Prevalence and Correlates of Polypharmacy in Elderly Outpatients at Specialist Hospitals in Imo State, South East Nigeria: An Analytical Assessment

Polypharmacy, defined as the concurrent use of five or more medications, is a growing concern in aging populations and is associated with increased risks of drug interactions, adverse drug reactions, falls, and medication non-adherence. In Nigerian specialist hospitals, the burden of polypharmacy among elderly outpatients is undercharacterized. This study assessed the prevalence and correlates of polypharmacy in elderly outpatients at specialist hospitals in Imo State, South East Nigeria. A cross-sectional analytical study was conducted among 380 outpatients aged 65 years and above attending three specialist hospitals. Medication data were obtained from current prescriptions, patient-held drug cards, and self-report. Polypharmacy was defined as five or more regular medications and hyperpolypharmacy as ten or more. Logistic regression identified independent correlates of polypharmacy. Polypharmacy was present in 48 percent of participants, with hyperpolypharmacy in 14 percent. Hypertension, diabetes, heart failure, and arthritis were the most prevalent comorbidities associated with polypharmacy. Number of diagnoses, regular specialist clinic attendance, and private hospital use were the strongest predictors. Inclusion of herbal medicines in the medication count increased polypharmacy prevalence to 63 percent. Drug-drug interaction risk was rated as moderate or high in 41 percent of polypharmacy cases. The study recommends routine pharmacist-led medication review and deprescribing initiatives targeting elderly outpatients in Imo State specialist hospitals. Structured medication reconciliation at every clinic visit should be instituted. Keywords: polypharmacy, elderly patients, specialist hospitals, Imo State, drug interactions