People are usually not aware of returning their unused or expired medicines or not ready to practice pharmaceutical waste management (PWM) safely. The present research aimed to explore Malaysians’ awareness, readiness and practice (ARP) on safe and sustainable PWM. The research was conducted from April 2023 to April 2024 among 318 randomly selected people having unused or expired medicines. A cross-sectional survey was conducted with a semi-structured questionnaire. Exploratory factor analysis was performed sequentially among ARP domains. Reliability of research instrument was checked with Cronbach’s alpha. Correlation among ARP scores was analysed with Pearson’s correlation, and generalized linear model was performed to analyse statistical relationships of outcome variables with various predictors. Data were analysed in SPSS 29.0 considering p-value <0.05 statistically significant at 95% confidence interval. A total of 112 (35.2%) respondents had good awareness, but 176 (55.3%) had sub-optimum readiness and 130 (40.9%) had sub-optimum practice level in terms of safe and sustainable PWM. Though there were positive and significant correlations (p < 0.001 in all) between awareness and readiness (r = 0.339), readiness and practice (r = 0.414) and awareness and practice (r = 0.420), their strengths were small. It means the aware people may also not be ready to practice safely. Hence, policymakers should encourage people’s participation in managing pharmaceutical wastes effectively. The present research has implications on Sustainable Development Goal 12, that is, rational consumption and production by its exploration of people’s ARP constructs on safe and sustainable PWM.
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