length,s=new Array(a),c=0;c e())),t};function m(e,t){i.inPlace(t,["onreadystatechange"],"fn-",E)}function b(){var e=this,t=r.context(e);e.readyState>3&&!t.resolved&&(t.resolved=!0,r.emit("xhr-resolved",[],e)),i.inPlace(e,f,"fn-",E)}if(function(e,t){for(var r in e)t[r]=e[r]}(o,p),p.prototype=o.prototype,i.inPlace(p.prototype,J,"-xhr-",E),r.on("send-xhr-start",(function(e,t){m(e,t),function(e){h.push(e),a&&(y?y.then(A):u?u(A):(w=-w,x.data=w))}(t)})),r.on("open-xhr-start",m),a){var y=c&&c.resolve();if(!u&&!c){var w=1,x=document.createTextNode(w);new a(A).observe(x,{characterData:!0})}}else t.on("fn-end",(function(e){e[0]&&e[0].type===d||A()}));function A(){for(var e=0;e {r.d(t,{t:()=>n});const n=r(3325).D.ajax},6660:(e,t,r)=>{r.d(t,{A:()=>i,t:()=>n});const n=r(3325).D.jserrors,i="nr@seenError"},3081:(e,t,r)=>{r.d(t,{gF:()=>o,mY:()=>i,t9:()=>n,vz:()=>s,xS:()=>a});const n=r(3325).D.metrics,i="sm",o="cm",a="storeSupportabilityMetrics",s="storeEventMetrics"},4649:(e,t,r)=>{r.d(t,{t:()=>n});const n=r(3325).D.pageAction},7633:(e,t,r)=>{r.d(t,{Dz:()=>i,OJ:()=>a,qw:()=>o,t9:()=>n});const n=r(3325).D.pageViewEvent,i="firstbyte",o="domcontent",a="windowload"},9251:(e,t,r)=>{r.d(t,{t:()=>n});const n=r(3325).D.pageViewTiming},3614:(e,t,r)=>{r.d(t,{BST_RESOURCE:()=>i,END:()=>s,FEATURE_NAME:()=>n,FN_END:()=>u,FN_START:()=>c,PUSH_STATE:()=>d,RESOURCE:()=>o,START:()=>a});const n=r(3325).D.sessionTrace,i="bstResource",o="resource",a="-start",s="-end",c="fn"+a,u="fn"+s,d="pushState"},7836:(e,t,r)=>{r.d(t,{BODY:()=>A,CB_END:()=>E,CB_START:()=>u,END:()=>x,FEATURE_NAME:()=>i,FETCH:()=>_,FETCH_BODY:()=>v,FETCH_DONE:()=>m,FETCH_START:()=>p,FN_END:()=>c,FN_START:()=>s,INTERACTION:()=>l,INTERACTION_API:()=>d,INTERACTION_EVENTS:()=>o,JSONP_END:()=>b,JSONP_NODE:()=>g,JS_TIME:()=>T,MAX_TIMER_BUDGET:()=>a,REMAINING:()=>f,SPA_NODE:()=>h,START:()=>w,originalSetTimeout:()=>y});var n=r(5763);const i=r(3325).D.spa,o=["click","submit","keypress","keydown","keyup","change"],a=999,s="fn-start",c="fn-end",u="cb-start",d="api-ixn-",f="remaining",l="interaction",h="spaNode",g="jsonpNode",p="fetch-start",m="fetch-done",v="fetch-body-",b="jsonp-end",y=n.Yu.ST,w="-start",x="-end",A="-body",E="cb"+x,T="jsTime",_="fetch"},5938:(e,t,r)=>{r.d(t,{W:()=>o});var n=r(5763),i=r(2177);class o{constructor(e,t,r){this.agentIdentifier=e,this.aggregator=t,this.ee=i.ee.get(e,(0,n.OP)(this.agentIdentifier).isolatedBacklog),this.featureName=r,this.blocked=!1}}},9144:(e,t,r)=>{r.d(t,{j:()=>m});var n=r(3325),i=r(5763),o=r(5546),a=r(2177),s=r(7894),c=r(8e3),u=r(3960),d=r(385),f=r(50),l=r(3081),h=r(8632);function g(){const e=(0,h.gG)();["setErrorHandler","finished","addToTrace","inlineHit","addRelease","addPageAction","setCurrentRouteName","setPageViewName","setCustomAttribute","interaction","noticeError","setUserId"].forEach((t=>{e[t]=function(){for(var r=arguments.length,n=new Array(r),i=0;i 1?r-1:0),i=1;i {e.exposed&&e.api[t]&&o.push(e.api[t](...n))})),o.length>1?o:o[0]}(t,...n)}}))}var p=r(2587);function m(e){let t=arguments.length>1&&void 0!==arguments[1]?arguments[1]:{},m=arguments.length>2?arguments[2]:void 0,v=arguments.length>3?arguments[3]:void 0,{init:b,info:y,loader_config:w,runtime:x={loaderType:m},exposed:A=!0}=t;const E=(0,h.gG)();y||(b=E.init,y=E.info,w=E.loader_config),(0,i.Dg)(e,b||{}),(0,i.GE)(e,w||{}),(0,i.sU)(e,x),y.jsAttributes??={},d.v6&&(y.jsAttributes.isWorker=!0),(0,i.CX)(e,y),g();const T=function(e,t){t||(0,c.R)(e,"api");const h={};var g=a.ee.get(e),p=g.get("tracer"),m="api-",v=m+"ixn-";function b(t,r,n,o){const a=(0,i.C5)(e);return null===r?delete a.jsAttributes[t]:(0,i.CX)(e,{...a,jsAttributes:{...a.jsAttributes,[t]:r}}),x(m,n,!0,o||null===r?"session":void 0)(t,r)}function y(){}["setErrorHandler","finished","addToTrace","inlineHit","addRelease"].forEach((e=>h[e]=x(m,e,!0,"api"))),h.addPageAction=x(m,"addPageAction",!0,n.D.pageAction),h.setCurrentRouteName=x(m,"routeName",!0,n.D.spa),h.setPageViewName=function(t,r){if("string"==typeof t)return"/"!==t.charAt(0)&&(t="/"+t),(0,i.OP)(e).customTransaction=(r||"http://custom.transaction")+t,x(m,"setPageViewName",!0)()},h.setCustomAttribute=function(e,t){let r=arguments.length>2&&void 0!==arguments[2]&&arguments[2];if("string"==typeof e){if(["string","number"].includes(typeof t)||null===t)return b(e,t,"setCustomAttribute",r);(0,f.Z)("Failed to execute setCustomAttribute.\nNon-null value must be a string or number type, but a type of was provided."))}else(0,f.Z)("Failed to execute setCustomAttribute.\nName must be a string type, but a type of was provided."))},h.setUserId=function(e){if("string"==typeof e||null===e)return b("enduser.id",e,"setUserId",!0);(0,f.Z)("Failed to execute setUserId.\nNon-null value must be a string type, but a type of was provided."))},h.interaction=function(){return(new y).get()};var w=y.prototype={createTracer:function(e,t){var r={},i=this,a="function"==typeof t;return(0,o.p)(v+"tracer",[(0,s.z)(),e,r],i,n.D.spa,g),function(){if(p.emit((a?"":"no-")+"fn-start",[(0,s.z)(),i,a],r),a)try{return t.apply(this,arguments)}catch(e){throw p.emit("fn-err",[arguments,this,"string"==typeof e?new Error(e):e],r),e}finally{p.emit("fn-end",[(0,s.z)()],r)}}}};function x(e,t,r,i){return function(){return(0,o.p)(l.xS,["API/"+t+"/called"],void 0,n.D.metrics,g),i&&(0,o.p)(e+t,[(0,s.z)(),...arguments],r?null:this,i,g),r?void 0:this}}function A(){r.e(439).then(r.bind(r,7438)).then((t=>{let{setAPI:r}=t;r(e),(0,c.L)(e,"api")})).catch((()=>(0,f.Z)("Downloading runtime APIs failed...")))}return["actionText","setName","setAttribute","save","ignore","onEnd","getContext","end","get"].forEach((e=>{w[e]=x(v,e,void 0,n.D.spa)})),h.noticeError=function(e,t){"string"==typeof e&&(e=new Error(e)),(0,o.p)(l.xS,["API/noticeError/called"],void 0,n.D.metrics,g),(0,o.p)("err",[e,(0,s.z)(),!1,t],void 0,n.D.jserrors,g)},d.il?(0,u.b)((()=>A()),!0):A(),h}(e,v);return(0,h.Qy)(e,T,"api"),(0,h.Qy)(e,A,"exposed"),(0,h.EZ)("activatedFeatures",p.T),T}},3325:(e,t,r)=>{r.d(t,{D:()=>n,p:()=>i});const n={ajax:"ajax",jserrors:"jserrors",metrics:"metrics",pageAction:"page_action",pageViewEvent:"page_view_event",pageViewTiming:"page_view_timing",sessionReplay:"session_replay",sessionTrace:"session_trace",spa:"spa"},i={[n.pageViewEvent]:1,[n.pageViewTiming]:2,[n.metrics]:3,[n.jserrors]:4,[n.ajax]:5,[n.sessionTrace]:6,[n.pageAction]:7,[n.spa]:8,[n.sessionReplay]:9}}},n={};function i(e){var t=n[e];if(void 0!==t)return t.exports;var o=n[e]={exports:{}};return r[e](o,o.exports,i),o.exports}i.m=r,i.d=(e,t)=>{for(var r in t)i.o(t,r)&&!i.o(e,r)&&Object.defineProperty(e,r,{enumerable:!0,get:t[r]})},i.f={},i.e=e=>Promise.all(Object.keys(i.f).reduce(((t,r)=>(i.f[r](e,t),t)),[])),i.u=e=>(({78:"page_action-aggregate",147:"metrics-aggregate",242:"session-manager",317:"jserrors-aggregate",348:"page_view_timing-aggregate",412:"lazy-feature-loader",439:"async-api",538:"recorder",590:"session_replay-aggregate",675:"compressor",733:"session_trace-aggregate",786:"page_view_event-aggregate",873:"spa-aggregate",898:"ajax-aggregate"}[e]||e)+"."+{78:"ac76d497",147:"3dc53903",148:"1a20d5fe",242:"2a64278a",317:"49e41428",348:"bd6de33a",412:"2f55ce66",439:"30bd804e",538:"1b18459f",590:"cf0efb30",675:"ae9f91a8",733:"83105561",786:"06482edd",860:"03a8b7a5",873:"e6b09d52",898:"998ef92b"}[e]+"-1.236.0.min.js"),i.o=(e,t)=>Object.prototype.hasOwnProperty.call(e,t),e={},t="NRBA:",i.l=(r,n,o,a)=>{if(e[r])e[r].push(n);else{var s,c;if(void 0!==o)for(var u=document.getElementsByTagName("script"),d=0;d {s.onerror=s.onload=null,clearTimeout(h);var i=e[r];if(delete e[r],s.parentNode&&s.parentNode.removeChild(s),i&&i.forEach((e=>e(n))),t)return t(n)},h=setTimeout(l.bind(null,void 0,{type:"timeout",target:s}),12e4);s.onerror=l.bind(null,s.onerror),s.onload=l.bind(null,s.onload),c&&document.head.appendChild(s)}},i.r=e=>{"undefined"!=typeof Symbol&&Symbol.toStringTag&&Object.defineProperty(e,Symbol.toStringTag,{value:"Module"}),Object.defineProperty(e,"__esModule",{value:!0})},i.j=364,i.p="https://js-agent.newrelic.com/",(()=>{var e={364:0,953:0};i.f.j=(t,r)=>{var n=i.o(e,t)?e[t]:void 0;if(0!==n)if(n)r.push(n[2]);else{var o=new Promise(((r,i)=>n=e[t]=[r,i]));r.push(n[2]=o);var a=i.p+i.u(t),s=new Error;i.l(a,(r=>{if(i.o(e,t)&&(0!==(n=e[t])&&(e[t]=void 0),n)){var o=r&&("load"===r.type?"missing":r.type),a=r&&r.target&&r.target.src;s.message="Loading chunk "+t+" failed.\n("+o+": "+a+")",s.name="ChunkLoadError",s.type=o,s.request=a,n[1](s)}}),"chunk-"+t,t)}};var t=(t,r)=>{var n,o,[a,s,c]=r,u=0;if(a.some((t=>0!==e[t]))){for(n in s)i.o(s,n)&&(i.m[n]=s[n]);if(c)c(i)}for(t&&t(r);u {i.r(o);var e=i(3325),t=i(5763);const r=Object.values(e.D);function n(e){const n={};return r.forEach((r=>{n[r]=function(e,r){return!1!==(0,t.Mt)(r,"".concat(e,".enabled"))}(r,e)})),n}var a=i(9144);var s=i(5546),c=i(385),u=i(8e3),d=i(5938),f=i(3960),l=i(50);class h extends d.W{constructor(e,t,r){let n=!(arguments.length>3&&void 0!==arguments[3])||arguments[3];super(e,t,r),this.auto=n,this.abortHandler,this.featAggregate,this.onAggregateImported,n&&(0,u.R)(e,r)}importAggregator(){let e=arguments.length>0&&void 0!==arguments[0]?arguments[0]:{};if(this.featAggregate||!this.auto)return;const r=c.il&&!0===(0,t.Mt)(this.agentIdentifier,"privacy.cookies_enabled");let n;this.onAggregateImported=new Promise((e=>{n=e}));const o=async()=>{let t;try{if(r){const{setupAgentSession:e}=await Promise.all([i.e(860),i.e(242)]).then(i.bind(i,3228));t=e(this.agentIdentifier)}}catch(e){(0,l.Z)("A problem occurred when starting up session manager. This page will not start or extend any session.",e)}try{if(!this.shouldImportAgg(this.featureName,t))return void(0,u.L)(this.agentIdentifier,this.featureName);const{lazyFeatureLoader:r}=await i.e(412).then(i.bind(i,8582)),{Aggregate:o}=await r(this.featureName,"aggregate");this.featAggregate=new o(this.agentIdentifier,this.aggregator,e),n(!0)}catch(e){(0,l.Z)("Downloading and initializing ".concat(this.featureName," failed..."),e),this.abortHandler?.(),n(!1)}};c.il?(0,f.b)((()=>o()),!0):o()}shouldImportAgg(r,n){return r!==e.D.sessionReplay||!1!==(0,t.Mt)(this.agentIdentifier,"session_trace.enabled")&&(!!n?.isNew||!!n?.state.sessionReplay)}}var g=i(7633),p=i(7894);class m extends h{static featureName=g.t9;constructor(r,n){let i=!(arguments.length>2&&void 0!==arguments[2])||arguments[2];if(super(r,n,g.t9,i),("undefined"==typeof PerformanceNavigationTiming||c.Tt)&&"undefined"!=typeof PerformanceTiming){const n=(0,t.OP)(r);n[g.Dz]=Math.max(Date.now()-n.offset,0),(0,f.K)((()=>n[g.qw]=Math.max((0,p.z)()-n[g.Dz],0))),(0,f.b)((()=>{const t=(0,p.z)();n[g.OJ]=Math.max(t-n[g.Dz],0),(0,s.p)("timing",["load",t],void 0,e.D.pageViewTiming,this.ee)}))}this.importAggregator()}}var v=i(1117),b=i(1284);class y extends v.w{constructor(e){super(e),this.aggregatedData={}}store(e,t,r,n,i){var o=this.getBucket(e,t,r,i);return o.metrics=function(e,t){t||(t={count:0});return t.count+=1,(0,b.D)(e,(function(e,r){t[e]=w(r,t[e])})),t}(n,o.metrics),o}merge(e,t,r,n,i){var o=this.getBucket(e,t,n,i);if(o.metrics){var a=o.metrics;a.count+=r.count,(0,b.D)(r,(function(e,t){if("count"!==e){var n=a[e],i=r[e];i&&!i.c?a[e]=w(i.t,n):a[e]=function(e,t){if(!t)return e;t.c||(t=x(t.t));return t.min=Math.min(e.min,t.min),t.max=Math.max(e.max,t.max),t.t+=e.t,t.sos+=e.sos,t.c+=e.c,t}(i,a[e])}}))}else o.metrics=r}storeMetric(e,t,r,n){var i=this.getBucket(e,t,r);return i.stats=w(n,i.stats),i}getBucket(e,t,r,n){this.aggregatedData[e]||(this.aggregatedData[e]={});var i=this.aggregatedData[e][t];return i||(i=this.aggregatedData[e][t]={params:r||{}},n&&(i.custom=n)),i}get(e,t){return t?this.aggregatedData[e]&&this.aggregatedData[e][t]:this.aggregatedData[e]}take(e){for(var t={},r="",n=!1,i=0;i t.max&&(t.max=e),e 2&&void 0!==arguments[2])||arguments[2];super(e,r,j.t,n),c.il&&((0,t.OP)(e).initHidden=Boolean("hidden"===document.visibilityState),(0,N.N)((()=>(0,s.p)("docHidden",[(0,p.z)()],void 0,j.t,this.ee)),!0),(0,O.bP)("pagehide",(()=>(0,s.p)("winPagehide",[(0,p.z)()],void 0,j.t,this.ee))),this.importAggregator())}}var P=i(3081);class C extends h{static featureName=P.t9;constructor(e,t){let r=!(arguments.length>2&&void 0!==arguments[2])||arguments[2];super(e,t,P.t9,r),this.importAggregator()}}var R,I=i(2210),k=i(1214),H=i(2177),L={};try{R=localStorage.getItem("__nr_flags").split(","),console&&"function"==typeof console.log&&(L.console=!0,-1!==R.indexOf("dev")&&(L.dev=!0),-1!==R.indexOf("nr_dev")&&(L.nrDev=!0))}catch(e){}function z(e){try{L.console&&z(e)}catch(e){}}L.nrDev&&H.ee.on("internal-error",(function(e){z(e.stack)})),L.dev&&H.ee.on("fn-err",(function(e,t,r){z(r.stack)})),L.dev&&(z("NR AGENT IN DEVELOPMENT MODE"),z("flags: "+(0,b.D)(L,(function(e,t){return e})).join(", ")));var M=i(6660);class B extends h{static featureName=M.t;constructor(r,n){let i=!(arguments.length>2&&void 0!==arguments[2])||arguments[2];super(r,n,M.t,i),this.skipNext=0;try{this.removeOnAbort=new AbortController}catch(e){}const o=this;o.ee.on("fn-start",(function(e,t,r){o.abortHandler&&(o.skipNext+=1)})),o.ee.on("fn-err",(function(t,r,n){o.abortHandler&&!n[M.A]&&((0,I.X)(n,M.A,(function(){return!0})),this.thrown=!0,(0,s.p)("err",[n,(0,p.z)()],void 0,e.D.jserrors,o.ee))})),o.ee.on("fn-end",(function(){o.abortHandler&&!this.thrown&&o.skipNext>0&&(o.skipNext-=1)})),o.ee.on("internal-error",(function(t){(0,s.p)("ierr",[t,(0,p.z)(),!0],void 0,e.D.jserrors,o.ee)})),this.origOnerror=c._A.onerror,c._A.onerror=this.onerrorHandler.bind(this),c._A.addEventListener("unhandledrejection",(t=>{const r=function(e){let t="Unhandled Promise Rejection: ";if(e instanceof Error)try{return e.message=t+e.message,e}catch(t){return e}if(void 0===e)return new Error(t);try{return new Error(t+(0,D.P)(e))}catch(e){return new Error(t)}}(t.reason);(0,s.p)("err",[r,(0,p.z)(),!1,{unhandledPromiseRejection:1}],void 0,e.D.jserrors,this.ee)}),(0,O.m$)(!1,this.removeOnAbort?.signal)),(0,k.gy)(this.ee),(0,k.BV)(this.ee),(0,k.em)(this.ee),(0,t.OP)(r).xhrWrappable&&(0,k.Kf)(this.ee),this.abortHandler=this.#e,this.importAggregator()}#e(){this.removeOnAbort?.abort(),this.abortHandler=void 0}onerrorHandler(t,r,n,i,o){"function"==typeof this.origOnerror&&this.origOnerror(...arguments);try{this.skipNext?this.skipNext-=1:(0,s.p)("err",[o||new F(t,r,n),(0,p.z)()],void 0,e.D.jserrors,this.ee)}catch(t){try{(0,s.p)("ierr",[t,(0,p.z)(),!0],void 0,e.D.jserrors,this.ee)}catch(e){}}return!1}}function F(e,t,r){this.message=e||"Uncaught error with no additional information",this.sourceURL=t,this.line=r}let U=1;const q="nr@id";function G(e){const t=typeof e;return!e||"object"!==t&&"function"!==t?-1:e===c._A?0:(0,I.X)(e,q,(function(){return U++}))}function V(e){if("string"==typeof e&&e.length)return e.length;if("object"==typeof e){if("undefined"!=typeof ArrayBuffer&&e instanceof ArrayBuffer&&e.byteLength)return e.byteLength;if("undefined"!=typeof Blob&&e instanceof Blob&&e.size)return e.size;if(!("undefined"!=typeof FormData&&e instanceof FormData))try{return(0,D.P)(e).length}catch(e){return}}}var X=i(7243);class W{constructor(e){this.agentIdentifier=e,this.generateTracePayload=this.generateTracePayload.bind(this),this.shouldGenerateTrace=this.shouldGenerateTrace.bind(this)}generateTracePayload(e){if(!this.shouldGenerateTrace(e))return null;var r=(0,t.DL)(this.agentIdentifier);if(!r)return null;var n=(r.accountID||"").toString()||null,i=(r.agentID||"").toString()||null,o=(r.trustKey||"").toString()||null;if(!n||!i)return null;var a=(0,_.M)(),s=(0,_.Ht)(),c=Date.now(),u={spanId:a,traceId:s,timestamp:c};return(e.sameOrigin||this.isAllowedOrigin(e)&&this.useTraceContextHeadersForCors())&&(u.traceContextParentHeader=this.generateTraceContextParentHeader(a,s),u.traceContextStateHeader=this.generateTraceContextStateHeader(a,c,n,i,o)),(e.sameOrigin&&!this.excludeNewrelicHeader()||!e.sameOrigin&&this.isAllowedOrigin(e)&&this.useNewrelicHeaderForCors())&&(u.newrelicHeader=this.generateTraceHeader(a,s,c,n,i,o)),u}generateTraceContextParentHeader(e,t){return"00-"+t+"-"+e+"-01"}generateTraceContextStateHeader(e,t,r,n,i){return i+"@nr=0-1-"+r+"-"+n+"-"+e+"----"+t}generateTraceHeader(e,t,r,n,i,o){if(!("function"==typeof c._A?.btoa))return null;var a={v:[0,1],d:{ty:"Browser",ac:n,ap:i,id:e,tr:t,ti:r}};return o&&n!==o&&(a.d.tk=o),btoa((0,D.P)(a))}shouldGenerateTrace(e){return this.isDtEnabled()&&this.isAllowedOrigin(e)}isAllowedOrigin(e){var r=!1,n={};if((0,t.Mt)(this.agentIdentifier,"distributed_tracing")&&(n=(0,t.P_)(this.agentIdentifier).distributed_tracing),e.sameOrigin)r=!0;else if(n.allowed_origins instanceof Array)for(var i=0;i 2&&void 0!==arguments[2])||arguments[2];super(r,n,Z.t,i),(0,t.OP)(r).xhrWrappable&&(this.dt=new W(r),this.handler=(e,t,r,n)=>(0,s.p)(e,t,r,n,this.ee),(0,k.u5)(this.ee),(0,k.Kf)(this.ee),function(r,n,i,o){function a(e){var t=this;t.totalCbs=0,t.called=0,t.cbTime=0,t.end=E,t.ended=!1,t.xhrGuids={},t.lastSize=null,t.loadCaptureCalled=!1,t.params=this.params||{},t.metrics=this.metrics||{},e.addEventListener("load",(function(r){_(t,e)}),(0,O.m$)(!1)),c.IF||e.addEventListener("progress",(function(e){t.lastSize=e.loaded}),(0,O.m$)(!1))}function s(e){this.params={method:e[0]},T(this,e[1]),this.metrics={}}function u(e,n){var i=(0,t.DL)(r);i.xpid&&this.sameOrigin&&n.setRequestHeader("X-NewRelic-ID",i.xpid);var a=o.generateTracePayload(this.parsedOrigin);if(a){var s=!1;a.newrelicHeader&&(n.setRequestHeader("newrelic",a.newrelicHeader),s=!0),a.traceContextParentHeader&&(n.setRequestHeader("traceparent",a.traceContextParentHeader),a.traceContextStateHeader&&n.setRequestHeader("tracestate",a.traceContextStateHeader),s=!0),s&&(this.dt=a)}}function d(e,t){var r=this.metrics,i=e[0],o=this;if(r&&i){var a=V(i);a&&(r.txSize=a)}this.startTime=(0,p.z)(),this.listener=function(e){try{"abort"!==e.type||o.loadCaptureCalled||(o.params.aborted=!0),("load"!==e.type||o.called===o.totalCbs&&(o.onloadCalled||"function"!=typeof t.onload)&&"function"==typeof o.end)&&o.end(t)}catch(e){try{n.emit("internal-error",[e])}catch(e){}}};for(var s=0;s 1?e[1]=i:e.push(i)}else e[0]&&e[0].headers&&s(e[0].headers,n)&&(this.dt=n);function s(e,t){var r=!1;return t.newrelicHeader&&(e.set("newrelic",t.newrelicHeader),r=!0),t.traceContextParentHeader&&(e.set("traceparent",t.traceContextParentHeader),t.traceContextStateHeader&&e.set("tracestate",t.traceContextStateHeader),r=!0),r}}function x(e,t){this.params={},this.metrics={},this.startTime=(0,p.z)(),this.dt=t,e.length>=1&&(this.target=e[0]),e.length>=2&&(this.opts=e[1]);var r,n=this.opts||{},i=this.target;"string"==typeof i?r=i:"object"==typeof i&&i instanceof Y?r=i.url:c._A?.URL&&"object"==typeof i&&i instanceof URL&&(r=i.href),T(this,r);var o=(""+(i&&i instanceof Y&&i.method||n.method||"GET")).toUpperCase();this.params.method=o,this.txSize=V(n.body)||0}function A(t,r){var n;this.endTime=(0,p.z)(),this.params||(this.params={}),this.params.status=r?r.status:0,"string"==typeof this.rxSize&&this.rxSize.length>0&&(n=+this.rxSize);var o={txSize:this.txSize,rxSize:n,duration:(0,p.z)()-this.startTime};i("xhr",[this.params,o,this.startTime,this.endTime,"fetch"],this,e.D.ajax)}function E(t){var r=this.params,n=this.metrics;if(!this.ended){this.ended=!0;for(var o=0;o 2&&void 0!==arguments[2])||arguments[2];super(e,t,we.t,r),this.importAggregator()}}new class{constructor(e){let t=arguments.length>1&&void 0!==arguments[1]?arguments[1]:(0,_.ky)(16);c._A?(this.agentIdentifier=t,this.sharedAggregator=new y({agentIdentifier:this.agentIdentifier}),this.features={},this.desiredFeatures=new Set(e.features||[]),this.desiredFeatures.add(m),Object.assign(this,(0,a.j)(this.agentIdentifier,e,e.loaderType||"agent")),this.start()):(0,l.Z)("Failed to initial the agent. Could not determine the runtime environment.")}get config(){return{info:(0,t.C5)(this.agentIdentifier),init:(0,t.P_)(this.agentIdentifier),loader_config:(0,t.DL)(this.agentIdentifier),runtime:(0,t.OP)(this.agentIdentifier)}}start(){const t="features";try{const r=n(this.agentIdentifier),i=[...this.desiredFeatures];i.sort(((t,r)=>e.p[t.featureName]-e.p[r.featureName])),i.forEach((t=>{if(r[t.featureName]||t.featureName===e.D.pageViewEvent){const n=function(t){switch(t){case e.D.ajax:return[e.D.jserrors];case e.D.sessionTrace:return[e.D.ajax,e.D.pageViewEvent];case e.D.sessionReplay:return[e.D.sessionTrace];case e.D.pageViewTiming:return[e.D.pageViewEvent];default:return[]}}(t.featureName);n.every((e=>r[e]))||(0,l.Z)("".concat(t.featureName," is enabled but one or more dependent features has been disabled (").concat((0,D.P)(n),"). This may cause unintended consequences or missing data...")),this.features[t.featureName]=new t(this.agentIdentifier,this.sharedAggregator)}})),(0,T.Qy)(this.agentIdentifier,this.features,t)}catch(e){(0,l.Z)("Failed to initialize all enabled instrument classes (agent aborted) -",e);for(const e in this.features)this.features[e].abortHandler?.();const r=(0,T.fP)();return delete r.initializedAgents[this.agentIdentifier]?.api,delete r.initializedAgents[this.agentIdentifier]?.[t],delete this.sharedAggregator,r.ee?.abort(),delete r.ee?.get(this.agentIdentifier),!1}}}({features:[J,m,S,class extends h{static featureName=oe;constructor(t,r){if(super(t,r,oe,!(arguments.length>2&&void 0!