"We throw away an incredible amount of unused medicines": Community pharmacy staff perspectives on environmental responsibility.

Background: Pharmaceutical pollution is an increasing environmental concern. As key actors in the healthcare chain, community pharmacies play an important role in managing pharmaceuticals from an environmental perspective. Although environmental initiatives exist at the corporate level in Sweden, it remains unclear how well these are known to, or implemented by, pharmacy staff. Objectives: To explore how community pharmacy staff in Sweden perceive their role in reducing pharmaceutical pollution, and identify the opportunities and challenges they face in promoting environmentally friendly use of pharmaceuticals. Methods: Focus group discussions and individual semi-structured interviews were conducted with pharmacy staff in Sweden between May 2024 and February 2025. All focus group discussions and interviews were audio recorded, transcribed, and analysed using inductive qualitative content analysis. Results: Four focus group discussions and five individual interviews were conducted. The analysis resulted in three main categories. First, while there was an awareness of environmental issues, participants expressed a lack of concrete guidance and requested more information, such as lists of environmentally harmful pharmaceuticals. Second, pharmaceutical waste, originating both from households and pharmacies, was highlighted as a major concern. Third, there appeared to be a sense of limited agency and a wish for support from, for example, regulatory authorities to address pharmaceutical pollution. Conclusion: Swedish pharmacy staff view themselves as potential contributors to reducing pharmaceutical pollution, but struggle to identify concrete actions. They are concerned about pharmaceutical waste and responsibility is often shifted to other stakeholders.