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. 2018 May 29;18(1):125.
doi: 10.1186/s12877-018-0817-0.

Polypharmacy among HIV positive older adults on anti-retroviral therapy attending an urban clinic in Uganda

Michael Ssonko  1 , Fiona Stanaway  2 , Harriet K Mayanja  3 , Tabitha Namuleme  4 , Robert Cumming  2 , John L Kyalimpa  4 , Yvonne Karamagi  4 , Barbara Mukasa  4 , Vasi Naganathan  5   6
Affiliations

Polypharmacy among HIV positive older adults on anti-retroviral therapy attending an urban clinic in Uganda

Michael Ssonko et al. BMC Geriatr. .

Abstract

Background: Polypharmacy has not been investigated in patients living with HIV in developing countries. The aims of this study were to determine the prevalence of polypharmacy, the factors associated with polypharmacy and whether polypharmacy was associated with adverse effects among older adults on anti-retroviral therapy (ART).

Methods: Cross-sectional study in older adults aged 50 and over on ART attending an outpatient HIV/AIDS care centre in Uganda. Demographic and clinical data collected on number and type of medications plus supplements, possible medication related side-effects, comorbidity, frailty, cognitive impairment, current CD4 count and viral load.

Results: Of 411 participants, 63 (15.3, 95% C.I. 11.9, 18.8) had polypharmacy (≥ 4 non- HIV medications). In multivariate analyses, polypharmacy was associated with one or more hospitalisations in the last year (Prevalence Ratio PR = 1.8, 95% C.I. 1.1, 3.1, p = 0.02), prescription by an internist (PR = 3.6, 95% C.I. 1.3, 10.5, p = 0.02) and frailty index scores of 5 to 6 (PR = 10.6, 95% C.I. 1.4, 78, p = 0.02), and 7 or more (PR = 17.4, 95% C.I. 2.4, 126.5, p = 0.005). Polypharmacy was not associated with frequency and severity of possible medication related side effects and falls.

Conclusion: Polypharmacy is common among older HIV infected patients in sub-Saharan Africa. It's more prevalent among frail people, who have been in hospital in the last year and who have been seen by an internist. We found no evidence that polypharmacy results in any harm but this is worth exploring further.

Keywords: Drug-related side effects and adverse reactions; HIV; Polypharmacy.

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Conflict of interest statement

Ethics approval and consent to participate

The study was approved by the Mildmay Uganda Research and Ethics Committee (# REC REF 0212–2014). Permission to do the study was obtained from Uganda National Council for Science and Technology (HS 1745). The client provided written consent to participate in the study during that clinic visit. In case the client was physically incapacitated like having very poor vision, then the next of kin (who was either a spouse or an immediate relative) provided written consent with permission from the client.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Screening and recruitment of HIV positive older adults on ART into the study
See this image and copyright information in PMC

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