==arguments[2])||arguments[2]),!c.il)return;const n=this.ee;let i;(0,k.QU)(n),this.eventsEE=(0,k.em)(n),this.eventsEE.on(se,(function(e,t){this.bstStart=(0,p.z)()})),this.eventsEE.on(ae,(function(t,r){(0,s.p)("bst",[t[0],r,this.bstStart,(0,p.z)()],void 0,e.D.sessionTrace,n)})),n.on(ce+ne,(function(e){this.time=(0,p.z)(),this.startPath=location.pathname+location.hash})),n.on(ce+ie,(function(t){(0,s.p)("bstHist",[location.pathname+location.hash,this.startPath,this.time],void 0,e.D.sessionTrace,n)}));try{i=new PerformanceObserver((t=>{const r=t.getEntries();(0,s.p)(te,[r],void 0,e.D.sessionTrace,n)})),i.observe({type:re,buffered:!0})}catch(e){}this.importAggregator({resourceObserver:i})}},C,xe,B,class extends h{static featureName=de;constructor(e,r){if(super(e,r,de,!(arguments.length>2&&void 0!==arguments[2])||arguments[2]),!c.il)return;if(!(0,t.OP)(e).xhrWrappable)return;try{this.removeOnAbort=new AbortController}catch(e){}let n,i=0;const o=this.ee.get("tracer"),a=(0,k._L)(this.ee),s=(0,k.Lg)(this.ee),u=(0,k.BV)(this.ee),d=(0,k.Kf)(this.ee),f=this.ee.get("events"),l=(0,k.u5)(this.ee),h=(0,k.QU)(this.ee),g=(0,k.Gm)(this.ee);function m(e,t){h.emit("newURL",[""+window.location,t])}function v(){i++,n=window.location.hash,this[ve]=(0,p.z)()}function b(){i--,window.location.hash!==n&&m(0,!0);var e=(0,p.z)();this[pe]=~~this[pe]+e-this[ve],this[ye]=e}function y(e,t){e.on(t,(function(){this[t]=(0,p.z)()}))}this.ee.on(ve,v),s.on(be,v),a.on(be,v),this.ee.on(ye,b),s.on(ge,b),a.on(ge,b),this.ee.buffer([ve,ye,"xhr-resolved"],this.featureName),f.buffer([ve],this.featureName),u.buffer(["setTimeout"+le,"clearTimeout"+fe,ve],this.featureName),d.buffer([ve,"new-xhr","send-xhr"+fe],this.featureName),l.buffer([me+fe,me+"-done",me+he+fe,me+he+le],this.featureName),h.buffer(["newURL"],this.featureName),g.buffer([ve],this.featureName),s.buffer(["propagate",be,ge,"executor-err","resolve"+fe],this.featureName),o.buffer([ve,"no-"+ve],this.featureName),a.buffer(["new-jsonp","cb-start","jsonp-error","jsonp-end"],this.featureName),y(l,me+fe),y(l,me+"-done"),y(a,"new-jsonp"),y(a,"jsonp-end"),y(a,"cb-start"),h.on("pushState-end",m),h.on("replaceState-end",m),window.addEventListener("hashchange",m,(0,O.m$)(!0,this.removeOnAbort?.signal)),window.addEventListener("load",m,(0,O.m$)(!0,this.removeOnAbort?.signal)),window.addEventListener("popstate",(function(){m(0,i>1)}),(0,O.m$)(!0,this.removeOnAbort?.signal)),this.abortHandler=this.#e,this.importAggregator()}#e(){this.removeOnAbort?.abort(),this.abortHandler=void 0}}],loaderType:"spa"})})(),window.NRBA=o})(); window.jQuery || document.write(' ') CKEDITOR_BASEPATH='https://f1000research.com/js/vendor/ckeditor/' window.reactTheme = 'research'; window.MathJax = { CommonHTML: { linebreaks: { automatic: true } }, 'HTML-CSS': { linebreaks: { automatic: true } }, SVG: { linebreaks: { automatic: true } }, AuthorInit: function() { MathJax.Hub.Register.MessageHook('End Process', function () { let timeout = false; // holder for timeout id const delay = 250; // delay after event is "complete" to run callback const reflowMath = function() { const dispFormulas = document.querySelectorAll('.disp-formula.panel'); if (!dispFormulas) { return; } for (const dispFormula of dispFormulas) { const child = dispFormula.querySelector('.MathJax_Preview').nextSibling.firstChild; const isMultiline = MathJax.Hub.getAllJax(dispFormula)[0].root.isMultiline; if (dispFormula.offsetWidth < child.offsetWidth || isMultiline) { MathJax.Hub.Queue(['Rerender', MathJax.Hub, dispFormula]); } } }; window.addEventListener('resize', function() { clearTimeout(timeout); // clear the timeout timeout = setTimeout(reflowMath, delay); // start timing for event "completion" }); }); }, }; if (window.location.hash == '#_=_'){ window.location = window.location.href.split('#')[0] } !function(f,b,e,v,n,t,s){if(f.fbq)return;n=f.fbq=function() {n.callMethod? n.callMethod.apply(n,arguments):n.queue.push(arguments)} ;if(!f._fbq)f._fbq=n; n.push=n;n.loaded=!0;n.version='2.0';n.queue=[];t=b.createElement(e);t.async=!0; t.src=v;s=b.getElementsByTagName(e)[0];s.parentNode.insertBefore(t,s)}(window, document,'script','https://connect.facebook.net/en_US/fbevents.js'); fbq('init', '1641728616063202'); fbq('track', "PixelInitialized", {}); (function(h,o,t,j,a,r){ h.hj=h.hj||function(){(h.hj.q=h.hj.q||[]).push(arguments)}; h._hjSettings={hjid:2318163,hjsv:6}; a=o.getElementsByTagName('head')[0]; r=o.createElement('script');r.async=1; r.src=t+h._hjSettings.hjid+j+h._hjSettings.hjsv; a.appendChild(r); })(window,document,'https://static.hotjar.com/c/hotjar-','.js?sv='); search file_upload Submit your research search menu close search Browse Gateways & Collections How to Publish Submit your Research My Submissions Article Guidelines Article Guidelines (New Versions) Open Data, Software and Code Guidelines Open Data and Accessible Source Materials Guidelines (HSS) Open Data, Software and Code Guidelines (PSE) Prepublication Checks Production Process Posters and Slides Guidelines Document Guidelines Article Processing Charges Peer Review Finding Article Reviewers About How it Works For Reviewers Our Advisors Policies Glossary FAQs For Developers Newsroom Contact My Research Submissions Content and Tracking Alerts My Details Sign In file_upload Submit your research { "@context": "https://schema.org", "@type": "ScholarlyArticle", "mainEntityOfPage": { "@type": "WebPage", "@id": "https://f1000research.com/articles/15-314" }, "headline": "Views, Barriers and Facilitators of Policymakers, Pharmacists and Health Community Representative in...", "datePublished": "2026-02-24T06:08:24", "dateModified": "2026-05-04T07:09:37", "author": [ { "@type": "Person", "name": "Raden Aldizal Mahendra Rizkio Syamsudin" }, { "@type": "Person", "name": "Susi Ari Kristina" }, { "@type": "Person", "name": "Chairun Wiedyaningsih" }, { "@type": "Person", "name": "Pauline Siew Mei Lai" } ], "publisher": { "@type": "Organization", "name": "F1000Research", "logo": { "@type": "ImageObject", "url": "https://f1000research.com/img/AMP/F1000Research_image.png", "height": 480, "width": 60 } }, "image": { "@type": "ImageObject", "url": "https://f1000research.com/img/AMP/F1000Research_image.png", "height": 1200, "width": 150 }, "description": " Background Unused medicine poses a serious risk to community and environmental health. Several studies have been conducted on how patient behave however little is known about how this issue is viewed through the lens of different stakeholders. Objective To explore the views, barriers and facilitators of policymakers, pharmacists and community-representative on community behavior in managing unused medicines in Garut Regency, Indonesia. Methods A qualitative study was conducted with policymakers, pharmacists and community -representatives. Data were analyzed inductively using thematic analysis framework. Emergent themes were further interpreted using the Socio-Ecological approach to situate behaviors and challenges within individual, community, organizational, and policy levels. Results Fourty one participants were recruited. Five themes were identified: (1) Storing and disposing medicines, (2) causes of unused medicines, (3) individual-level barriers including knowledge gaps and cultural beliefs, (4) structural barriers such as limited facilities, regulatory gaps, and institutional constraints, and (5) facilitators including rising awareness, supportive legal frameworks, and cross-sectoral initiatives. Mapping these findings onto the Socio-Ecological approach highlighted the interplay between patient practices, social norms, institutional resources, and policy environments. Conclusion Stakeholders recognize that unused medicine management is shaped by multi-level factors beyond individual awareness. Effective interventions will require a comprehensive approach that integrates patient education, community engagement, health system support, and regulatory frameworks. " } { "@context": "http://schema.org", "@type": "BreadcrumbList", "itemListElement": [ { "@type": "ListItem", "position": "1", "item": { "@id": "https://f1000research.com/", "name": "Home" } }, { "@type": "ListItem", "position": "2", "item": { "@id": "https://f1000research.com/browse/articles", "name": "Browse" } }, { "@type": "ListItem", "position": "3", "item": { "@id": "https://f1000research.com/articles/15-314/v1", "name": "Views, Barriers and Facilitators of Policymakers, Pharmacists and..." } } ] } Home Browse Views, Barriers and Facilitators of Policymakers, Pharmacists and... ALL Metrics - Views Downloads Get PDF Get XML Cite How to cite this article Syamsudin RAMR, Kristina SA, Wiedyaningsih C and Lai PSM. Views, Barriers and Facilitators of Policymakers, Pharmacists and Health Community Representative in Managing Unused Medicine in a Socioeconomically Diverse District in Indonesia [version 1; peer review: 2 approved with reservations] . F1000Research 2026, 15 :314 ( https://doi.org/10.12688/f1000research.177671.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Research Article Views, Barriers and Facilitators of Policymakers, Pharmacists and Health Community Representative in Managing Unused Medicine in a Socioeconomically Diverse District in Indonesia [version 1; peer review: 2 approved with reservations] Raden Aldizal Mahendra Rizkio Syamsudin https://orcid.org/0009-0003-0813-0758 1,2 , Susi Ari Kristina https://orcid.org/0000-0003-4248-6830 3 , Chairun Wiedyaningsih 3 , Pauline Siew Mei Lai https://orcid.org/0000-0002-9940-9644 4,5 Raden Aldizal Mahendra Rizkio Syamsudin https://orcid.org/0009-0003-0813-0758 1,2 , Susi Ari Kristina https://orcid.org/0000-0003-4248-6830 3 , Chairun Wiedyaningsih 3 , Pauline Siew Mei Lai https://orcid.org/0000-0002-9940-9644 4,5 PUBLISHED 24 Feb 2026 Author details Author details 1 Pharmacy Program, Faculty of Mathematics and Natural Sciences, Universitas Garut, Garut, Indonesia 2 Doctoral Program of Pharmacy, Gadjah Mada University Faculty of Pharmacy, Yogyakarta, Special Region of Yogyakarta, Indonesia 3 Department of Pharmaceutical, Gadjah Mada University Faculty of Pharmacy, Yogyakarta, Special Region of Yogyakarta, Indonesia 4 Department of Primary Care Medicine, University of Malaya Faculty of Medicine, Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia 5 Sir Jeffrey Cheah Sunway Medical School, Sunway University School of Medical and Life Sciences, Bandar Sunway, Selangor, Malaysia Raden Aldizal Mahendra Rizkio Syamsudin Roles: Conceptualization, Formal Analysis, Investigation, Project Administration, Writing – Original Draft Preparation Susi Ari Kristina Roles: Conceptualization, Supervision, Validation, Writing – Review & Editing Chairun Wiedyaningsih Roles: Investigation, Supervision, Validation, Writing – Review & Editing Pauline Siew Mei Lai Roles: Data Curation, Methodology, Supervision, Writing – Review & Editing OPEN PEER REVIEW DETAILS REVIEWER STATUS Abstract Background Unused medicine poses a serious risk to community and environmental health. Several studies have been conducted on how patient behave however little is known about how this issue is viewed through the lens of different stakeholders. Objective To explore the views, barriers and facilitators of policymakers, pharmacists and community-representative on community behavior in managing unused medicines in Garut Regency, Indonesia. Methods A qualitative study was conducted with policymakers, pharmacists and community -representatives. Data were analyzed inductively using thematic analysis framework. Emergent themes were further interpreted using the Socio-Ecological approach to situate behaviors and challenges within individual, community, organizational, and policy levels. Results Fourty one participants were recruited. Five themes were identified: (1) Storing and disposing medicines, (2) causes of unused medicines, (3) individual-level barriers including knowledge gaps and cultural beliefs, (4) structural barriers such as limited facilities, regulatory gaps, and institutional constraints, and (5) facilitators including rising awareness, supportive legal frameworks, and cross-sectoral initiatives. Mapping these findings onto the Socio-Ecological approach highlighted the interplay between patient practices, social norms, institutional resources, and policy environments. Conclusion Stakeholders recognize that unused medicine management is shaped by multi-level factors beyond individual awareness. Effective interventions will require a comprehensive approach that integrates patient education, community engagement, health system support, and regulatory frameworks. READ ALL READ LESS Keywords Unused medicines, Stakeholder perspectives, Qualitative study, Thematic analysis, Socio-ecological approach Corresponding Author(s) Susi Ari Kristina ( [email protected] ) Close Corresponding author: Susi Ari Kristina Competing interests: No competing interests were disclosed. Grant information: This study was funded by the Indonesia Endowment Fund for Education (LPDP), Ministry of Finance, Republic of Indonesia (RAMRS as awardee). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Copyright: © 2026 Syamsudin RAMR et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Syamsudin RAMR, Kristina SA, Wiedyaningsih C and Lai PSM. Views, Barriers and Facilitators of Policymakers, Pharmacists and Health Community Representative in Managing Unused Medicine in a Socioeconomically Diverse District in Indonesia [version 1; peer review: 2 approved with reservations] . F1000Research 2026, 15 :314 ( https://doi.org/10.12688/f1000research.177671.1 ) First published: 24 Feb 2026, 15 :314 ( https://doi.org/10.12688/f1000research.177671.1 ) Latest published: 04 May 2026, 15 :314 ( https://doi.org/10.12688/f1000research.177671.2 )  There is a newer version of this article available. Suppress this message for one day. Introduction Pharmaceutical waste should become a global public health and environmental concern, with unused medicines representing a major contributor. When inappropriately consumed, especially by vulnerable populations such as children or older adults, unused medicines can lead to accidental poisoning or toxicity ( Insani et al., 2020 ). Expired medicine knowingly caused death to cancer patient in Yemen ( Associated Press, 2022 ). Improper disposal, such as burning, burying, or discarding medicines into household trash or water systems, contributes to soil and water contamination and poses risks to ecological health. This could pose serious risks as some antibiotic had already found in European river and seas ( Szymańska et al., 2019 ) while compound from common medicine for instance acetaminophen, β-blocker, carbamazepine, cetirizine, lidocaine, metformin, naproxen, trimethoprim or venlafaxine antidepressant had been found in every sampling site from the river at almost every continent ( Wilkinson et al., 2022 ). From an economic perspective, unused medicines represent wasted expenditure, not only at the household level however also for health systems and pharmacies that supply them. Estimated cost of collected medicine could be varies from 7,416 USD to 1,118,020 USD ( Wang et al., 2024 ). In high-income countries, generally structured return programs and pharmaceutical waste management policies have been established. Some countries in Europe mandated by law to accept unused medicine. In contrast, many low- and middle-income countries (LMICs), lack systematic approaches at both the national and local levels resulting in improper disposal practice ( Rogowska & Zimmermann, 2022 ). Despite being one of the world’s most populous countries with increasing pharmaceutical consumption, Indonesia does not have a national program, regulatory framework, or budget allocation dedicated to the management of household pharmaceutical waste ( Alfian, Rendrayani, et al., 2024b ). Consequently, households often rely on informal or unsafe disposal practices. Existing research in Indonesia and comparable contexts has largely examined unused medicines from the perspective of individual patients, often focusing on medication adherence and self-medication practices ( Insani et al., 2020 ). Some also examined perspectives from pharmacist about their willingness as collecting agent ( Alfian et al., 2023 ; Alfian, Azzahra, et al., 2024a ). Those work tend to emphasize individual-level knowledge and practices rather than broader structural and institutional factors. Yet, addressing unused medicines requires the involvement of multiple stakeholders, including policymakers, pharmacists, and community organizations who can influence not only household behaviours but also the systems that enable safe medicine management. Public health frameworks emphasize that health behaviours are not solely individual choices however are shaped by factors operating across multiple levels, including individual, community, organizational, and policy environments, also entitled as Socio-ecological approach ( Golden & Earp, 2012 ). This socio-ecological perspective underscores the importance of examining barriers and facilitators beyond the individual, and of designing interventions that align with these layered influences. Furthermore, this system could be applied in different settings to implement transformational change in health care system, for example reducing polypharmacy incident in Canada ( Tannenbaum et al., 2017 ). The present study therefore aims to explore stakeholders’ perspectives on community behaviour in managing unused medicines in Garut Regency, Indonesia. Specifically, it seeks to identify the barriers and facilitators that influence their management. By capturing insights from multiple stakeholders across government, professional, and community sectors, this study contributes to understanding how household practices intersect with systemic gaps, and provides evidence to inform the development of comprehensive strategies for pharmaceutical waste management in LMIC settings. Methods Study design This study employed a qualitative approach with descriptive design using Focus Group Discussions (FGD) as the primary data collection method to investigate the perspective from multiple stake holder in Garut Regency. FGD was chosen to enabling multi stakeholder participation in stating their perspectives and experiences while also using each other’s in describing unused medicine management in Garut Regency ( Jakobsen et al., 2023 ). Qualitative research was conducted due to its multifaceted nature to explore complex phenomena, giving relevance, and add holistic perspective in understanding one issue ( Lim, 2025 ). Study setting and context Administratively, Garut is often informally divided into three areas: northern, southern, and the central city region. Most government offices and administrative centers are located in the city area, creating disparities in access to public services, including health and environmental services, for communities in other regions ( Badan Pusat Statistik Kabupaten Garut, 2022 ). To address these disparities, the local Health Office operates Community Health Centers (Puskesmas) distributed across districts, supported by pharmacists who also establish private pharmacies in closer proximity to communities. In addition, the government launched the Family Welfare and Empowerment Team (Tim Penggerak Pemberdayaan dan Kesejahteraan Keluarga/TP PKK), a nationwide initiative implemented at the regency, district, and village levels. The TP PKK is composed of female volunteers who play a vital role in bridging communities and the government ( Sukmawati et al., 2025 ). Their responsibilities include monitoring the social and economic conditions of households and supporting health promotion initiatives at the community level. Despite these structures, no formal program or policy currently exists for the disposal of unused medicines at the household level, leaving communities without clear guidance or accessible facilities to manage pharmaceutical waste properly. Participant sampling and recruitment Eligible participants were representatives from selected institutions who possessed broad knowledge of medicine management, provided pharmaceutical services, and/or had experience in community health. They were required to have at least one year of professional experience in a related field and to obtain an official recommendation from their institutional leader. Participants were excluded if they had less than one year of relevant professional experience, did not receive formal approval from their institution, were on temporary leave or not actively engaged in their professional duties during data collection, declined to provide informed consent, or had potential conflicts of interest that might compromise the integrity of the study. No prior relationship was established between the researcher and participants before the study commenced. This study employed purposive sampling in purpose to choosing individual with relevant experience and perspective while fairly representing their institution. Purposive sampling was chosen to met convenience element in voluntary nature of all participant ( Campbell et al., 2020 ). Eligible participants were representatives from selected institutions who possessed broad knowledge of medicine management, provided pharmaceutical services, and/or had experience in community health. They were required to have at least one year of professional experience in a related field and to obtain an official recommendation from their institutional leader. Participants were excluded if they had less than one year of relevant professional experience, did not receive formal approval from their institution, were on temporary leave or not actively engaged in their professional duties during data collection, declined to provide informed consent, or had potential conflicts of interest that might compromise the integrity of the study. No prior relationship was established between the researcher and participants before the study commenced. Before the FGDs were conducted, an official request letter was sent to institutional leaders along with research approval and an endorsement from National and Political Unity Agency. Each institution proposed list of participants, who then received a formal invitation. All selected participants were added to different communication group to coordinate schedules and methods of data collection, and were provided with a study overview, informed consent, a non-disclosure agreement, and a short demographic questionnaire including in Additional File 1. This process resulted in four FGDs and one separate interview with BBPOM due to scheduling constraints: Group 1 consisted of policymakers, Group 2 & 3 community pharmacists in private pharmacies and community health centers while Group 4 of PKK representatives. Ethical consideration and data collection Ethical approval for this study was obtained from the Ethics Committee of the Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada (Number KE/FK/0965/EC/2025). All participants provided written informed consent prior to data collection. Anonymity and confidentiality were ensured by removing all personal identifiers and reporting data only at the institutional or role level. Data collection was conducted between June and September 2025 using Focus Group Discussions (FGDs) with stakeholders from various institutions. Each FGD lasted approximately 100–130 minutes and was facilitated by a male researcher (RAMRS), a licensed pharmacist trained in qualitative methods, supported by a note-taking team. Four FGDs were held: (1) district government officials (Environmental Agency, Health Office, and Indonesian Pharmacists Association), (2) pharmacists from private pharmacies, (3) representatives of the Family Welfare and Empowerment Team (TP PKK), and (4) pharmacists from community health centers (Puskesmas). In addition, one separate interview was conducted with the Bandung National Food and Drug Authority (BBPOM) due to scheduling constraints. Two FGDs were held in person at designated meeting rooms at the University, while the other two FGDs and the individual interview were conducted via Zoom because of time and logistical barriers. The facilitator maintained a neutral stance during the discussions and was aware of his professional background as a pharmacist, which could potentially influence interpretations. A semi-structured FGD guide was developed based on the study objectives, comprising open-ended and follow-up questions. Socio-Ecological Model (SEM) was being used as theoritical framework which conceptualises individual, interpersonal, organisational, and policy-level determinants of health behaviour. The guide explored participants’ perceptions of community practices, barriers, and facilitators related to unused medicine management across these levels. The interview questions were refined following expert consultation (SAK and CW) and pilot testing. In addition, a brief baseline demographic questionnaire captured participants’ roles, gender, institutional affiliation, and years of experience was obtained from participants prior to the discussion using a brief self-administered form. The guide covered two main domains: (1) stakeholders’ perspectives on pharmaceutical waste management in the community and (2) perceived challenges in implementing proper management practices. The topic guide was structured according to the four levels of the Socio-Ecological Model. Examples of guiding questions are presented in Table 1 while the full FGD guide is provided in Additional File. Table 1. Example of FGD topic guide based on the socio-ecological model. SEM level Focus area Example questions Individual Current practices, knowledge, and perceptions “Can you describe what people usually do with leftover or expired medicines?” Interpersonal Social relation to medicine waste “Based on your perspective, are there any factors in community such cultural, social, or economic that influence this behavior?” Organizational Institutional roles and resources “How do health facilities or pharmacies manage unused medicines from patients?” Policy Regulations and governance “What policies or programs that give guiding for households to dispose their unused medicines?” Facilitators Opportunities and enablers “What encourages or supports community efforts to improve unused medicine management?” Data analysis All data were transcribed verbatim into five separate Microsoft Word files, each corresponding to one FGD or interview session and containing both the guiding questions and participants’ responses. The principal investigator verified the accuracy of the transcripts by repeatedly listening to the recordings and cross-checking them against the written text. Transcripts were shared with participants for validation and feedback evaluation. Transcripts were then imported into NVivo version 12 for coding and analysis. A thematic analysis was applied using an inductive and reflexive approach due to its flexibility ( Jakobsen et al., 2023 ) and guided by Braun and Clarke’s six-phase framework. First, the research team familiarized themselves with the data through repeated reading of the transcripts. Second, open coding was conducted to capture meaningful segments of text. Third, codes were organized into initial categories, which were subsequently refined into sub-themes. Fourth, emerging sub-themes were reviewed and synthesized into main themes that reflected shared concepts across the data. Fifth, these themes were critically examined and refined to ensure coherence with the dataset. Finally, each theme was clearly defined and labeled to capture its essence ( Braun & Clarke, 2006 ). Rather than seeking thematic saturation, data collection was designed to ensure diversity of perspectives and contextual richness across stakeholder groups. Coding and theme development were discussed collaboratively among members of the research team to enhance analytical rigor, reduce individual bias, and ensure dependability of the findings. Themes were subsequently organized using the Socio-Ecological approach to illustrate how barriers and facilitators operate across individual, community, organizational, and policy levels ( Golden & Earp, 2012 ). In addition, this study followed the consolidated criteria for reporting qualitative research (COREQ) and its 32-item checklist to enhance transparency and trustworthiness in the reporting process ( Tong et al., 2007 ). Rigour and trustworthiness of the study To ensure rigour and trustworthiness, this study followed Lincoln and Guba’s four evaluative criteria. Credibility was enhanced through triangulation across diverse stakeholder groups and peer debriefing among the research team. Dependability was ensured by maintaining a detailed audit trail of methodological decisions, coding processes, and theme development. Confirmability was strengthened through collaborative analysis and transparent documentation to minimize individual bias. Transferability was supported by providing a rich description of the study context, participant characteristics, and thematic findings, enabling readers to assess the applicability of results to other settings ( Lincoln & Guba, 1985 ). Results Characteristics of participants Total number of participants were 43 with 2 participants withdrawing due to scheduling issue. No repeat interviews were conducted. Most participants were adult between 25-55 years (median = 41). The majority were female (34,8%), reflecting gender composition of community organization. Most had completed tertiary-level education, and several holding postgraduate degrees, particularly among policymakers, whereas within the PKK group showed more diverse educational background. Over half of the participants had worked for more than 10 years in their respective sectors, suggesting substantial institutional experience. Details of participants’ roles, gender, and work experience are presented in Additional File 1. Themes and subthemes Researcher team led by RAMRS identified four interrelated themes. The foundational theme concerns community behaviour in managing unused medicines, including practices of storage and disposal, as well as the underlying reasons shaping these practices. Themes and subthemes used in this study are presented in Table 2 . Table 2. Themes, and sub themes generated from the finding. Theme Sub theme 1. Community Behavior in Managing Unused Medicines 1. Storing medicines, even when it has expired 2. Disposal Practices: a. Disposing into garbage b. Improper incineration c. Throwing it in drainage system 2. Community Knowledge level 3. Low community knowledge in waste management 3. Attitude Toward Unused Medicine Management 4. Community attitude: a. Reluctance to dispose of medicines due to economic considerations b. Tendency to store medicines for “just in case” purposes c. Reluctance and lack of prioritization in managing leftover medicines d. Perceptions of the impacts of leftover medicines e. Growing public awareness 4. Reasons for having unused medications at home 5. Expired medicine 6. Patient passed away 7. Loose packaging 8. Non-inquisitive patients 9. Lack of facilities to return medicine 10. Ease of Medicines Accessibility 11. Limitations of Regulation and Service Standards 12. Institutional Resource Limitations 13. Geographical Barriers 14. Budgetary constraints of institutions 15. Institutional authority limitations 16. Ineffective education 17. Facilitator for proper disposal practice Community behaviour in managing unused medicines Participants described diverse behaviours related to unused medicines, including storing expired medicines at home, discarding them in household waste, burning or burying them, and even using them for non-scientific purposes. These practices illustrate how community members manage unused medicines in the absence of formal disposal facilities. Behavior and quotation are presented in Table 3 . Table 3. Improper community behavior in managing medicines. Sub theme Illustrative quotes Storing medicines at home, even when expired ”People often keep one or two tablets and stop using them once they feel recovered. Later, when officers visit, the medicines are neatly arranged but already covered in dust.” (P36) Disposing into trash ”From the community’s side, there are some patients who behave like once there are no more symptoms, they store the medicines. Most of them get the medicines without prescriptions, especially antibiotics, and then they just throw them away into the trash.” (P38) Burying medicines in the ground “What I know is that expired medicines are first removed from their packaging. The packaging is thrown away, while the medicine itself is crushed. The final step is usually to dig a hole, bury the medicine, and cover it with soil.” (P24) Burning medicines “For the community here, medicines are still mixed with household waste. There is no waste collection system from the Environmental Agency like in the city. So, in this area, medicines are still burned together with household waste.” (P14) Pouring into drainage systems “For unused syrups, sometimes when they are no longer good, people simply pour them into the drainage system.” (P22) Disposing into fish ponds “The disposal pattern is either burning together with other household waste, or throwing them into the fish ponds located beside or behind their houses.” (P6) Using unused medicines for non-scientific purposes “I enjoy growing orchids. I take unused medicines and then put them into a spray bottle, and spray them on the plants when I see pests. Now the flowers look fresh and healthy. I believe the medicines help.” (P30) “A belief passed down through generations, that to make meat tender more quickly, you can add paracetamol when boiling it. But I’m not sure about the exact ratio of meat to paracetamol.” (P25) Mapping of barriers and facilitators in improper medicine disposal using socio-ecological approach In addition to behavioural observations, our findings revealed multiple barriers and facilitators that influence community practices in managing unused medicines. To better illustrate the complexity of these interrelated factors, we organised them using the Socio-Ecological Model ( Golden & Earp, 2012 ), which distinguishes individual, interpersonal, organisational, and policy levels. Complete illustration could be found in Table 4 and Figure 1 . Table 4. Socio-ecological approach in mapping the barriers and facilitator of unused medicine disposal. Level Barrier Facilitator Individual − Low knowledge in waste management − Negative attitudes toward leftover medicines − Economic considerations − “Just in case” practice − Passive patient − Accumulated medicine − Growing public awareness after COVID-19. − Stronger health and environmental awareness. Interpersonal − Sharing medicines norm − Socioeconomic disparities − Low prioritization of waste management − Experience of community-based networks that could be mobilized for household monitoring and education. Organizational − Ease of accessibility − Lack of service standards − Institutional resource limitations − Ineffective education − Absence of facilities − Existing institutional programs that could integrated with medicine waste issues. − Readiness of Pharmacist associations and health centers to collaborate in future initiatives. Policy − Regulatory limitations − Budgetary constraints − Institutional authority limitations − Geographical barriers − Availability of related national guidelines. − Ministerial and political attention to the issue. − Growing intersectoral collaboration initiatives. Figure 1. Barriers and facilitators across socio-ecological levels influencing leftover medicine management. Individual level At the individual level, the main issue could be affected by attitude and cultural beliefs. Many viewed discarding medicines as wasteful or financially disadvantageous, leading to the habit of storing them for “just in case” use. Passive patients also contribute to accumulated medicine in home as they tend to not question any medication they received from physicians. We could state that all of these caused by limited knowledge. “Sometimes people keep unused medicines therefore they or their acquaintances can use them later without buying new ones. There is also a cultural belief that throwing medicines away is wasteful.” (P41) “Unused medicines are more common among adults, especially the elderly, who tend to accept whatever their medication is and accumulate them without checking expiry dates. ” (P42) Despite these challenges, some facilitators were identified at this level. Respondents observed a gradual increase in public awareness and participation following the COVID-19 pandemic, as communities became more health-conscious. “From our experience, people were willing to adopt proper waste management practices, especially after COVID-19 made them more health-conscious.” (P8) Interpersonal level At the interpersonal level, social norms and family practices played a significant role in shaping behaviours. The sharing of leftover medicines among relatives or neighbours was reported as a common practice, particularly in lower-income communities. They also viewed medicine disposal as minor issue and possibly didn’t want to contribute financially as in current conditions people often rejected to pay waste transporting fee. Participant from Health Office once mentioned their experiences in finding Digoxin being sold in small kiosk (warung) due to seller’s ignorance. “People often give unused medicines to their family or friends if they have similar symptoms, rather than disposing of them.” (P36) Organizational level At the organizational level, several structural and institutional barriers emerged. Respondents consistently mentioned the absence of standardized procedures and limited disposal facilities. Health facilities also faced workforce and resource constraints that limited their ability to conduct consistent education and outreach. Mostly participants from Health Office and Community Health Center stated their problem in not having enough resources for even standard pharmaceutical services. “Even when people are aware that medicines must be properly managed, they still ask, ‘Where should this be taken?’ because the facilities are limited.” (P5) Policy level At the policy level, barriers related to regulation, coordination, and budget allocation were dominant. Respondents emphasized the absence of clear national or local regulations governing household pharmaceutical waste, leading to uncertainty among implementers. Fragmented institutional responsibilities also hampered effective management as no special taskforce was appointed to be in charge. “Currently, no mandatory regulations govern this issue. If such policies existed, they would come with programs and budgets.” (P42) Nevertheless, participants recognized several emerging facilitators at this level, including the existence of national guidelines and the growing political attention such as from The Coordinating Ministry for Human Development and Cultural Affairs or The Regent toward pharmaceutical waste. “The Directorate General of Pharmaceutical Services issued Decree No. HK 02031708/2021, which provides household-level guidelines for managing expired and damaged medicines.” (P8) Intersectoral initiatives and community-based programs such as Climate Village (Kampung Iklim), or Eco-friendly Village (Kangraling) by Environmental Agency, and Pharmacists Go to Village (Sonagar Mapay ka Lembur) by the Pharmacists Association were viewed as potential platforms to integrate unused medicine management into broader environmental and health policies. Discussion This study explored how stakeholders from different institutions view unused medicines as an issue in community. We identified their perspectives on community practices, barriers and facilitator related to unused medicines management in Garut regency. By using socio-ecological approach as an analytical framework, we can explain that community behaviour in managing unused medicine could be shaped by various things worked at the individual, interpersional, organizational, and policy level. Community behaviours and household practices The storage and unsafe disposal of unused medicines were constantly mentioned by stakeholders, mainly those whose directly interact with the people. Many community members most likely to keeping medicines at home, sometimes beyond expiry, or discarding them into household trash, open burning, or even throwing it into fish ponds. These practices could lead to more environmental hazard. Burning medicine in low temperatures could produce toxic air pollutant caused by the halogens structure in the structure and leave ashes as the product of heavy metals contained by some dietary supplements such as iron, zinc, manganese etc ( Alnahas et al., 2020 ). Recent study in China told us that at least 62 active pharmaceutical ingredients were detected in leachate sample taken from waste landfill slide). In addition, unused medicines were sometimes side-tracked for non-medical, likewise, non scientific purposes, such as tenderizing meat or spraying plants. Though acetamoniphen is chemically probable to be used as meat tenderizer, these action could be led to hazardous impact on liver, kidney and reproductive general physiological signaling ( Ezugwu et al., 2023 ). No study had been conducted in evaluate potential risk of human exposure to medicine-watered plant, however recent finding in several plants exposed to an solution containing pharmaceutical ingredient explain how the chemical substances could be potentially taken up to shoots and roots of edible plants ( Tanoue et al., 2012 ). Leaving us in the risk of accidental accumulation of API in human bodies. Similar studies in low and middle-income countries, which have documented similar behaviours driven by limited awareness of environmental risks and weak disposal infrastructure ( Mohammed & Al-Hamadani, 2023 ; Mostafanejad et al., 2025 ). In similar contexts where pharmaceutical return programs are present, households in high income country showing same behavior i.e throwing into bin or flush