Polypharmacy among adults receiving outpatient care at Kitgum General Hospital, Northern Uganda

Abstract Background Polypharmacy is a major safety concern, associated with adverse outcomes, higher health services utilization, and healthcare costs. However, there is limited data on polypharmacy in the outpatient settings in semi-urban primary care settings. We assessed the prevalence and factor...

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Main Authors: Nixson Oyoo, David Musoke, Ritah Nantale, Jolly Joe Lapat, Jimmyy Opee, Daniel S. Ebbs, Felix Bongomin
Format: Article
Language:English
Published: BMC 2025-05-01
Series:BMC Primary Care
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Online Access:https://doi.org/10.1186/s12875-025-02863-5
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author Nixson Oyoo
David Musoke
Ritah Nantale
Jolly Joe Lapat
Jimmyy Opee
Daniel S. Ebbs
Felix Bongomin
author_facet Nixson Oyoo
David Musoke
Ritah Nantale
Jolly Joe Lapat
Jimmyy Opee
Daniel S. Ebbs
Felix Bongomin
author_sort Nixson Oyoo
collection DOAJ
description Abstract Background Polypharmacy is a major safety concern, associated with adverse outcomes, higher health services utilization, and healthcare costs. However, there is limited data on polypharmacy in the outpatient settings in semi-urban primary care settings. We assessed the prevalence and factors associated with polypharmacy among adults receiving outpatient care at Kitgum General Hospital, Uganda. Methods We conducted a facility-based, cross-sectional study among adults receiving outpatient care at Kitgum General Hospital between October and December 2023. Polypharmacy was defined as the concurrent use of five or more medicines. Data was collected using a structured tool. 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) (95% CI: 38.7–48.2) of the participants had polypharmacy. The majority were on antibiotics (91.8%, n = 168) and analgesics (77.6%, n = 142). In total, 145 (34.4%) reported use of over-the-counter drugs and 60 (14.2) used herbal medicines. 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 Polypharmacy was observed in almost 2 in every 5 adults receiving outpatient care in Kitgum General Hospital. Chronic illness and use of over the counter medicines increased the odds of polypharmacy among adult outpatients. Priority should be put in place to mitigate polypharmacy among outpatients in Northern Uganda and similar low resource settings.
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spelling doaj-art-cd112eef0383462c85e84725d33719ca2025-08-20T01:49:36ZengBMCBMC Primary Care2731-45532025-05-0126111110.1186/s12875-025-02863-5Polypharmacy among adults receiving outpatient care at Kitgum General Hospital, Northern UgandaNixson Oyoo0David Musoke1Ritah Nantale2Jolly Joe Lapat3Jimmyy Opee4Daniel S. Ebbs5Felix Bongomin6Department of Public Health, Faculty of Medicine, Gulu UniversityDepartment of Pharmacology and Therapeutics, Faculty of Medicine, Gulu UniversityDepartment of Community and Public Health, Faculty of Health Sciences Mbale, Busitema UniversityDepartment of Public Health, Faculty of Medicine, Gulu UniversityDepartment of Public Health, Faculty of Medicine, Gulu UniversitySection of Critical Care Medicine, Department of Paediatrics, Yale UniversityDepartment of Medical Microbiology and Immunology, Faculty of Medicine, Gulu UniversityAbstract Background Polypharmacy is a major safety concern, associated with adverse outcomes, higher health services utilization, and healthcare costs. However, there is limited data on polypharmacy in the outpatient settings in semi-urban primary care settings. We assessed the prevalence and factors associated with polypharmacy among adults receiving outpatient care at Kitgum General Hospital, Uganda. Methods We conducted a facility-based, cross-sectional study among adults receiving outpatient care at Kitgum General Hospital between October and December 2023. Polypharmacy was defined as the concurrent use of five or more medicines. Data was collected using a structured tool. 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) (95% CI: 38.7–48.2) of the participants had polypharmacy. The majority were on antibiotics (91.8%, n = 168) and analgesics (77.6%, n = 142). In total, 145 (34.4%) reported use of over-the-counter drugs and 60 (14.2) used herbal medicines. 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 Polypharmacy was observed in almost 2 in every 5 adults receiving outpatient care in Kitgum General Hospital. Chronic illness and use of over the counter medicines increased the odds of polypharmacy among adult outpatients. Priority should be put in place to mitigate polypharmacy among outpatients in Northern Uganda and similar low resource settings.https://doi.org/10.1186/s12875-025-02863-5PolypharmacyOutpatientKitgum General HospitalUganda
spellingShingle Nixson Oyoo
David Musoke
Ritah Nantale
Jolly Joe Lapat
Jimmyy Opee
Daniel S. Ebbs
Felix Bongomin
Polypharmacy among adults receiving outpatient care at Kitgum General Hospital, Northern Uganda
BMC Primary Care
Polypharmacy
Outpatient
Kitgum General Hospital
Uganda
title Polypharmacy among adults receiving outpatient care at Kitgum General Hospital, Northern Uganda
title_full Polypharmacy among adults receiving outpatient care at Kitgum General Hospital, Northern Uganda
title_fullStr Polypharmacy among adults receiving outpatient care at Kitgum General Hospital, Northern Uganda
title_full_unstemmed Polypharmacy among adults receiving outpatient care at Kitgum General Hospital, Northern Uganda
title_short Polypharmacy among adults receiving outpatient care at Kitgum General Hospital, Northern Uganda
title_sort polypharmacy among adults receiving outpatient care at kitgum general hospital northern uganda
topic Polypharmacy
Outpatient
Kitgum General Hospital
Uganda
url https://doi.org/10.1186/s12875-025-02863-5
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