ASSESSMENT OF DRUG UTILIZATION PATTERNS IN CARDIOVASCULAR DISEASE PATIENTS WITH CO-MORBIDITIES AT J.L.N. MEDICAL COLLEGE AND ASSOCIATED HOSPITALS, AJMER: A PROSPECTIVE STUDY

Background: Cardiovascular diseases (CVDs) continue to be a primary cause of morbidity and mortality around the world followed by co-morbidities like hypertension, diabetes, and dyslipidemias. Rational utilization of drugs is a key factor in optimizing treatment outcomes and minimizing adverse effects.  Objective: The aim of this prospective study was to evaluate the patterns of drug utilization in patients with CVD and co-morbidities at J.L.N. Medical College and Associated Hospitals, Ajmer.  Methods: A total of 400 patients diagnosed with cardiovascular diseases and co-morbidities were included in the study. Data on demographics, disease patterns, prescribed medications, polypharmacy, and adherence to WHO core drug prescribing indicators were collected and analyzed. The study also assessed the occurrence of adverse drug reactions (ADRs) and potential drug-drug interactions (DDIs).  Results: The study found that the most frequently prescribed cardiovascular drugs were antiplatelet agents, statins, nitrates, and anticoagulants, with significant use of oral medications such as Aspirin (89.25%), Clopidogrel (70.25%), and Atorvastatin (88.25%). The pattern also revealed a high reliance on injectables, particularly Heparin (75.25%). Non-cardiovascular drugs, such as Pantoprazole (58%), Bisacodyl (55.25%), and Alprazolam (64.25%), were commonly prescribed to manage gastrointestinal, metabolic, and psychiatric co-morbidities. Polypharmacy was prevalent, with an average of 11.35 drugs prescribed per patient, which raised concerns about the potential for DDIs and ADRs. Adherence to essential drug lists (100%) and generic drug prescribing (99.9%) were notable, but overuse of antibiotics (43.5%) and injectables (86.5%) exceeded optimal prescribing recommendations.  Conclusion: The study highlights the complex pharmacotherapy required for managing cardiovascular diseases with co-morbidities. While there is strong adherence to essential drug lists and the use of generics, the over-prescription of antibiotics and injectables necessitates further attention. Optimizing drug therapy, reducing polypharmacy, and ensuring rational antibiotic use are essential for improving patient safety and outcomes. This study emphasizes the need for continuous monitoring and improvement in prescribing practices, especially in multi-morbid populations.