it down to the sink ( Kelly et al., 2018 ). More finding could be done to explain what things could influence those behaviours. Individual level barriers to proper disposal of unused medicine Barriers at the individual level reflected both knowledge and attitudinal dimensions. Low community knowledge about waste management in general, combined with limited understanding of pharmaceutical hazards, reduced the likelihood of good attitude and possibly safe practices ( Ayele & Mamu, 2018 ; Kusuma et al., 2023 ; Sim et al., 2018 ). While representatives from the community stated their lack of knowledge in safely disposing of medicine, stakeholders from local health and environment sector also mentioned poor obedience showed by the communities in the smalest scale of waste management, sorting the trash. Public in Asian is more likely to do waste sortation when they have perception of environmental risk ( Cai et al., 2024 ). Furthermore, medicines were often regarded as valuable commodities, leading to reluctance in discarding them. Economic considerations reinforced this tendency: households preferred to keep medicines for future use to avoid costs, reflecting cultural perceptions of medicines as resources not to be wasted. These attitude often led to practice of medicine reuse as some studies found it cost saving, especially in more expensive medicine ( Alhamad et al., 2018 ). Accumulated medicine could be directly caused by expired products, medicines left behind after patient death, and drugs dispensed in loose packaging without clear labeling. Demised patient potentially left half of their medication unused and could be end in their family not using it anymore ( Ekedahl, 2006 ). Loose packaging led to inadequate label or unclear instruction and could end with patient confusion and tend to not using the medicine. These phenomenon observed in Srilanka which inadequate label and packaging mostly happened to medicine obtained from public sector compared to private sector ( Athuraliya et al., 2016 ). Passive patient attitudes, particularly among older adults, contributed to stockpiling. Active patient which had known more about their medication tend to had better management of their medication once discharged from hospital care ( McTier et al., 2015 ). This highlights the need for preventive strategies such as knowledge sharing, rational prescribing and controlled dispensing. Interpersonal level barriers to proper disposal of unused medicine Our findings empashized social aspect, like norms and socioeconomic disparities, shape the management of unused medicines within households and communities. The practice of sharing medicines was frequently reported, highlight cultural norms where medicines are perceived as communal valuable resources rather than personal prescriptions. This practice could be seen as a positive thing and participant often have stated that this was an act of justice in the way of saving cost and improve their social relationship ( Beyene et al., 2016 ). However it raise some concern regarding increasing risk of drug resistance ( Dimitrov et al., 2012 ) or kidney failure ( Makówka et al., 2015 ) in population. Similar patterns have been documented in both Asian (S. Song et al., 2022 ) and African contexts ( Obol et al., 2018 ), where medicine reuse and sharing are normalized. Furthermore, participant from higher economic status mentioned that some of their worker often asked for their leftover medicines to be taken home. This socioeconomic discrepancies explained as lower-income groups that rely on leftover medicines from others to reduce healthcare costs as also seen in methadone maintenance patient ( Caviness et al., 2013 ). Finally, proper disposal of unused medicines is rarely prioritized, as it is perceived as a burden without immediate benefits to households. Some participant mentioned that this act of proper disposal didn’t benefit them, difficult to implement or just have no motivation in doing therefore. The lack of tangible incentives, coupled with limited awareness of environmental and health risks, leads to low community engagement in safe disposal practices. Study in middle income country also mentioned incorrect practice of disposal when no incentives provided ( Lago et al., 2022 ). Together, these barriers illustrate how economic constraints and cultural norms strengthen improper practices at the community level, highlighting the need for both educational interventions and system-level solutions to provide more accessible and acceptable disposal pathways. Organizational level barriers to proper disposal of unused medicine At the organizational level, several systemic barriers were identified that could be postponing effective management of unused medicines. Main point is medicines are too easily accessible, as they are frequently sold in small shops without prescriptions, while overprescribing practices within health facilities further contribute to accumulation at the household level. Recent study in same country highlighted antibiotic availability in three quarters of roadside stall (kiosk) asked. Some dispensed as repackaged blister strip resulting to out of pharmacopeia standard in 18% of the sample ( Hadi et al., 2010 ). This practice in LMIC could be caused by the business orientation, customers’ demand, lack of regulations; and staff’s lack of knowledge and poor attitudes about medicine use ( Belachew et al., 2021 ). Some study also mentioned high overprescription practices by physicians however in contrast, participant showed good knowledge and attitudes toward appropriate antibiotic use ( Amin et al., 2022 ). This reflects external factor such as weak enforcement of dispensing regulations and creates a surplus of medicines in the community. Heightening this issue is the lack of standardized service protocols which health centers, pharmacies, and professional associations such as the Indonesian Pharmacists Association reported uncertainty in handling unused medicines due to the absence of clear SOPs. Similar to recent finding that reported that there were no regulation in handling household pharmaceutical waste, only addressing waste from healthcare institution or pharmacies ( Alfian, Azzahra, et al., 2024a ) and confusion due to low awareness of the guideline and no reported training on how to managing medication waste ( Alfian, Rendrayani, et al., 2024b ). This also influenced by the absence of formal return facilities. It left households without viable options for safe disposal. Studies conducted in Portland compared communities in place with returned medicine dropbox showed higher behavior to safely dispose their medicine compared to another without ( Ehrhart et al., 2020 ). Institutional capacity also plays a critical role, as limited numbers of health workers and pharmacists are often required to prioritize clinical service delivery, leaving pharmaceutical waste education and monitoring under-addressed. Although educational initiatives such as “Counseling, Information and Education” (KIE), “Lets Throw Medication Waste” (ABSO), and “Smart Medicine Use Movement for Community” (Gema Cermat) have been introduced to improve public awareness, their reach and impact remain limited, with many community members reporting minimal exposure or comprehension. Some studies suggest that even the methods given (didactic) was effective in increasing public knowledge ( Kristina et al., 2021 ), some program like ABSO still not too recognized in local level ( Wahyudi & Kristina, 2022 ). Those finding leaves message to address more in medicine disposal using available program. Together, these organizational challenges reveal how gaps in accessibility control, professional guidance, human resources, and health education may be contribute to unsafe community practices, emphasizing the need for stronger institutional frameworks and coordinated efforts to integrate medicine disposal into routine healthcare delivery. Policy level barriers to proper disposal of unused medicine At the policy and structural level, the management of household pharmaceutical waste is constrained by several systemic limitations. Regulatory frameworks remain unclear, as no comprehensive national or local regulations specifically address the disposal of unused medicines at the household level. This regulatory gap translates into the absence of formal mandates or accountability structures, leaving frontline institutions uncertain about their roles. This underlined similar patterns in Asean countries where there were still lack of pharmaceutical waste management even in Indonesia, Malaysia, Philippines, Singapore, Thailand or Vietnam ( Sapkota & Pariatamby, 2025 ). It still unclear who is responsible for its governance wether it is government or private sector ( Ravinetto et al., 2025 ). Financial constraints further exacerbate the problem, since no specific budget allocation has been made for pharmaceutical waste management outside of healthcare facilities, making it difficult for local authorities to design and sustain interventions. OECD Report (2022) mentioning 34 countries with pharmaceutical waste management system. Particularly, no LMIC countries mentioned in this report. Some of those countries were funded by government wether it is by ministry, district board or office. Some of them by private sector through extended producer responsibilities scheme, and some of them funded by healthcare facilities it self ( Organisation for Economic Co-operation and Development, 2022 ). This could raise option to openning up into some scheme in managing pharmaceutical waste. In addition, institutional authority is fragmented: responsibilities are distributed across the Health Office, Environmental Agency, and professional associations, yet without clear coordination mechanisms, their efforts often overlap or remain incomplete. For example the association clearly mentioned that their authority is limited to their member hence the agency also mention their lack of human resources. Similar cases happens in local setting highlighting limited resources from government or community health center to solve medical waste problem. In addition they add community medical waste bank program to help processing the waste in their area ( Syafriani et al., 2021 ). Therefore, collaborative governance modelling runs in China give a simulation of participation rate through different models. Collaboration between government agency, enterprises and resident participation could increase participation for each parties in handling waste (W. Song et al., 2025 ). This could call for more community involvement in handling this issue together. Finally, geographical barriers pose practical challenges, as Garut’s wide and diverse terrain hinders consistent outreach, education, and monitoring, particularly in rural and remote communities. These disparities could resulting in poor waste management as people in rural area less likely to have an access to improved sanitation compared to urban areas ( Irianti & Prasetyoputra, 2021 ). This could ensuing inequalities in accessing pharmaceutical services in region with low number of pharmacies ( Ismail & Setyawan, 2025 ). These structural weaknesses highlight the urgent need for integrated policy frameworks, designated funding streams, and cross-sectoral collaboration to ensure that household pharmaceutical waste is managed in a safe, equitable, and sustainable manner. Facilitators and opportunities for intervention Despite these challenges, participants highlighted several facilitators that could support future interventions. Increased public awareness, particularly after COVID-19, suggested growing receptiveness to safe practices. This phenomenon could be related to growing awareness influenced by cultural, social, or biological norm post COVID-19 ( Raesi et al., 2024 ). Study in Asia unveiled that people tend to have adequate knowledge and collective awareness regarding medical waste because they experienced living with medical equipment i.e gloves or masks and medicine in their everyday life ( Alomari et al., 2021 ). The existence of national guidelines provided a potential legal foundation, although their local implementation remained limited. Ongoing programs led by PKK volunteers, environmental initiatives such as Kampung Iklim, and pharmacist-led campaigns demonstrated avenues for integrating unused medicine management into existing community and institutional platforms. These facilitators reflect opportunities for multi-sectoral collaboration, aligning with calls for integrated approaches to pharmaceutical waste management. Attempt to collaborate in increasing medication safety had been launched in Kuwait. Their take-back campaign implemented through coordination and communication among several stakeholders i.e primary care provider, drug regulation officer, medical waste management, environmental protection agency, academia, international organizations, non-governmental support, and community member ( Abahussain et al., 2024 ). Positioning findings within a socio-ecological perspective Although the themes were derived inductively, their interconnections can be mapped onto different levels of influence, consistent with the socio-ecological model. Household behaviours reflect individual knowledge, attitudes, and economic considerations. These are embedded within community norms of sharing and storing medicines, constrained further by institutional gaps in regulation, resources, and infrastructure, and shaped ultimately by the broader policy environment. This layered understanding underscores the importance of multi-level interventions. Awareness campaigns at the household level are necessary however insufficient without parallel investments in institutional capacity and regulatory enforcement. Likewise, community-based monitoring initiatives, such as PKK household visits, can only be effective if supported by policy frameworks and resource allocation. Taken together, these findings suggest that addressing unused medicine management in Garut requires a comprehensive strategy that engages actors across multiple levels. While the absence of local policies and return systems currently hinders safe practices, the presence of community networks, national guidelines, and increasing public awareness provides a foundation for developing context-specific, multi-level interventions. Conclusion This study demonstrates how stakeholders perceive management of unused medicines in Garut Regency is shaped by complex and interrelated factors at the individual, community, organizational, and policy levels. Stakeholders highlighted unsafe household medicine practices, cultural norms of medicine reuse, weak institutional protocols, and fragmented regulatory responsibilities as key barriers. At the same time, facilitators such as increasing public awareness, existing national guidelines, and community-led initiatives present important opportunities for improvement. These findings emphasize that interventions cannot rely solely on patient education however must adopt a comprehensive and coordinated strategy that engages households, health professionals, local authorities, and regulatory bodies. Strengthening cross-sectoral collaboration, clarifying institutional roles, and ensuring dedicated resources are essential steps to build sustainable systems for safe pharmaceutical waste management. Strength and limitation A strength of this study lies in its diverse stakeholders, providing a multi-layered understanding of the issue. The qualitative approach and separated FGDs enabled the identification of context-specific barriers and facilitators that may not emerge in survey-based studies in each stakeholders context. However, several limitations should be acknowledged. First, the study was conducted in a single regency, which may limit generalizability across different regions of Indonesia. Second, participant perspectives may reflect institutional view points more strongly than those of the wider community. Finally, while the socio-ecological approach offers broad explanatory power, it may oversimplify interactions between levels and does not measure the relative magnitude of each factor. Ethical considerations Ethical approval for this study was obtained from the Ethics Committee of the Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada (Number KE/FK/0965/EC/2025). All participants provided written informed consent prior to data collection. Anonymity and confidentiality were ensured by removing all personal identifiers and reporting data only at the institutional or role level. Data availability Underlying data Figshare: Underlying data for Views, Barriers and Facilitators of Policymakers, Pharmacists and Health Community Representative in Managing Unused Medicine in a Socioeconomically Diverse District in Indonesia. https://doi.org/10.6084/m9.figshare.31015444 ( Syamsudin et al., 2026 ) This project contains participant demographic characteristics. Access to the interview transcripts is restricted due to ethical and confidentiality considerations. Researchers may request access by contacting the author at [email protected] Data are available under the terms of the Creative Commons Attribution 4.0 International license (CC BY 4.0) . Extended data Figshare: Extended data for Views, Barriers and Facilitators of Policymakers, Pharmacists and Health Community Representative in Managing Unused Medicine in a Socioeconomically Diverse District in Indonesia. https://doi.org/10.6084/m9.figshare.31015444 ( Syamsudin et al., 2026 ). This project contains the following extended data: 1. FGD Guide (Guide used to facilitate focus group discussions and interviews). 2. Thematic coding framework (Example of the coding framework developed during qualitative analysis). 3. Informed consent template (Template of the informed consent form provided to participants). Data are available under the terms of the Creative Commons Attribution 4.0 International license (CC BY 4.0) . Reporting guidelines Repository: COREQ checklist and for ‘Views, Barriers and Facilitators of Policymakers, Pharmacists and Health Community Representative in Managing Unused Medicine in a Socioeconomically Diverse District in Indonesia’. https://doi.org/10.6084/m9.figshare.31015321 . References Abahussain E, Alyahia A, Alajeel N: A multisectoral approach to medication safety in Kuwait using the take-back campaign. East Mediterr. Health J. 2024; 30 (4): 304–311. WE - Science Citation Index Expanded (SCI-EXPANDED) WE - Social Science Citation Index (SSCI). PubMed Abstract | Publisher Full Text Alfian SD, Azzahra AM, Khoiry QA, et al. : Pharmacists perspectives on challenges and facilitators in initiating medications take-back program in Indonesia: A qualitative study. SAGE Open Medicine. 2024a; 12 . PubMed Abstract | Publisher Full Text | Free Full Text Alfian SD, Khoiry QA, Pratama MAA, et al. : Awareness and beliefs of community pharmacists on disposal of unused and expired household medications in Indonesia: a cross-sectional study. J. Pharm. Health Serv. Res. 2023; 14 (4): 401–406. Publisher Full Text Alfian SD, Rendrayani F, Khoiry QA, et al. : Do pharmacists counsel customers on the disposal of unused or expired household medications? A national survey among 1,596 pharmacists in Indonesia. Saudi Pharm. J. 2024b; 32 (5): 102020. PubMed Abstract | Publisher Full Text | Free Full Text Alhamad H, Patel N, Donyai P: How do people conceptualise the reuse of medicines? An interview study. Int. J. Pharm. Pract. 2018; 26 (3): 232–241. PubMed Abstract | Publisher Full Text | Free Full Text Alnahas F, Yeboah P, Fliedel L, et al. : Expired Medication: Societal, Regulatory and Ethical Aspects of a Wasted Opportunity. Int. J. Environ. Res. Public Health. 2020; 17 (3). PubMed Abstract | Publisher Full Text | Free Full Text Alomari A-H, Aga O, El Sahmarany L, et al. : Public perception towards medical waste generated in the environment during the COVID-19 pandemic in Eastern Province, Saudi Arabia. Heliyon. 2021; 7 (11): e08363. PubMed Abstract | Publisher Full Text | Free Full Text Amin MT, El Aty MAA, Ahmed SM, et al. : Over prescription of antibiotics in children with acute upper respiratory tract infections: A study on the knowledge, attitude and practices of non-specialized physicians in Egypt. PLoS ONE. 2022; 17 (11 November): 1–20. PubMed Abstract | Publisher Full Text | Free Full Text Associated Press: Expired drug kills 10 child leukemia patients in Yemen.2022. Reference Source Athuraliya N, Walkom EJ, Dharmaratne S, et al. : Assessing medication packaging and labelling appropriateness in Sri Lanka. Journal of Pharmaceutical Policy and Practice. 2016; 9 (1): 38. PubMed Abstract | Publisher Full Text | Free Full Text Ayele Y, Mamu M: Assessment of knowledge, attitude and practice towards disposal of unused and expired pharmaceuticals among community in Harar city, Eastern Ethiopia. Journal of Pharmaceutical Policy and Practice. 