Prevalence of Missed Medication Doses and Outcomes of Hospitalized Patients Living with HIV in Uganda

Background: Missed Medication Doses (MMD) are a common but preventable form of medication error that compromise treatment outcomes. Evidence on the burden and consequences of MMD among hospitalized people living with HIV (PLHIV) in Uganda remains limited. Methods: We conducted a cross-sectional study at KNRH, Kampala, Uganda, reviewing medical records of PLHIV admitted to the infectious diseases unit between January 2022 and December 2023. Eligible files included treatment charts documenting prescribed and administered parenteral medications. Descriptive statistics summarized patient characteristics and prevalence of MMD. Associations between patient factors and MMD were assessed using chi-square tests and multivariable logistic regression. Outcomes examined included length of hospital stay, in-hospital mortality, and readmission. Results: Of 814 records screened, 462 met the inclusion criteria. Patients were predominantly female (61.0%), with a mean age of 25.8 years (SD 14.4). Overall, 403 patients (87.2%; 95% CI: 84.1–90.0) experienced at least one MMD. Missed doses were common across nearly all medications, with omission rates exceeding 80% for ceftriaxone, paracetamol, metronidazole, omeprazole, metoclo-pramide, and levofloxacin, and approaching 100% for furosemide, co-amoxiclav, ondansetron, enoxaparin, albumin, and artesunate. Lower odds of MMD were independently associated with Luo ethnicity (aOR = 0.15, 95% CI: 0.03–0.59), separated marital status (aOR = 0.16, 95% CI: 0.03–0.73), and Muslim faith (aOR = 0.21, 95% CI: 0.07–0.61). Older age was associated with a modest increase in risk (aOR = 1.02 per year, p = 0.032). Length of hospital stay did not differ significantly between patients with and without MMD. Overall in-hospital mortality was high (69.0%) and was lower among patients with documented MMD compared to those without (p < 0.001). Conclusion: Missed parenteral medication doses are highly prevalent among hospitalized PLHIV in Uganda. Strengthening medication administration and documentation systems is urgently needed to improve patient safety and outcomes.