<![CDATA[This study employed a descriptive qualitative approach through literature review to examine household pharmaceutical waste disposal pathways and their impacts on aquatic environments. Using the PICO framework, the review focused on Indonesian households (P) practicing improper disposal methods such as trash bins or drainage systems (I), compared to safe practices like take-back programs (C), with outcomes including water contamination and antimicrobial resistance (O). The literature selection followed the PRISMA flowchart, screening over 500 articles from Google Scholar, PubMed, and Scopus (2017-2025) to yield 30+ relevant sources. Findings revealed that over 70% of respondents dispose of medications improperly, leading to pharmaceutical residues (antibiotics, analgesics) detected in groundwater and rivers, posing risks to aquatic ecosystems and human health. Recommendations include intensive pharmacist-led education and national medication return programs to mitigate environmental risks.]]>
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