2018; 11 (1): 27. PubMed Abstract | Publisher Full Text | Free Full Text Badan Pusat Statistik Kabupaten Garut: Jumlah Penduduk Kabupaten Garut Menurut Kecamatan dan Jenis Kelamin (Jiwa) (Jiwa), 2020.2022. Reference Source Belachew SA, Hall L, Erku DA, et al. : No prescription? No problem: drivers of non-prescribed sale of antibiotics among community drug retail outlets in low and middle income countries: a systematic review of qualitative studies. BMC Public Health. 2021; 21 (1): 1056. PubMed Abstract | Publisher Full Text | Free Full Text Beyene K, Aspden T, Sheridan J: Prescription medicine sharing: exploring patients’ beliefs and experiences. Journal of Pharmaceutical Policy and Practice. 2016; 9 (1): 23. PubMed Abstract | Publisher Full Text | Free Full Text Braun V, Clarke V: Using thematic analysis in psychology. Qual. Res. Psychol. 2006; 3 (2): 77–101. Publisher Full Text Cai L, Li Q, Wan E, et al. : Cultural worldviews and waste sorting among urban Chinese dwellers: the mediating role of environmental risk perception. Front. Public Health. 2024; 12 (April): 1–8. PubMed Abstract | Publisher Full Text | Free Full Text Campbell S, Greenwood M, Prior S, et al. : Purposive sampling: complex or simple? Research case examples. Journal of Research in Nursing : JRN. 2020; 25 (8): 652–661. PubMed Abstract | Publisher Full Text | Free Full Text Caviness CM, Anderson BJ, de Dios MA , et al. : Prescription medication exchange patterns among methadone maintenance patients. Drug Alcohol Depend. 2013; 127 (1–3): 232–238. PubMed Abstract | Publisher Full Text | Free Full Text Dimitrov D, Boily M-C, Mâsse BR, et al. : Impact of Pill Sharing on Drug Resistance Due to a Wide-Scale Oral Prep Intervention in Generalized Epidemics. Journal of AIDS & Clinical Research. 2012; Suppl 5 (4). PubMed Abstract | Publisher Full Text | Free Full Text Ehrhart AL, Granek EF, Nielsen-Pincus M, et al. : Leftover drug disposal: Customer behavior, pharmacist recommendations, and obstacles to drug take-back box implementation. Waste Manag. 2020; 118 : 416–425. PubMed Abstract | Publisher Full Text Ekedahl ABE: Reasons why medicines are returned to Swedish pharmacies unused. Pharm. World Sci. 2006; 28 (6): 352–358. PubMed Abstract | Publisher Full Text Ezugwu AL, Anaduaka EG, Chibuogwu CC, et al. : Meat tenderization using acetaminophen (paracetamol/APAP): A review on deductive biochemical mechanisms, toxicological implications and strategies for mitigation. Heliyon. 2023; 9 (5): e15628. PubMed Abstract | Publisher Full Text | Free Full Text Golden SD, Earp JAL: Social Ecological Approaches to Individuals and Their Contexts: Twenty Years of Health Education & Behavior Health Promotion Interventions. Health Educ. Behav. 2012; 39 (3): 364–372. PubMed Abstract | Publisher Full Text Hadi U, van den Broek P , Kolopaking EP, et al. : Cross-sectional study of availability and pharmaceutical quality of antibiotics requested with or without prescription (Over The Counter) in Surabaya, Indonesia. BMC Infect. Dis. 2010; 10 : 203. PubMed Abstract | Publisher Full Text | Free Full Text Insani WN, Qonita NA, Jannah SS, et al. : Improper disposal practice of unused and expired pharmaceutical products in Indonesian households. Heliyon. 2020; 6 (7). PubMed Abstract | Publisher Full Text | Free Full Text Irianti S, Prasetyoputra P: Rural–Urban Disparities in Access to Improved Sanitation in Indonesia: A Decomposition Approach. SAGE Open. 2021; 11 (3): 21582440211029920. Publisher Full Text Ismail H, Setyawan F: The Relationship Between Distribution of Pharmacy Locations and The Availability of Pharmaceutical Services In Kediri City.2025; 6 (2): 276–283. Jakobsen AH, Småbrekke L, Chen TF, et al. : Exploring stakeholders’ perspectives on the quality of services provided through community pharmacies. Res. Soc. Adm. Pharm. 2023; 19 (9): 1307–1313. PubMed Abstract | Publisher Full Text Kelly F, McMillan S, Spinks J, et al. : “You don’t throw these things out:” an exploration of medicines retention and disposal practices in Australian homes. BMC Public Health. 2018; 18 (1): 1026. PubMed Abstract | Publisher Full Text | Free Full Text Kristina SA, Salsabila NN, Yulianto Y, et al. : Effect of Didactic Educational Intervention on Improving Knowledge of Antibiotics Use and Resistance in Yogyakarta Community. Pharmaceutical Sciences Asia. 2021; 48 (4): 346–353. Publisher Full Text Kusuma F, Munir M, Yuda A, et al. : Assessment of medicines and potential pharmaceutical wastes management among households in Lamongan, Indonesia. Pharm. Educ. 2023; 23 (4): 145–148. Publisher Full Text Lago NC, Auler MS, Fleith de Medeiros J, et al. : Promoting unused medicine pro-environmental disposal: Characterization of consumer behavior and strategic propositions. Environ. Dev. 2022; 44 : 100770. Publisher Full Text Lim WM: What Is Qualitative Research? An Overview and Guidelines. Australas. Mark. J. 2025; 33 (2): 199–229. Publisher Full Text Lincoln YS, Guba EG: Naturalistic Inquiry. SAGE Publications Ltd.; 1985. Publisher Full Text Makówka A, Zawiasa A, Nowicki M: Prescription-medication sharing among family members: an unrecognized cause of a serious drug adverse event in a patient with impaired renal function. Clin. Nephrol. 2015; 83 (3): 196–200. PubMed Abstract | Publisher Full Text McTier L, Botti M, Duke M: Patient participation in medication safety during an acute care admission. Health Expectations : An International Journal of Public Participation in Health Care and Health Policy. 2015; 18 (5): 1744–1756. PubMed Abstract | Publisher Full Text | Free Full Text Mohammed A-UM, Al-Hamadani F: Assessment of general population knowledge, attitude, and practice on safe unused and expired drugs disposal: a cross-sectional study. F1000Res. 2023; 12 : 1333. PubMed Abstract | Publisher Full Text | Free Full Text Mostafanejad R, Ghassab-Abdollahi N, Derakhshani N, et al. : Medication waste and disposal behaviors among Iranian households: A Cross-sectional study. Sci. Rep. 2025; 15 (1): 15714. PubMed Abstract | Publisher Full Text | Free Full Text Obol JH, Akera P, Atim PO, et al. : Prevalence of borrowing and sharing prescription medicines and associated socio-demographic factors: findings from COBERS health centres in northern Uganda. BMC Pharmacol. Toxicol. 2018; 19 (1): 17. PubMed Abstract | Publisher Full Text | Free Full Text Organisation for Economic Co-operation and Development: Management of Pharmaceutical Household Waste: Limiting Environmental Impacts of Unused or Expired Medicine. Management of Pharmaceutical Household Waste. OECD Publisher; 2022. Publisher Full Text Raesi R, Khalesi N, Safavi M, et al. : Identifying factors affecting a healthy lifestyle in the post-COVID-19 era. J. Educ. Health Promot. 2024; 13 : 130. PubMed Abstract | Publisher Full Text | Free Full Text Ravinetto R, Lates J, Jonkman L, et al. : Inadequate last-mile pharmaceutical waste management is a neglected threat to environmental and public health: a call to action. BMJ Glob. Health. 2025; 10 (7). PubMed Abstract | Publisher Full Text | Free Full Text Rogowska J, Zimmermann A: Household Pharmaceutical Waste Disposal as a Global Problem-A Review. Int. J. Environ. Res. Public Health. 2022; 19 (23). PubMed Abstract | Publisher Full Text | Free Full Text Sapkota B, Pariatamby A: Pharmaceutical waste management legislations: Where do ASEAN countries stand in harmonization? A review of regulatory documents. Waste Management (New York, N.Y.). 2025; 195 : 107–128. PubMed Abstract | Publisher Full Text Sim SM, Lai PSM, Tan KM, et al. : Development and Validation of the Return and Disposal of Unused Medications Questionnaire (ReDiUM) in Malaysia. Asia Pac. J. Public Health. 2018; 30 (8): 737–749. PubMed Abstract | Publisher Full Text Song S, Kim S, Shin S, et al. : Evaluation of Prescription Medication Sharing Among Adults in South Korea: A Cross-Sectional Survey. Front. Pharmacol. 2022; 13 : 773454. PubMed Abstract | Publisher Full Text | Free Full Text Song W, Elahi E, Hou G, et al. : Collaborative governance for urban waste management: A case study using evolutionary game theory. Sustain. Cities Soc. 2025; 126 : 106380. Publisher Full Text Sukmawati S, Hermayanti Y, Fadlyana E, et al. : Health cadres’ experiences in detecting and preventing childhood stunting in Indonesia: a qualitative study. BMC Public Health. 2025; 25 (1). PubMed Abstract | Publisher Full Text | Free Full Text Syafriani, Sutena M, Padmawati RS, et al. : Challenges and facilitating factors in handling domestic medical waste during the COVID-19 pandemic. BKM Public Health and Community Medicine. 2021. Reference Source Syamsudin RAMR, Kristina SA, Wiedyaningsih C, et al. : Dataset for Views, Barriers and Facilitators of Policymakers, Pharmacists and Health Community Representative in Managing Unused Medicine in a Socioeconomically Diverse District in Indonesia. Figshare. 2026. Publisher Full Text Szymańska U, Wiergowski M, Sołtyszewski I, et al. : Presence of antibiotics in the aquatic environment in Europe and their analytical monitoring: Recent trends and perspectives. Microchem. J. 2019; 147 : 729–740. Publisher Full Text Tannenbaum C, Farrell B, Shaw J, et al. : An Ecological Approach to Reducing Potentially Inappropriate Medication Use: Canadian Deprescribing Network. Can. J. Aging. 2017; 36 (1): 97–107. PubMed Abstract | Publisher Full Text Tanoue R, Sato Y, Motoyama M, et al. : Plant Uptake of Pharmaceutical Chemicals Detected in Recycled Organic Manure and Reclaimed Wastewater. J. Agric. Food Chem. 2012; 60 (41): 10203–10211. PubMed Abstract | Publisher Full Text Tong A, Sainsbury P, Craig J: Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care. 2007; 19 (6): 349–357. PubMed Abstract | Publisher Full Text Wahyudi A, Kristina SA: Pengetahuan Tentang Program Ayo Buang Sampah Obat Pada Apoteker yang Bekerja di Apotek Wilayah Yogyakarta. Majalah Farmaseutik. 2022; 18 (3): 372. Publisher Full Text Wang LS, Aziz Z, Wang ES, et al. : Unused medicine take-back programmes: a systematic review. Journal of Pharmaceutical Policy and Practice. 2024; 17 (1): 1–19. PubMed Abstract | Publisher Full Text | Free Full Text Wilkinson JL, Boxall ABA, Kolpin DW, et al. : Pharmaceutical pollution of the world’s rivers. Proc. Natl. Acad. Sci. 2022; 119 (8): e2113947119. PubMed Abstract | Publisher Full Text | Free Full Text Comments on this article Comments (0) Version 2 VERSION 2 PUBLISHED 24 Feb 2026 ADD YOUR COMMENT Comment Author details Author details 1 Pharmacy Program, Faculty of Mathematics and Natural Sciences, Universitas Garut, Garut, Indonesia 2 Doctoral Program of Pharmacy, Gadjah Mada University Faculty of Pharmacy, Yogyakarta, Special Region of Yogyakarta, Indonesia 3 Department of Pharmaceutical, Gadjah Mada University Faculty of Pharmacy, Yogyakarta, Special Region of Yogyakarta, Indonesia 4 Department of Primary Care Medicine, University of Malaya Faculty of Medicine, Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia 5 Sir Jeffrey Cheah Sunway Medical School, Sunway University School of Medical and Life Sciences, Bandar Sunway, Selangor, Malaysia Raden Aldizal Mahendra Rizkio Syamsudin Roles: Conceptualization, Formal Analysis, Investigation, Project Administration, Writing – Original Draft Preparation Susi Ari Kristina Roles: Conceptualization, Supervision, Validation, Writing – Review & Editing Chairun Wiedyaningsih Roles: Investigation, Supervision, Validation, Writing – Review & Editing Pauline Siew Mei Lai Roles: Data Curation, Methodology, Supervision, Writing – Review & Editing Competing interests No competing interests were disclosed. Grant information This study was funded by the Indonesia Endowment Fund for Education (LPDP), Ministry of Finance, Republic of Indonesia (RAMRS as awardee). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Article Versions (2) version 2 Revised Published: 04 May 2026, 15:314 https://doi.org/10.12688/f1000research.177671.2 version 1 Published: 24 Feb 2026, 15:314 https://doi.org/10.12688/f1000research.177671.1 Copyright © 2026 Syamsudin RAMR et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics Views Downloads F1000Research - - PubMed Central info_outline Data from PMC are received and updated monthly. - - Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article Syamsudin RAMR, Kristina SA, Wiedyaningsih C and Lai PSM. Views, Barriers and Facilitators of Policymakers, Pharmacists and Health Community Representative in Managing Unused Medicine in a Socioeconomically Diverse District in Indonesia [version 1; peer review: 2 approved with reservations] . F1000Research 2026, 15 :314 ( https://doi.org/10.12688/f1000research.177671.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS track receive updates on this article Track an article to receive email alerts on any updates to this article. TRACK THIS ARTICLE Share Open Peer Review Current Reviewer Status: ? Key to Reviewer Statuses VIEW HIDE Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Version 1 VERSION 1 PUBLISHED 24 Feb 2026 Views 0 Cite How to cite this report: Breen L. Reviewer Report For: Views, Barriers and Facilitators of Policymakers, Pharmacists and Health Community Representative in Managing Unused Medicine in a Socioeconomically Diverse District in Indonesia [version 1; peer review: 2 approved with reservations] . F1000Research 2026, 15 :314 ( https://doi.org/10.5256/f1000research.195928.r462273 ) The direct URL for this report is: https://f1000research.com/articles/15-314/v1#referee-response-462273 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 18 Mar 2026 Liz Breen , University of Bradford, Bradford, England, UK Approved with Reservations VIEWS 0 https://doi.org/10.5256/f1000research.195928.r462273 Really interesting focus for investigation. I would opt to bring in your socio-ecological approach earlier as it underpins your study, and the content of your introduction works within this realm. Can we have some additional insight into ... Continue reading READ ALL Really interesting focus for investigation. I would opt to bring in your socio-ecological approach earlier as it underpins your study, and the content of your introduction works within this realm. Can we have some additional insight into what the government position is on pharmaceutical sustainability generally even if this does not drill down to household waste. There has to be a clear indication why this research is needed at this time and how it will impact. In your introduction (last paragraph) you state the following - can you deliver to this given you have only examined on location? I would advocate that there could be learning for other LMICs but it isn't a given as it will require interpretation. ......... and provides evidence to inform the development of comprehensive strategies for pharmaceutical waste management in LMIC settings. Methods - This section is repeated: Eligible participants were representatives from selected institutions who possessed broad knowledge of medicine management, provided pharmaceutical services, and/or had experience in community health. They were required to have at least one year of professional experience in a related field and to obtain an official recommendation from their institutional leader. Participants were excluded if they had less than one year of relevant professional experience, did not receive formal approval from their institution, were on temporary leave or not actively engaged in their professional duties during data collection, declined to provide informed consent, or had potential conflicts of interest that might compromise the integrity of the study. No prior relationship was established between the researcher and participants before the study commenced. I would advocate a separate and more comprehensive section on Ethics. Data collection should have its own identity. Table 1 insights are very limited, can we see the additional line of questioning? 34,8% should be recorded as 34.8% Fig 1 are awareness post Covid etc facilitators or is it the action taken because of these that are facilitators? On their own they are inanimate and don't have an impact. Individual level - why do you say could be? Surely the data tells you it is or isn't as this is speculative. - at the individual level, the main issue could be affected by attitude and cultural beliefs. Where you have a respondent, you should put in their role. Given this is a qualitative piece of work with focus group discussions the results are very quickly reduced to tables etc. Whilst the presentation in this form is help and is an excellent synthesis of data, I would expect to see it supplemented by rich data in the form of more quotes, even if these are tabularised. Discussion - In the discussion it would be helpful to map the status quo with the stakeholders, what current waste management practice looks like. Do you have this information? Your paper would benefit from a grammar check e.g. Recent study in China told us .......would read better as A recent study set in China advised that..... from waste landfill slide) - why is this ) here? Can the findings as discussed here be narrowed down to a group e.g. which stakeholder group was burning medicines? Or putting them into landfill to correlate with the China example? It's difficult to know what content in the Discussion at times the study findings v is previous literature/research. This should be clear. Referencing accuracy - remove W (W. Song et al., 2025 ). Why are the barriers broken down by the different levels but not the facilitators - because of the volume reported? There is interesting data here but the depth of analysis in the discussion can be enhanced with insight into discrete stakeholder views - currently they are aggregated so difficult to know which should be targeted for action, which could have the most influence in expediting change etc. The socio-ecological model could be introduced in more depth to determine its influence on this study. This would be applicable to both the introduction and the Discussion. I encourage the authors to explore this section further and insert the additional content to strengthen this paper and its offer. Good luck with your revisions. Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Not applicable Are all the source data underlying the results available to ensure full reproducibility? Partly Are the conclusions drawn adequately supported by the results? Partly Competing Interests: No competing interests were disclosed. Reviewer Expertise: Pharmaceutical supply chain, design, improvement and sustainability. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Breen L. Reviewer Report For: Views, Barriers and Facilitators of Policymakers, Pharmacists and Health Community Representative in Managing Unused Medicine in a Socioeconomically Diverse District in Indonesia [version 1; peer review: 2 approved with reservations] . F1000Research 2026, 15 :314 ( https://doi.org/10.5256/f1000research.195928.r462273 ) The direct URL for this report is: https://f1000research.com/articles/15-314/v1#referee-response-462273 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 04 May 2026 Aldizal Mahendra , Pharmacy Program, Faculty of Mathematics and Natural Sciences, Universitas Garut, Garut, Indonesia 04 May 2026 Author Response Dear Dr Liz Breen Thank you for your insightful and constructive feedback. We have carefully revised the manuscript accordingly: SEM introduced earlier: The socio-ecological model has now been ... Continue reading Dear Dr Liz Breen Thank you for your insightful and constructive feedback. We have carefully revised the manuscript accordingly: SEM introduced earlier: The socio-ecological model has now been introduced earlier in the Introduction and further elaborated to clarify its role in framing the study. Government position on pharmaceutical sustainability: Additional context on national policy and pharmaceutical waste management frameworks has been incorporated in the Introduction Claim on LMIC relevance: We refined the statement to avoid overgeneralisation and clarified that findings may offer transferable insights with contextual interpretation. Repeated Methods text: The duplicated participant eligibility section has been removed. Ethics section: A separate and more detailed Ethics section has been added. Data collection clarity: Data collection procedures have been expanded and separated clearly from recruitment. Table 1 depth: Additional explanation of the FGD guide and its SEM basis has been included. Figure 1 clarification: Figure 1 is now better integrated into the Results section and explicitly explained. Speculative language: Revised to reflect evidence-based statements. Use of participant roles: Participant roles are now consistently indicated in the findings. Limited quotes: Additional quotes have been incorporated to enrich qualitative depth. Discussion clarity: Revised to clearly distinguish findings from supporting literature. Grammar and formatting issues: The manuscript has undergone thorough language editing and correction. Stakeholder-specific insights: The discussion now better differentiates perspectives across stakeholder groups. We hope that these revisions have addressed the your concerns and have strengthened the clarity, rigor, and overall contribution of the manuscript. We sincerely appreciate the reviewer’s insightful comments, which have been invaluable in improving the quality of this work. Dear Dr Liz Breen Thank you for your insightful and constructive feedback. We have carefully revised the manuscript accordingly: SEM introduced earlier: The socio-ecological model has now been introduced earlier in the Introduction and further elaborated to clarify its role in framing the study. Government position on pharmaceutical sustainability: Additional context on national policy and pharmaceutical waste management frameworks has been incorporated in the Introduction Claim on LMIC relevance: We refined the statement to avoid overgeneralisation and clarified that findings may offer transferable insights with contextual interpretation. Repeated Methods text: The duplicated participant eligibility section has been removed. Ethics section: A separate and more detailed Ethics section has been added. Data collection clarity: Data collection procedures have been expanded and separated clearly from recruitment. Table 1 depth: Additional explanation of the FGD guide and its SEM basis has been included. Figure 1 clarification: Figure 1 is now better integrated into the Results section and explicitly explained. Speculative language: Revised to reflect evidence-based statements. Use of participant roles: Participant roles are now consistently indicated in the findings. Limited quotes: Additional quotes have been incorporated to enrich qualitative depth. Discussion clarity: Revised to clearly distinguish findings from supporting literature. Grammar and formatting issues: The manuscript has undergone thorough language editing and correction. Stakeholder-specific insights: The discussion now better differentiates perspectives across stakeholder groups. We hope that these revisions have addressed the your concerns and have strengthened the clarity, rigor, and overall contribution of the manuscript. We sincerely appreciate the reviewer’s insightful comments, which have been invaluable in improving the quality of this work. Competing Interests: No competing interests were disclosed. Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 04 May 2026 Aldizal Mahendra , Pharmacy Program, Faculty of Mathematics and Natural Sciences, Universitas Garut, Garut, Indonesia 04 May 2026 Author Response Dear Dr Liz Breen Thank you for your insightful and constructive feedback. We have carefully revised the manuscript accordingly: SEM introduced earlier: The socio-ecological model has now been ... Continue reading Dear Dr Liz Breen Thank you for your insightful and constructive feedback. We have carefully revised the manuscript accordingly: SEM introduced earlier: The socio-ecological model has now been introduced earlier in the Introduction and further elaborated to clarify its role in framing the study. Government position on pharmaceutical sustainability: Additional context on national policy and pharmaceutical waste management frameworks has been incorporated in the Introduction Claim on LMIC relevance: We refined the statement to avoid overgeneralisation and clarified that findings may offer transferable insights with contextual interpretation. Repeated Methods text: The duplicated participant eligibility section has been removed. Ethics section: A separate and more detailed Ethics section has been added. Data collection clarity: Data collection procedures have been expanded and separated clearly from recruitment. Table 1 depth: Additional explanation of the FGD guide and its SEM basis has been included. Figure 1 clarification: Figure 1 is now better integrated into the Results section and explicitly explained. Speculative language: Revised to reflect evidence-based statements. Use of participant roles: Participant roles are now consistently indicated in the findings. Limited quotes: Additional quotes have been incorporated to enrich qualitative depth. Discussion clarity: Revised to clearly distinguish findings from supporting literature. Grammar and formatting issues: The manuscript has undergone thorough language editing and correction. Stakeholder-specific insights: The discussion now better differentiates perspectives across stakeholder groups. We hope that these revisions have addressed the your concerns and have strengthened the clarity, rigor, and overall contribution of the manuscript. We sincerely appreciate the reviewer’s insightful comments, which have been invaluable in improving the quality of this work. Dear Dr Liz Breen Thank you for your insightful and constructive feedback. We have carefully revised the manuscript accordingly: SEM introduced earlier: The socio-ecological model has now been introduced earlier in the Introduction and further elaborated to clarify its role in framing the study. Government position on pharmaceutical sustainability: Additional context on national policy and pharmaceutical waste management frameworks has been incorporated in the Introduction Claim on LMIC relevance: We refined the statement to avoid overgeneralisation and clarified that findings may offer transferable insights with contextual interpretation. Repeated Methods text: The duplicated participant eligibility section has been removed. Ethics section: A separate and more detailed Ethics section has been added. Data collection clarity: Data collection procedures have been expanded and separated clearly from recruitment. Table 1 depth: Additional explanation of the FGD guide and its SEM basis has been included. Figure 1 clarification: Figure 1 is now better integrated into the Results section and explicitly explained. Speculative language: Revised to reflect evidence-based statements. Use of participant roles: Participant roles are now consistently indicated in the findings. Limited quotes: Additional quotes have been incorporated to enrich qualitative depth. Discussion clarity: Revised to clearly distinguish findings from supporting literature. Grammar and formatting issues: The manuscript has undergone thorough language editing and correction. Stakeholder-specific insights: The discussion now better differentiates perspectives across stakeholder groups. We hope that these revisions have addressed the your concerns and have strengthened the clarity, rigor, and overall contribution of the manuscript. We sincerely appreciate the reviewer’s insightful comments, which have been invaluable in improving the quality of this work. Competing Interests: No competing interests were disclosed. Close Report a concern COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Husaini DC. Reviewer Report For: Views, Barriers and Facilitators of Policymakers, Pharmacists and Health Community Representative in Managing Unused Medicine in a Socioeconomically Diverse District in Indonesia [version 1; peer review: 2 approved with reservations] . F1000Research 2026, 15 :314 ( https://doi.org/10.5256/f1000research.195928.r464363 ) The direct URL for this report is: https://f1000research.com/articles/15-314/v1#referee-response-464363 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 12 Mar 2026 Danladi Chiroma Husaini , University of Belize, Belmopan, Belize Approved with Reservations VIEWS 0 https://doi.org/10.5256/f1000research.195928.r464363 Dear Authors, First and foremost, I would like to commend you on tackling a critically important and under-researched public health and environmental issue. The problem of unused medicines is a global concern, and your focus on Indonesia, a ... Continue reading READ ALL Dear Authors, First and foremost, I would like to commend you on tackling a critically important and under-researched public health and environmental issue. The problem of unused medicines is a global concern, and your focus on Indonesia, a country with a complex socio-economic landscape, is both timely and necessary. The decision to move beyond patient-level analysis and engage with a diverse group of stakeholders—policymakers, pharmacists, and community representatives—is a significant strength of your work. By applying the Socio-Ecological Model (SEM), you have laid a strong foundation for understanding the multi-layered challenges and opportunities in managing pharmaceutical waste. This is a valuable contribution that has the potential to inform real-world policy and practice. The following feedback is intended to help you refine and strengthen your manuscript for indexing. General Assessment This is a well-conceived qualitative study with a robust methodology. The use of focus group discussions (FGDs) and thematic analysis is appropriate for your research aims. The findings are insightful and clearly demonstrate the interplay between individual behaviors, community norms, institutional constraints, and policy gaps. The manuscript is well-structured, but there are several areas where clarity, depth, and presentation can be significantly improved to enhance its impact and meet the standards of a high-quality journal. Major Recommendations for Revision These are the key areas that require your attention to strengthen the manuscript's core arguments and contribution. Sharpen the Focus and Introduction: Clarify the Research Gap: The introduction does a good job of outlining the problem. However, the specific research gap you are filling could be stated more powerfully. You mention that existing research focuses on individual patients or pharmacist willingness , but you don't explicitly state that no one has yet brought these three stakeholder groups (policymakers, pharmacists, community reps) together in a single, comparative qualitative study in the Indonesian context. Explicitly stating this as your unique contribution will make your paper's significance immediately clear from the outset. Streamline the Argument: The introduction could be more concise. For instance, the paragraph beginning "In high-income countries..." (Page 3) could be merged with the following one about Indonesia to create a sharper contrast between established systems and the local gap. Strengthen the Methods Section: Consistency is Key: There is a significant redundancy in the "Participant sampling and recruitment" section (Page 4). A large block of text describing eligibility criteria is repeated verbatim. Please remove the duplicate text to ensure a clean and professional presentation. Provide More Detail on the FGDs: You mention that two FGDs were in-person and two were via Zoom. It would be valuable to briefly comment on whether you observed any differences in the dynamics or richness of data between these two modes. Did the online setting affect participation or the depth of discussion? Acknowledging this adds transparency. Clarify the Role of the SEM: You state the FGD guide was "based on the Socio-Ecological Model." However, the guide questions presented in Table 1 are thematically organized. It would be helpful to briefly explain how the SEM informed the guide's development. For example, did you deliberately craft questions to probe each of the four SEM levels? Enhance the Presentation of Results: Refine Table 2: Table 2 (Themes and sub-themes) currently mixes themes and raw findings. For example, "Low community knowledge in waste management" is a finding, not a sub-theme. "Reasons for having unused medications" is too broad. I recommend restructuring this table to reflect your analytical process better: Theme 1: Community Practices in Managing Unused Medicines (Sub-themes: Storing medicines; Disposal into garbage; Burning; Disposal into water systems; Alternative uses). Theme 2: Barriers to Proper Management (Sub-themes: Individual-level barriers [knowledge, attitudes, beliefs]; Interpersonal-level barriers [medicine sharing, social norms]; Organizational-level barriers [lack of facilities, resources]; Policy-level barriers [regulatory gaps, budget]). Theme 3: Facilitators for Proper Management (Sub-themes: Growing public awareness; Existing organizational programs; National policy guidelines; Intersectoral collaboration). This structure would make your findings much clearer and directly map onto your SEM analysis. Integrate Figure 1 More Deeply: Figure 1 is a fantastic visual summary of your findings. However, it is introduced almost as an afterthought. In the text, you should explicitly guide the reader through the figure. For example: "As illustrated in Figure 1, the barriers are not isolated but form a system of influences. For instance, the individual-level barrier of 'economic considerations' (storing for 'just in case') is reinforced by the interpersonal norm of 'medicine sharing' and the organizational-level 'absence of facilities,' all within a policy environment of 'regulatory limitations.'" Deepen the Discussion and Conclusion: Elevate the Discussion Beyond Description: The discussion currently does an excellent job of reiterating your findings and linking them to the literature. To make it more impactful, try to synthesize your findings into a higher-level argument. For example, you could argue that "The persistence of unsafe practices is not a failure of individual rationality, but a rational response to systemic failures." This reframes the problem from one of patient education to one of health system and policy design. Use your data (e.g., P41's quote about wastefulness) to support this. Make the Recommendations Actionable: In your conclusion, you state the need for "comprehensive and coordinated strategy." This is a great starting point. Now, based on your findings, can you offer one or two concrete, actionable recommendations for Garut or similar districts? For example: "Based on the facilitator of existing community networks, a pilot program could be designed that trains PKK volunteers to collect unused medicines during their household visits, which are then collected by pharmacists from the local Puskesmas, with clear guidance and support from the Health Office and BBPOM." This would demonstrate the practical value of your research. Acknowledge Limitations More Specifically: The limitations section is good, but could be more specific. Instead of "may limit generalizability," you could say, "As a single-regency study in West Java, the findings may not be transferable to regions with different cultural norms, geographic characteristics (e.g., island communities), or healthcare infrastructures, such as Eastern Indonesia." This shows a deeper reflection on your study's context. Minor Recommendations for Revision These are minor points that will improve the manuscript's clarity and professionalism. Copyediting: There are several typographical and grammatical errors throughout the manuscript. For example: Page 1: "Yogakarta" should be "Yogyakarta." Page 2: "ConclusionConclusion" is a duplicate. Page 12: "Positioning findings within a socio- ecological perspective" is repeated as a subheading. Page 12: "Facilitators and opportunities for intervention" is repeated as a subheading. A thorough proofread by a native English speaker or a professional editing service is highly recommended. Terminology: The term "health community representative" is a bit unclear. Using "community health representatives" or "Family Welfare and Empowerment Team (PKK) representatives" throughout would be more precise. Figures and Tables: Table 3: The quote from P30 about using medicines for orchids is fascinating. It powerfully illustrates the theme of "non-scientific purposes." Its value might be slightly diminished by the less clear quote from P25. Consider keeping P30 and finding a clearer quote to illustrate the meat-tenderizing myth, or simply describing this finding in the text without a direct quote. Figure 1: The resolution of the figure seems low in the PDF. Please ensure a high-resolution version is submitted. As indicated earlier, this is a valuable piece of research that deserves indexing. The strength of your multi-stakeholder approach and the application of the Socio-Ecological Model provide a nuanced and comprehensive understanding of the issue. By addressing the recommendations above—particularly sharpening your unique contribution, refining the presentation of your themes, and deepening the discussion to offer more actionable insights—you will significantly enhance the manuscript's clarity, impact, and suitability for indexing. I look forward to seeing the final version of your important work. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes Competing Interests: No competing interests were disclosed. Reviewer Expertise: Experiential learning, Ethnopharmacology, Toxicology, Pharmacy education, Therapeutics, Climate change and health, Public Health, Environmental Health. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Husaini DC. Reviewer Report For: Views, Barriers and Facilitators of Policymakers, Pharmacists and Health Community Representative in Managing Unused Medicine in a Socioeconomically Diverse District in Indonesia [version 1; peer review: 2 approved with reservations] . F1000Research 2026, 15 :314 ( https://doi.org/10.5256/f1000research.195928.r464363 ) The direct URL for this report is: https://f1000research.com/articles/15-314/v1#referee-response-464363 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 04 May 2026 Aldizal Mahendra , Pharmacy Program, Faculty of Mathematics and Natural Sciences, Universitas Garut, Garut, Indonesia 04 May 2026 Author Response Dear Dr Danladi Chiroma Husaini Thank you for your thoughtful and encouraging feedback. We have addressed your recommendations as follows: Clarify research gap: The Introduction has been revised ... Continue reading Dear Dr Danladi Chiroma Husaini Thank you for your thoughtful and encouraging feedback. We have addressed your recommendations as follows: Clarify research gap: The Introduction has been revised to explicitly state the novelty of combining multiple stakeholder perspectives in a single qualitative study. Streamline introduction: Redundant sections have been merged for better flow and clarity. Methods consistency: Duplicate text has been removed and methodological clarity improved. Role of SEM in FGD design: Added explanation on how SEM informed question development. Refinement of Table 2: Table 2 has been restructured to distinguish themes and sub-themes and align with SEM levels. Integration of Figure 1: The figure is now explicitly discussed and linked to findings in the text. Elevating discussion: We incorporated a higher-level analytical argument, emphasizing that unsafe practices are shaped by systemic constraints. Supporting participant quotes have been integrated. Actionable recommendation: The Conclusion now includes a concrete pilot intervention model involving PKK, pharmacists, and local authorities. Limitations refinement: Expanded to reflect contextual transferability across Indonesian regions. Table 3 quote refinement: The less clear quote has been revised to improve clarity and contextual relevance. Language and formatting: Comprehensive proofreading has been conducted. We hope that these revisions have addressed the reviewer’s concerns and have strengthened the clarity, rigor, and overall contribution of the manuscript. We sincerely appreciate the reviewer’s insightful comments, which have been invaluable in improving the quality of this work. Dear Dr Danladi Chiroma Husaini Thank you for your thoughtful and encouraging feedback. We have addressed your recommendations as follows: Clarify research gap: The Introduction has been revised to explicitly state the novelty of combining multiple stakeholder perspectives in a single qualitative study. Streamline introduction: Redundant sections have been merged for better flow and clarity. Methods consistency: Duplicate text has been removed and methodological clarity improved. Role of SEM in FGD design: Added explanation on how SEM informed question development. Refinement of Table 2: Table 2 has been restructured to distinguish themes and sub-themes and align with SEM levels. Integration of Figure 1: The figure is now explicitly discussed and linked to findings in the text. Elevating discussion: We incorporated a higher-level analytical argument, emphasizing that unsafe practices are shaped by systemic constraints. Supporting participant quotes have been integrated. Actionable recommendation: The Conclusion now includes a concrete pilot intervention model involving PKK, pharmacists, and local authorities. Limitations refinement: Expanded to reflect contextual transferability across Indonesian regions. Table 3 quote refinement: The less clear quote has been revised to improve clarity and contextual relevance. Language and formatting: Comprehensive proofreading has been conducted. We hope that these revisions have addressed the reviewer’s concerns and have strengthened the clarity, rigor, and overall contribution of the manuscript. We sincerely appreciate the reviewer’s insightful comments, which have been invaluable in improving the quality of this work. Competing Interests: No competing interests were disclosed. Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 04 May 2026 Aldizal Mahendra , Pharmacy Program, Faculty of Mathematics and Natural Sciences, Universitas Garut, Garut, Indonesia 04 May 2026 Author Response Dear Dr Danladi Chiroma Husaini Thank you for your thoughtful and encouraging feedback. We have addressed your recommendations as follows: Clarify research gap: The Introduction has been revised ... Continue reading Dear Dr Danladi Chiroma Husaini Thank you for your thoughtful and encouraging feedback. We have addressed your recommendations as follows: Clarify research gap: The Introduction has been revised to explicitly state the novelty of combining multiple stakeholder perspectives in a single qualitative study. Streamline introduction: Redundant sections have been merged for better flow and clarity. Methods consistency: Duplicate text has been removed and methodological clarity improved. Role of SEM in FGD design: Added explanation on how SEM informed question development. Refinement of Table 2: Table 2 has been restructured to distinguish themes and sub-themes and align with SEM levels. Integration of Figure 1: The figure is now explicitly discussed and linked to findings in the text. Elevating discussion: We incorporated a higher-level analytical argument, emphasizing that unsafe practices are shaped by systemic constraints. Supporting participant quotes have been integrated. Actionable recommendation: The Conclusion now includes a concrete pilot intervention model involving PKK, pharmacists, and local authorities. Limitations refinement: Expanded to reflect contextual transferability across Indonesian regions. Table 3 quote refinement: The less clear quote has been revised to improve clarity and contextual relevance. Language and formatting: Comprehensive proofreading has been conducted. We hope that these revisions have addressed the reviewer’s concerns and have strengthened the clarity, rigor, and overall contribution of the manuscript. We sincerely appreciate the reviewer’s insightful comments, which have been invaluable in improving the quality of this work. Dear Dr Danladi Chiroma Husaini Thank you for your thoughtful and encouraging feedback. We have addressed your recommendations as follows: Clarify research gap: The Introduction has been revised to explicitly state the novelty of combining multiple stakeholder perspectives in a single qualitative study. Streamline introduction: Redundant sections have been merged for better flow and clarity. Methods consistency: Duplicate text has been removed and methodological clarity improved. Role of SEM in FGD design: Added explanation on how SEM informed question development. Refinement of Table 2: Table 2 has been restructured to distinguish themes and sub-themes and align with SEM levels. Integration of Figure 1: The figure is now explicitly discussed and linked to findings in the text. Elevating discussion: We incorporated a higher-level analytical argument, emphasizing that unsafe practices are shaped by systemic constraints. Supporting participant quotes have been integrated. Actionable recommendation: The Conclusion now includes a concrete pilot intervention model involving PKK, pharmacists, and local authorities. Limitations refinement: Expanded to reflect contextual transferability across Indonesian regions. Table 3 quote refinement: The less clear quote has been revised to improve clarity and contextual relevance. Language and formatting: Comprehensive proofreading has been conducted. We hope that these revisions have addressed the reviewer’s concerns and have strengthened the clarity, rigor, and overall contribution of the manuscript. We sincerely appreciate the reviewer’s insightful comments, which have been invaluable in improving the quality of this work. Competing Interests: No competing interests were disclosed. Close Report a concern COMMENT ON THIS REPORT Comments on this article Comments (0) Version 2 VERSION 2 PUBLISHED 24 Feb 2026 ADD YOUR COMMENT Comment keyboard_arrow_left keyboard_arrow_right Open Peer Review Reviewer Status info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Reviewer Reports Invited Reviewers 1 2 Version 2 (revision) 04 May 26 read read Version 1 24 Feb 26 read read Danladi Chiroma Husaini , University of Belize, Belmopan, Belize Liz Breen , University of Bradford, Bradford, UK Comments on this article All Comments (0) Add a comment Sign up for content alerts Sign Up You are now signed up to receive this alert Browse by related subjects keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2026 Breen L. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 08 May 2026 | for Version 2 Liz Breen , University of Bradford, Bradford, England, UK 0 Views copyright © 2026 Breen L. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions The authors have completed the revisions to the expected standard and the paper is a more thorough version. Well done. Competing Interests No competing interests were disclosed. Reviewer Expertise Pharmaceutical supply chain, design, improvement and sustainability. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (0) Breen L. Peer Review Report For: Views, Barriers and Facilitators of Policymakers, Pharmacists and Health Community Representative in Managing Unused Medicine in a Socioeconomically Diverse District in Indonesia [version 1; peer review: 2 approved with reservations] . F1000Research 2026, 15 :314 ( https://doi.org/10.5256/f1000research.198938.r481405) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/15-314/v2#referee-response-481405 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2026 Husaini D. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 06 May 2026 | for Version 2 Danladi Chiroma Husaini , University of Belize, Belmopan, Belize 0 Views copyright © 2026 Husaini D. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions The authors have addressed all my concerns. I have no further comments. I wish them success. Competing Interests No competing interests were disclosed. Reviewer Expertise Experiential learning, Ethnopharmacology, Toxicology, Pharmacy education, Therapeutics, Climate change and health, Public Health, Environmental Health. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (0) Husaini DC. Peer Review Report For: Views, Barriers and Facilitators of Policymakers, Pharmacists and Health Community Representative in Managing Unused Medicine in a Socioeconomically Diverse District in Indonesia [version 1; peer review: 2 approved with reservations] . F1000Research 2026, 15 :314 ( https://doi.org/10.5256/f1000research.198938.r481406) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/15-314/v2#referee-response-481406 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2026 Breen L. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 18 Mar 2026 | for Version 1 Liz Breen , University of Bradford, Bradford, England, UK 0 Views copyright © 2026 Breen L. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Really interesting focus for investigation. I would opt to bring in your socio-ecological approach earlier as it underpins your study, and the content of your introduction works within this realm. Can we have some additional insight into what the government position is on pharmaceutical sustainability generally even if this does not drill down to household waste. There has to be a clear indication why this research is needed at this time and how it will impact. In your introduction (last paragraph) you state the following - can you deliver to this given you have only examined on location? I would advocate that there could be learning for other LMICs but it isn't a given as it will require interpretation. ......... and provides evidence to inform the development of comprehensive strategies for pharmaceutical waste management in LMIC settings. Methods - This section is repeated: Eligible participants were representatives from selected institutions who possessed broad knowledge of medicine management, provided pharmaceutical services, and/or had experience in community health. They were required to have at least one year of professional experience in a related field and to obtain an official recommendation from their institutional leader. Participants were excluded if they had less than one year of relevant professional experience, did not receive formal approval from their institution, were on temporary leave or not actively engaged in their professional duties during data collection, declined to provide informed consent, or had potential conflicts of interest that might compromise the integrity of the study. No prior relationship was established between the researcher and participants before the study commenced. I would advocate a separate and more comprehensive section on Ethics. Data collection should have its own identity. Table 1 insights are very limited, can we see the additional line of questioning? 34,8% should be recorded as 34.8% Fig 1 are awareness post Covid etc facilitators or is it the action taken because of these that are facilitators? On their own they are inanimate and don't have an impact. Individual level - why do you say could be? Surely the data tells you it is or isn't as this is speculative. - at the individual level, the main issue could be affected by attitude and cultural beliefs. Where you have a respondent, you should put in their role. Given this is a qualitative piece of work with focus group discussions the results are very quickly reduced to tables etc. Whilst the presentation in this form is help and is an excellent synthesis of data, I would expect to see it supplemented by rich data in the form of more quotes, even if these are tabularised. Discussion - In the discussion it would be helpful to map the status quo with the stakeholders, what current waste management practice looks like. Do you have this information? Your paper would benefit from a grammar check e.g. Recent study in China told us .......would read better as A recent study set in China advised that..... from waste landfill slide) - why is this ) here? Can the findings as discussed here be narrowed down to a group e.g. which stakeholder group was burning medicines? Or putting them into landfill to correlate with the China example? It's difficult to know what content in the Discussion at times the study findings v is previous literature/research. This should be clear. Referencing accuracy - remove W (W. Song et al., 2025 ). Why are the barriers broken down by the different levels but not the facilitators - because of the volume reported? There is interesting data here but the depth of analysis in the discussion can be enhanced with insight into discrete stakeholder views - currently they are aggregated so difficult to know which should be targeted for action, which could have the most influence in expediting change etc. The socio-ecological model could be introduced in more depth to determine its influence on this study. This would be applicable to both the introduction and the Discussion. I encourage the authors to explore this section further and insert the additional content to strengthen this paper and its offer. Good luck with your revisions. Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Not applicable Are all the source data underlying the results available to ensure full reproducibility? Partly Are the conclusions drawn adequately supported by the results? Partly Competing Interests No competing interests were disclosed. Reviewer Expertise Pharmaceutical supply chain, design, improvement and sustainability. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (1) Author Response 04 May 2026 Aldizal Mahendra, Pharmacy Program, Faculty of Mathematics and Natural Sciences, Universitas Garut, Garut, Indonesia Dear Dr Liz Breen Thank you for your insightful and constructive feedback. We have carefully revised the manuscript accordingly: SEM introduced earlier: The socio-ecological model has now been introduced earlier in the Introduction and further elaborated to clarify its role in framing the study. Government position on pharmaceutical sustainability: Additional context on national policy and pharmaceutical waste management frameworks has been incorporated in the Introduction Claim on LMIC relevance: We refined the statement to avoid overgeneralisation and clarified that findings may offer transferable insights with contextual interpretation. Repeated Methods text: The duplicated participant eligibility section has been removed. Ethics section: A separate and more detailed Ethics section has been added. Data collection clarity: Data collection procedures have been expanded and separated clearly from recruitment. Table 1 depth: Additional explanation of the FGD guide and its SEM basis has been included. Figure 1 clarification: Figure 1 is now better integrated into the Results section and explicitly explained. Speculative language: Revised to reflect evidence-based statements. Use of participant roles: Participant roles are now consistently indicated in the findings. Limited quotes: Additional quotes have been incorporated to enrich qualitative depth. Discussion clarity: Revised to clearly distinguish findings from supporting literature. Grammar and formatting issues: The manuscript has undergone thorough language editing and correction. Stakeholder-specific insights: The discussion now better differentiates perspectives across stakeholder groups. We hope that these revisions have addressed the your concerns and have strengthened the clarity, rigor, and overall contribution of the manuscript. We sincerely appreciate the reviewer’s insightful comments, which have been invaluable in improving the quality of this work. View more View less Competing Interests No competing interests were disclosed. reply Respond Report a concern Breen L. Peer Review Report For: Views, Barriers and Facilitators of Policymakers, Pharmacists and Health Community Representative in Managing Unused Medicine in a Socioeconomically Diverse District in Indonesia [version 1; peer review: 2 approved with reservations] . F1000Research 2026, 15 :314 ( https://doi.org/10.5256/f1000research.195928.r462273) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/15-314/v1#referee-response-462273 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2026 Husaini D. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 12 Mar 2026 | for Version 1 Danladi Chiroma Husaini , University of Belize, Belmopan, Belize 0 Views copyright © 2026 Husaini D. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Dear Authors, First and foremost, I would like to commend you on tackling a critically important and under-researched public health and environmental issue. The problem of unused medicines is a global concern, and your focus on Indonesia, a country with a complex socio-economic landscape, is both timely and necessary. The decision to move beyond patient-level analysis and engage with a diverse group of stakeholders—policymakers, pharmacists, and community representatives—is a significant strength of your work. By applying the Socio-Ecological Model (SEM), you have laid a strong foundation for understanding the multi-layered challenges and opportunities in managing pharmaceutical waste. This is a valuable contribution that has the potential to inform real-world policy and practice. The following feedback is intended to help you refine and strengthen your manuscript for indexing. General Assessment This is a well-conceived qualitative study with a robust methodology. The use of focus group discussions (FGDs) and thematic analysis is appropriate for your research aims. The findings are insightful and clearly demonstrate the interplay between individual behaviors, community norms, institutional constraints, and policy gaps. The manuscript is well-structured, but there are several areas where clarity, depth, and presentation can be significantly improved to enhance its impact and meet the standards of a high-quality journal. Major Recommendations for Revision These are the key areas that require your attention to strengthen the manuscript's core arguments and contribution. Sharpen the Focus and Introduction: Clarify the Research Gap: The introduction does a good job of outlining the problem. However, the specific research gap you are filling could be stated more powerfully. You mention that existing research focuses on individual patients or pharmacist willingness , but you don't explicitly state that no one has yet brought these three stakeholder groups (policymakers, pharmacists, community reps) together in a single, comparative qualitative study in the Indonesian context. Explicitly stating this as your unique contribution will make your paper's significance immediately clear from the outset. Streamline the Argument: The introduction could be more concise. For instance, the paragraph beginning "In high-income countries..." (Page 3) could be merged with the following one about Indonesia to create a sharper contrast between established systems and the local gap. Strengthen the Methods Section: Consistency is Key: There is a significant redundancy in the "Participant sampling and recruitment" section (Page 4). A large block of text describing eligibility criteria is repeated verbatim. Please remove the duplicate text to ensure a clean and professional presentation. Provide More Detail on the FGDs: You mention that two FGDs were in-person and two were via Zoom. It would be valuable to briefly comment on whether you observed any differences in the dynamics or richness of data between these two modes. Did the online setting affect participation or the depth of discussion? Acknowledging this adds transparency. Clarify the Role of the SEM: You state the FGD guide was "based on the Socio-Ecological Model." However, the guide questions presented in Table 1 are thematically organized. It would be helpful to briefly explain how the SEM informed the guide's development. For example, did you deliberately craft questions to probe each of the four SEM levels? Enhance the Presentation of Results: Refine Table 2: Table 2 (Themes and sub-themes) currently mixes themes and raw findings. For example, "Low community knowledge in waste management" is a finding, not a sub-theme. "Reasons for having unused medications" is too broad. I recommend restructuring this table to reflect your analytical process better: Theme 1: Community Practices in Managing Unused Medicines (Sub-themes: Storing medicines; Disposal into garbage; Burning; Disposal into water systems; Alternative uses). Theme 2: Barriers to Proper Management (Sub-themes: Individual-level barriers [knowledge, attitudes, beliefs]; Interpersonal-level barriers [medicine sharing, social norms]; Organizational-level barriers [lack of facilities, resources]; Policy-level barriers [regulatory gaps, budget]). Theme 3: Facilitators for Proper Management (Sub-themes: Growing public awareness; Existing organizational programs; National policy guidelines; Intersectoral collaboration). This structure would make your findings much clearer and directly map onto your SEM analysis. Integrate Figure 1 More Deeply: Figure 1 is a fantastic visual summary of your findings. However, it is introduced almost as an afterthought. In the text, you should explicitly guide the reader through the figure. For example: "As illustrated in Figure 1, the barriers are not isolated but form a system of influences. For instance, the individual-level barrier of 'economic considerations' (storing for 'just in case') is reinforced by the interpersonal norm of 'medicine sharing' and the organizational-level 'absence of facilities,' all within a policy environment of 'regulatory limitations.'" Deepen the Discussion and Conclusion: Elevate the Discussion Beyond Description: The discussion currently does an excellent job of reiterating your findings and linking them to the literature. To make it more impactful, try to synthesize your findings into a higher-level argument. For example, you could argue that "The persistence of unsafe practices is not a failure of individual rationality, but a rational response to systemic failures." This reframes the problem from one of patient education to one of health system and policy design. Use your data (e.g., P41's quote about wastefulness) to support this. Make the Recommendations Actionable: In your conclusion, you state the need for "comprehensive and coordinated strategy." This is a great starting point. Now, based on your findings, can you offer one or two concrete, actionable recommendations for Garut or similar districts? For example: "Based on the facilitator of existing community networks, a pilot program could be designed that trains PKK volunteers to collect unused medicines during their household visits, which are then collected by pharmacists from the local Puskesmas, with clear guidance and support from the Health Office and BBPOM." This would demonstrate the practical value of your research. Acknowledge Limitations More Specifically: The limitations section is good, but could be more specific. Instead of "may limit generalizability," you could say, "As a single-regency study in West Java, the findings may not be transferable to regions with different cultural norms, geographic characteristics (e.g., island communities), or healthcare infrastructures, such as Eastern Indonesia." This shows a deeper reflection on your study's context. Minor Recommendations for Revision These are minor points that will improve the manuscript's clarity and professionalism. Copyediting: There are several typographical and grammatical errors throughout the manuscript. For example: Page 1: "Yogakarta" should be "Yogyakarta." Page 2: "ConclusionConclusion" is a duplicate. Page 12: "Positioning findings within a socio- ecological perspective" is repeated as a subheading. Page 12: "Facilitators and opportunities for intervention" is repeated as a subheading. A thorough proofread by a native English speaker or a professional editing service is highly recommended. Terminology: The term "health community representative" is a bit unclear. Using "community health representatives" or "Family Welfare and Empowerment Team (PKK) representatives" throughout would be more precise. Figures and Tables: Table 3: The quote from P30 about using medicines for orchids is fascinating. It powerfully illustrates the theme of "non-scientific purposes." Its value might be slightly diminished by the less clear quote from P25. Consider keeping P30 and finding a clearer quote to illustrate the meat-tenderizing myth, or simply describing this finding in the text without a direct quote. Figure 1: The resolution of the figure seems low in the PDF. Please ensure a high-resolution version is submitted. As indicated earlier, this is a valuable piece of research that deserves indexing. The strength of your multi-stakeholder approach and the application of the Socio-Ecological Model provide a nuanced and comprehensive understanding of the issue. By addressing the recommendations above—particularly sharpening your unique contribution, refining the presentation of your themes, and deepening the discussion to offer more actionable insights—you will significantly enhance the manuscript's clarity, impact, and suitability for indexing. I look forward to seeing the final version of your important work. