Abstract

PRESCRIBING PATTERNS AND DRUG-RELATED PROBLEMS IN ISCHEMIC HEART DISEASE: A PROSPECTIVE OBSERVATIONAL STUDY AT A TERTIARY CARE TEACHING HOSPITAL

Ullas Gouda, Darshan Kandagal, Raghavendra S. Hegde*, Sagar Desai

Abstract

Ischemic heart disease remains the largest single contributor to cardiovascular mortality worldwide, and those affected seldom carry a single diagnosis. This prospective observational study was undertaken in the cardiology inpatient unit of a tertiary care teaching hospital over six months to describe prescribing practice, profile coexisting illness, and identify drug-related problems in this population. Ninety consecutive adults admitted with ischemic heart disease or a related cardiovascular condition were enrolled after written informed consent. Demographic details, diagnoses, coexisting conditions and complete medication data were recorded on a structured form and reviewed daily until discharge. Drug-related problems were detected through independent medication review and classified using the Pharmaceutical Care Network Europe classification, version 9.1. Data were analysed descriptively and the chi -square test was applied, with a probability value below 0.05 regarded as significant. The cohort was predominantly male and elderly, most patients falling within the seventh decade of life, and the male excess was statistically significant. Diabetes mellitus and hypertension were the dominant coexisting conditions. Prescribing averaged between six and seven medicines per patient. Antiplatelet agents were used most often, led by aspirin and ticagrelor, followed by diuretics and lipid-lowering agents, among which atorvastatin was overwhelmingly preferred. Twenty drug-related problems were recorded; adverse drug reactions predominated, followed by medication errors and drug–drug interactions, and seven of every ten problems fell within the treatment-safety domain. Prescribing broadly reflected guideline-directed therapy, yet a measurable and largely preventable burden of medication-related harm persisted, supporting routine clinical pharmacist review within cardiology inpatient care.

Keywords: Ischemic heart disease, Drug utilization, Drug-related problems, Medication safety, Prescribing pattern, Clinical pharmacist.