Chronic Polypharmacy Among Pediatric Outpatients: Prevalence, Medication Patterns, and Associated Factors

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Abstract
Background: Pediatric polypharmacy is increasingly recognized among children with chronic medical conditions; however, data from outpatient settings, particularly in the Middle East, remain limited. This study aimed to determine the prevalence, patterns, and factors associated with pediatric polypharmacy among outpatients at a tertiary care hospital. Methods: We conducted a retrospective cross-sectional study of pediatric outpatients (p < 0.001) and outpatient visit frequency (OR 1.350, 95% CI 1.288–1.417; p < 0.001) as factors independently associated with polypharmacy, whereas sex, inpatient visits, and emergency visits were not independently associated. Epilepsy was the most common diagnosis, followed by bronchial asthma and chronic kidney disease. Pantoprazole was the most frequently prescribed medication, while endocrinology and rheumatology were the most frequently attended specialties. Conclusions: Using a definition requiring sustained concurrent medication use, pediatric polypharmacy was uncommon in this outpatient population but was independently associated with older age and greater outpatient healthcare utilization. These findings support targeted medication review and optimization strategies for children with chronic diseases requiring frequent outpatient follow-up and provide baseline data for pediatric medication safety initiatives.

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