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes Competing Interests No competing interests were disclosed. Reviewer Expertise Experiential learning, Ethnopharmacology, Toxicology, Pharmacy education, Therapeutics, Climate change and health, Public Health, Environmental Health. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (1) Author Response 04 May 2026 Aldizal Mahendra, Pharmacy Program, Faculty of Mathematics and Natural Sciences, Universitas Garut, Garut, Indonesia Dear Dr Danladi Chiroma Husaini Thank you for your thoughtful and encouraging feedback. We have addressed your recommendations as follows: Clarify research gap: The Introduction has been revised to explicitly state the novelty of combining multiple stakeholder perspectives in a single qualitative study. Streamline introduction: Redundant sections have been merged for better flow and clarity. Methods consistency: Duplicate text has been removed and methodological clarity improved. Role of SEM in FGD design: Added explanation on how SEM informed question development. Refinement of Table 2: Table 2 has been restructured to distinguish themes and sub-themes and align with SEM levels. Integration of Figure 1: The figure is now explicitly discussed and linked to findings in the text. Elevating discussion: We incorporated a higher-level analytical argument, emphasizing that unsafe practices are shaped by systemic constraints. Supporting participant quotes have been integrated. Actionable recommendation: The Conclusion now includes a concrete pilot intervention model involving PKK, pharmacists, and local authorities. Limitations refinement: Expanded to reflect contextual transferability across Indonesian regions. Table 3 quote refinement: The less clear quote has been revised to improve clarity and contextual relevance. Language and formatting: Comprehensive proofreading has been conducted. We hope that these revisions have addressed the reviewer’s concerns and have strengthened the clarity, rigor, and overall contribution of the manuscript. We sincerely appreciate the reviewer’s insightful comments, which have been invaluable in improving the quality of this work. View more View less Competing Interests No competing interests were disclosed. reply Respond Report a concern Husaini DC. Peer Review Report For: Views, Barriers and Facilitators of Policymakers, Pharmacists and Health Community Representative in Managing Unused Medicine in a Socioeconomically Diverse District in Indonesia [version 1; peer review: 2 approved with reservations] . F1000Research 2026, 15 :314 ( https://doi.org/10.5256/f1000research.195928.r464363) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/15-314/v1#referee-response-464363 Alongside their report, reviewers assign a status to the article: Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved - fundamental flaws in the paper seriously undermine the findings and conclusions Adjust parameters to alter display View on desktop for interactive features Includes Interactive Elements View on desktop for interactive features Competing Interests Policy Provide sufficient details of any financial or non-financial competing interests to enable users to assess whether your comments might lead a reasonable person to question your impartiality. Consider the following examples, but note that this is not an exhaustive list: Examples of 'Non-Financial Competing Interests' Within the past 4 years, you have held joint grants, published or collaborated with any of the authors of the selected paper. You have a close personal relationship (e.g. parent, spouse, sibling, or domestic partner) with any of the authors. You are a close professional associate of any of the authors (e.g. scientific mentor, recent student). You work at the same institute as any of the authors. You hope/expect to benefit (e.g. favour or employment) as a result of your submission. You are an Editor for the journal in which the article is published. Examples of 'Financial Competing Interests' You expect to receive, or in the past 4 years have received, any of the following from any commercial organisation that may gain financially from your submission: a salary, fees, funding, reimbursements. You expect to receive, or in the past 4 years have received, shared grant support or other funding with any of the authors. You hold, or are currently applying for, any patents or significant stocks/shares relating to the subject matter of the paper you are commenting on. Stay Updated Sign up for content alerts and receive a weekly or monthly email with all newly published articles Register with F1000Research Already registered? Sign in Not now, thanks close PLEASE NOTE If you are an AUTHOR of this article, please check that you signed in with the account associated with this article otherwise we cannot automatically identify your role as an author and your comment will be labelled as a “User Comment”. If you are a REVIEWER of this article, please check that you have signed in with the account associated with this article and then go to your account to submit your report, please do not post your review here. If you do not have access to your original account, please contact us . All commenters must hold a formal affiliation as per our Policies . The information that you give us will be displayed next to your comment. User comments must be in English, comprehensible and relevant to the article under discussion. We reserve the right to remove any comments that we consider to be inappropriate, offensive or otherwise in breach of the User Comment Terms and Conditions . Commenters must not use a comment for personal attacks. When criticisms of the article are based on unpublished data, the data should be made available. I accept the User Comment Terms and Conditions Please confirm that you accept the User Comment Terms and Conditions. Affiliation ✕ refresh Please enter your institution. Note: To add your institution or organisation, start typing the name and then select the correct name from the list. Where applicable, the name will appear in both the original language and in English. Do not paste in the name. If the name does not appear in the drop-down list, we will display the information you have entered. ✕ refresh Country/Region * USA UK Canada China France Germany Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory British Virgin Islands Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Cyprus Czech Republic Democratic Republic of the Congo Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Federated States of Micronesia Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and Mcdonald Islands Holy See (Vatican City State) Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kosovo (Serbia and Montenegro) Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Minor Outlying Islands of the United States Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea North Macedonia Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territory Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Helena Saint Kitts and Nevis Saint Lucia Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Is South Korea South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand The Gambia The Netherlands Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu UK USA Uganda Ukraine United Arab Emirates United States Virgin Islands Uruguay Uzbekistan Vanuatu Venezuela Vietnam Wallis and Futuna West Bank and Gaza Strip Western Sahara Yemen Zambia Zimbabwe Please select your country/region. You must enter a comment. Competing Interests Please disclose any competing interests that might be construed to influence your judgment of the article's or peer review report's validity or importance. Competing Interests Policy Provide sufficient details of any financial or non-financial competing interests to enable users to assess whether your comments might lead a reasonable person to question your impartiality. Consider the following examples, but note that this is not an exhaustive list: Examples of 'Non-Financial Competing Interests' Within the past 4 years, you have held joint grants, published or collaborated with any of the authors of the selected paper. You have a close personal relationship (e.g. parent, spouse, sibling, or domestic partner) with any of the authors. You are a close professional associate of any of the authors (e.g. scientific mentor, recent student). You work at the same institute as any of the authors. You hope/expect to benefit (e.g. favour or employment) as a result of your submission. You are an Editor for the journal in which the article is published. Examples of 'Financial Competing Interests' You expect to receive, or in the past 4 years have received, any of the following from any commercial organisation that may gain financially from your submission: a salary, fees, funding, reimbursements. You expect to receive, or in the past 4 years have received, shared grant support or other funding with any of the authors. You hold, or are currently applying for, any patents or significant stocks/shares relating to the subject matter of the paper you are commenting on. Please state your competing interests The comment has been saved. An error has occurred. Please try again. Cancel Post var lTitle = "Views, Barriers and Facilitators\u00A0 of...".replace("'", ''); var linkedInUrl = "http://www.linkedin.com/shareArticle?url=https://f1000research.com/articles/15-314/v1" + "&title=" + encodeURIComponent(lTitle) + "&summary=" + encodeURIComponent('Read the article by '); var deliciousUrl = "https://del.icio.us/post?url=https://f1000research.com/articles/15-314/v1&title=" + encodeURIComponent(lTitle); var redditUrl = "http://reddit.com/submit?url=https://f1000research.com/articles/15-314/v1" + "&title=" + encodeURIComponent(lTitle); linkedInUrl += encodeURIComponent('Syamsudin RAMR et al.'); var offsetTop = /chrome/i.test( navigator.userAgent ) ? 4 : -10; var addthis_config = { ui_offset_top: offsetTop, services_compact : "facebook,twitter,www.linkedin.com,www.mendeley.com,reddit.com", services_expanded : "facebook,twitter,www.linkedin.com,www.mendeley.com,reddit.com", services_custom : [ { name: "LinkedIn", url: linkedInUrl, icon:"/img/icon/at_linkedin.svg" }, { name: "Mendeley", url: "http://www.mendeley.com/import/?url=https://f1000research.com/articles/15-314/v1/mendeley", icon:"/img/icon/at_mendeley.svg" }, { name: "Reddit", url: redditUrl, icon:"/img/icon/at_reddit.svg" }, ] }; var addthis_share = { url: "https://f1000research.com/articles/15-314", templates : { twitter : "Views, Barriers and Facilitators\u00A0 of Policymakers, Pharmacists.... Syamsudin RAMR et al., published by " + "@F1000Research" + ", https://f1000research.com/articles/15-314/v1" } }; if (typeof(addthis) != "undefined"){ addthis.addEventListener('addthis.ready', checkCount); addthis.addEventListener('addthis.menu.share', checkCount); } $(".f1r-shares-twitter").attr("href", "https://twitter.com/intent/tweet?text=" + addthis_share.templates.twitter); $(".f1r-shares-facebook").attr("href", "https://www.facebook.com/sharer/sharer.php?u=" + addthis_share.url); $(".f1r-shares-linkedin").attr("href", addthis_config.services_custom[0].url); $(".f1r-shares-reddit").attr("href", addthis_config.services_custom[2].url); $(".f1r-shares-mendelay").attr("href", addthis_config.services_custom[1].url); function checkCount(){ setTimeout(function(){ $(".addthis_button_expanded").each(function(){ var count = $(this).text(); if (count !== "" && count != "0") $(this).removeClass("is-hidden"); else $(this).addClass("is-hidden"); }); }, 1000); } close How to cite this report {{reportCitation}} Cancel Copy Citation Details $(function(){R.ui.buttonDropdowns('.dropdown-for-downloads');}); $(function(){R.ui.toolbarDropdowns('.toolbar-dropdown-for-downloads');}); $.get("/articles/acj/177671/195928") new F1000.Clipboard(); new F1000.ThesaurusTermsDisplay("articles", "article", "195928"); $(document).ready(function() { $( "#frame1" ).on('load', function() { var mydiv = $(this).contents().find("div"); var h = mydiv.height(); console.log(h) }); var tooltipLivingFigure = jQuery(".interactive-living-figure-label .icon-more-info"), titleLivingFigure = tooltipLivingFigure.attr("title"); tooltipLivingFigure.simpletip({ fixed: true, position: ["-115", "30"], baseClass: 'small-tooltip', content:titleLivingFigure + " " }); tooltipLivingFigure.removeAttr("title"); $("body").on("click", ".cite-living-figure", function(e) { e.preventDefault(); var ref = $(this).attr("data-ref"); $(this).closest(".living-figure-list-container").find("#" + ref).fadeIn(200); }); $("body").on("click", ".close-cite-living-figure", function(e) { e.preventDefault(); $(this).closest(".popup-window-wrapper").fadeOut(200); }); $(document).on("mouseup", function(e) { var metricsContainer = $(".article-metrics-popover-wrapper"); if (!metricsContainer.is(e.target) && metricsContainer.has(e.target).length === 0) { $(".article-metrics-close-button").click(); } }); var articleId = $('#articleId').val(); if($("#main-article-count-box").attachArticleMetrics) { $("#main-article-count-box").attachArticleMetrics(articleId, { articleMetricsView: true }); } }); var figshareWidget = $(".new_figshare_widget"); if (figshareWidget.length > 0) { window.figshare.load("f1000", function(Widget) { // Select a tag/tags defined in your page. In this tag we will place the widget. _.map(figshareWidget, function(el){ var widget = new Widget({ articleId: $(el).attr("figshare_articleId") //height:300 // this is the height of the viewer part. [Default: 550] }); widget.initialize(); // initialize the widget widget.mount(el); // mount it in a tag that's on your page // this will save the widget on the global scope for later use from // your JS scripts. This line is optional. //window.widget = widget; }); }); } close Error Close Add Reset F1000.MICROSERVICES.AFFILIATION = ''; $(document).ready(function () { $('.js-affiliations-form').each((index, form) => { new AffiliationForm({ formId: form.id, institutionErrorSelector: '.comment-enter-institution', departmentErrorSelector: '.comment-enter-department', placeSelector: '.js-add-comment-place', stateSelector: '.js-add-comment-state', zipCodeSelector: '.js-add-comment-zipcode', countrySelector: '.js-add-comment-country', countryErrorSelector: '.comment-enter-country', }); }); }); $(document).ready(function () { var reportIds = { "462276": 0, "462275": 0, "462274": 0, "462273": 8, "462272": 0, "482519": 0, "482518": 0, "482517": 0, "482516": 0, "482515": 0, "482514": 0, "482523": 0, "482522": 0, "482521": 0, "482520": 0, "464359": 0, "464367": 0, "464366": 0, "464365": 0, "464364": 0, "464363": 13, "464362": 0, "464361": 0, "464360": 0, "464368": 0, "462271": 0, "481406": 6, "462270": 0, "481405": 3, "462269": 0, "462268": 0, "462267": 0, }; $(".referee-response-container,.js-referee-report").each(function(index, el) { var reportId = $(el).attr("data-reportid"), reportCount = reportIds[reportId] || 0; $(el).find(".comments-count-container,.js-referee-report-views").html(reportCount); }); var uuidInput = $("#article_uuid"), oldUUId = uuidInput.val(), newUUId = "89224480-790e-49e7-9c10-f6e8c4efad1d"; uuidInput.val(newUUId); $("a[href*='article_uuid=']").each(function(index, el) { var newHref = $(el).attr("href").replace(oldUUId, newUUId); $(el).attr("href", newHref); }); }); An innovative open access publishing platform offering rapid publication and open peer review, whilst supporting data deposition and sharing. Browse Gateways Collections How it Works Contact For Developers Cookie Notice Privacy Notice RSS Submit Your Research Follow us © 2012-2026 F1000 Research Ltd. ISSN 2046-1402 | Legal | Partner of Research4Life • CrossRef • ORCID • FAIRSharing R.templateTests.simpleTemplate = R.template(' $text $text $text $text $text '); R.templateTests.runTests(); var F1000platform = new F1000.Platform({ name: "f1000research", displayName: "F1000Research", hostName: "f1000research.com", id: "1", editorialEmail: "[email protected]", infoEmail: "[email protected]", usePmcStats: true }); $(function(){R.ui.dropdowns('.dropdown-for-authors, .dropdown-for-about, .dropdown-for-myresearch');}); // $(function(){R.ui.dropdowns('.dropdown-for-referees');}); $(document).ready(function () { if ($(".cookie-warning").is(":visible")) { $(".sticky").css("margin-bottom", "35px"); $(".devices").addClass("devices-and-cookie-warning"); } $(".cookie-warning .close-button").click(function (e) { $(".devices").removeClass("devices-and-cookie-warning"); $(".sticky").css("margin-bottom", "0"); }); $("#tweeter-feed .tweet-message").each(function (i, message) { var self = $(message); self.html(linkify(self.html())); }); $(".partner").on("mouseenter mouseleave", function() { $(this).find(".gray-scale, .colour").toggleClass("is-hidden"); }); }); Sign In Remember me Forgotten your password? Sign In Cancel Email or password not correct. Please try again Please wait... $(function(){ // Note: All the setup needs to run against a name attribute and *not* the id due the clonish // nature of facebox... $("a[id=googleSignInButton]").click(function(event){ event.preventDefault(); $("input[id=oAuthSystem]").val("GOOGLE"); $("form[id=oAuthForm]").submit(); }); $("a[id=facebookSignInButton]").click(function(event){ event.preventDefault(); $("input[id=oAuthSystem]").val("FACEBOOK"); $("form[id=oAuthForm]").submit(); }); $("a[id=orcidSignInButton]").click(function(event){ event.preventDefault(); $("input[id=oAuthSystem]").val("ORCID"); $("form[id=oAuthForm]").submit(); }); }); If you've forgotten your password, please enter your email address below and we'll send you instructions on how to reset your password. The email address should be the one you originally registered with F1000. Email address not valid, please try again You registered with F1000 via Google, so we cannot reset your password. To sign in, please click here . If you still need help with your Google account password, please click here . You registered with F1000 via Facebook, so we cannot reset your password. To sign in, please click here . If you still need help with your Facebook account password, please click here . Code not correct, please try again Reset password Cancel Email us for further assistance. Server error, please try again. If your email address is registered with us, we will email you instructions to reset your password. If you think you should have received this email but it has not arrived, please check your spam filters and/or contact for further assistance. Please wait... Register $(document).ready(function () { signIn.createSignInAsRow($("#sign-in-form-gfb-popup")); $(".target-field").each(function () { var uris = $(this).val().split("/"); if (uris.pop() === "login") { $(this).val(uris.toString().replace(",","/")); } }); });