Drug utilization study in Cardiology outpatient department at a tertiary care hospital

Indu Slathia, Pradeep R. Jadhav, Pooja Deb, Shashwat Verma


Background: Cardiovascular diseases are the most frequent cause of morbidity and mortality throughout the world particularly in South Asian population. With advent of newer, highly efficacious heterogeneous drugs and changing treatment guidelines, there’s a need to identify the cardiologist preference and prescribing patterns for rational utilization.

Methods: It was an open label, prospective, cross-sectional, descriptive type of study conducted in Cardiology Outpatients at a Tertiary care hospital, Navi Mumbai. The study included 100 patients suffering from cardiovascular diseases attending cardiology outpatient department from October 2016 to March 2017. Informed consent was obtained and the currently prescribed drug details were recorded from prescription. The data was analysed for WHO core prescribing indicators and different types of drugs prescribed.

Results: The average number of drug products prescribed was 3.4. Most commonly prescribed drugs were Antiplatelets (23%) followed by Statins (19.71%), β blockers (16%), Nitrates (11.70%), Angiotensin converting enzyme inhibitors (8.03%), Calcium channel blockers (5.50%), Angiotensin receptor blockers (4.70%), Diuretics (2.55%), Anticoagulant (1.83%), α+β blocker (1.46%), Cardiac glycosides ((1.09%), Potassium sparing diuretic and central sympatholytics. Majority of drugs were prescribed as single drugs (79.88%) while 20.11% as fixed dose combination (FDC). The combination of Telmisartan + Hydrochlorthiazide was the commonest prescribed FDC. Majority drugs were prescribed from NEDL 2015, but documented low generic prescribing.

Conclusions: Antiplatelet and Statins dominated the prescribing pattern with high prescribing trend from national essential drug list, but showed scope for improvement in encouraging the cardiologist to prescribe by generic name.


Cardiology, Drug utilization, Prescribing pattern

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World Health Organization (WHO) and International Network for Rational Use of Drugs. How to Investigate Drug Use in Health Facilities: Selected Drug Use indicators. Geneva, Switzerland: WHO; 1993.

Dukes MNG. Drug utilization studies: methods and uses. World Health Organization Regional Publications. European series; 45. Copenhagen, Denmark. Available at:

World Health Organization. Introduction to Drug Utilization Research. Oslo, Norway: WHO; 2003. Available at:

Lee D, Bergman U. Studies of drug utilization. In: Storm LB, editor. Pharmacoepidemiology. Chichester, UK: John Wiley and Sons; 2005:401-417.

Rubin RJ, Altman WM, Mendelson DN. Health care expenditures for people with diabetes mellitus, 1992. J Clin Endocrinol Metab. 1994 Apr;78(4):809A-809F.

Anand SS, Yusuf S, Vuksan V, Devanesen S, Teo KK, Montague PA, et al. Differences in risk factors, atherosclerosis, and cardiovascular disease between ethnic groups in Canada: The Study of Health Assessment and Risk in Ethnic groups (SHARE). Lancet. 2000 Jul 22;356(9226):279-84.

Manjhi PK, Mohan L, Kumar M, Dikshit H, Singh B, Pathak A, et al. Prescription pattern of fixed dose drug combination in cardiology department in a tertiary care hospital. International Journal of Basic & Clinical Pharmacology. 2016;5(3):951-55.

Ara S. A literature review of cardiovascular disease management programs in managed care populations. J Manag Care Pharm. 2004 Jul-Aug;10(4):326-44.

World Health Statistics. Cause-specific mortality and morbidity. Available at:

Prabhakaran D, Jeemon P, Roy A. Cardiovascular Diseases in India: Current Epidemiology and Future Directions. Circulation. 2016 Apr 19;133(16):1605-20.

Jankovió SM, Dejanovió SMD. Drug utilization trends in clinical hospital center Kragujevac from 1997 to 1999. Indian J Pharmacol. 2001;33:29-36.

Sutharson L, Hariharan RS, Vamsadhara C. Drug utilisation study in diabetology outpatient setting of a tertiary hospital. Indian J Pharmacol. 2003;35:237-40.

National List of Essential Medicines of India 2015. Ministry of Health and Family Welfare, Government of India. Available at:

Afroj F, Parveen F, Ara F, Iqbal M, Saha R, Rozario R. Patterns of Drug Utilization in Cardiology Department of a Tertiary Level Hospital in Bangladesh. Bangladesh Journal of Physiology and Pharmacology. 2014;28(1-2):1-4.

Rajanandh MG, Ramasamy C, Khan I. Pattern of cardiovascular drugs use in outpatients in a tertiary care hospital. Asian Journal of Pharmaceutical and Clinical Research. 2012;5(1):109-112.

Sandozi T, Naushe F. Drug utilization study in ischemic heart diseases associated with diabetes and hypertension. International Journal of Pharma and Bio Sciences. 2010;1(3):1-4.

Al-Junid SM, Ezat WP, Surianti S. Prescribing patterns and drug cost among cardiovascular patients in Hospital Universiti Kebangsaan Malaysia. Med J Malaysia. 2007 Mar;62(1):59-65.

Nwidu LL, Essien GE, N-Chris EE. Pattern of prescription in cardiovascular diseases management in Port Harcourt city, Nigeria. Journal of Pharmacy Research. 2009;2(10):1653-58.

Zafar F, Ali H, Naveed S, Korai OU, Rizvi M, Naqvi GR, et al. Drug Utilization Pattern in Cardiovascular Diseases: A Descriptive Study in Tertiary Care Settings in Pakistan. J Bioequiv Availab. 2015;7(1):59-62.

Divya G, Devi AR, Lakshmi P. Prescribing Patterns of Antihypertensive Drugs in Cardiology Department. Inventi Rapid: Pharmacy Practice. 2014; 2014(3):1-6.

Maillard MP, Burnier M. Is the fixed-dose combination of telmisartan and hydrochlorothiazide a good approach to treat hypertension? Vascular Health and Risk Management. 2007;3(3):265-278.

Vijayakumar TM, Poovi G, Swaroop TVSS, Thirumurugan G, Dhanaraju MD. Prescribing pattern of fixed dose combinations: focus on cardiovascular drugs in outpatient department of private hospitals. Journal of pharmacology and toxicology. 2010;5(5):215-21.