Polypharmacy among Adults Receiving Outpatient Care at a General Hospital in a Municipality, Northern Uganda

Abstract

Background Polypharmacy is a major safety concern. It’s a risk factor for adverse health outcomes, higher use of medical services and additional costs. Despite being a well-recognized problem, there is limited data regarding the prevalence and factors associated with polypharmacy among outpatients in Northern Uganda. We assessed the prevalence and factors associated with polypharmacy among adults receiving outpatient care at Kitgum General Hospital, Uganda. Methods This was a facility-based cross-sectional study; adults receiving outpatient care at Kitgum General Hospital between October and December 2023 were recruited. Polypharmacy was defined as the concurrent use of five or more medicines. A structured questionnaire was used to obtain information about the number of medicines a person takes concurrently and the participant’s demographic characteristics. Descriptive statistics were used to analyze the study sample. A multivariable logistic regression analysis was performed to assess the factors associated with polypharmacy. Results A total of 422 participants, with a mean age of 43.0 ± 18.3 years were enrolled. More than a third of the participants (35.3%, n = 149) had chronic medical conditions. Overall, 43.4% (n = 183) of participants had polypharmacy. Among the participants who had polypharmacy, the majority were taking antibiotics (91.8%, n = 168) and analgesics (77.6%, n = 142). More than a third (34.4%, n = 145) of the participants reported use of over-the-counter drugs. Having a chronic illness (Adjusted Odds Ratio (AOR): 5.93, 95% CI: 3.10-11.34, p < 0.001), and use of over-the-counter drugs (AOR: 16.7; 95% CI: 8.87–31.42, p = 0.009) were associated with higher odds of polypharmacy. Herbal medicine use was associated with 64% lower odds of polypharmacy (AOR: 0.36; 95% CI: 0.17–0.77, p < 0.001). Conclusion The prevalence of polypharmacy among adult outpatients is high. Chronic illness, use of over-the-counter drugs and intake of herbal medicines have significant impacts on polypharmacy among adult outpatients. Priority should be put in place to mitigate polypharmacy among outpatients in Uganda.