Drug Utilization in Ischemic Heart Disease Associated with Diabetes Mellitus and Hypertension in Patients Attending Medicine OPD at a Tertiary Care Hospital: An Observational Cross-sectional Study

Introduction: Ischemic heart disease (IHD), a leading cause of mortality in India, is frequently associated with hypertension and type 2 diabetes mellitus (T2DM).Rational drug use is critical in managing IHD and its comorbidities to optimize safety and efficacy.This study evaluates prescribing patterns, drug utilization, and the prevalence of drug-drug interactions (DDIs) in patients with IHD. Materials and methods: A cross-sectional, observational study was conducted over three months at Calcutta National Medical College and Hospital.Data from 100 patients with IHD aged 18-80 years were analyzed.Prescriptions were assessed for polypharmacy, rationality, and adherence to the World Health Organization (WHO) prescribing indicators.Results: Of the 100 patients, 70% were men (mean age 57.88 14.5 years).Comorbidities included hypertension in 24% and both hypertension and T2DM in 70%.The average number of drugs prescribed per patient exceeded six, with aspirin and atorvastatin as the most common combination therapy (72%).Among antihypertensives, telmisartan monotherapy (36%) predominated, while metformin and glimepiride (31%) were the most prescribed for T2DM.Polypharmacy was observed in 56% of prescriptions, raising concerns about DDIs.Notably, 90% of drugs were prescribed by generic names, and 91% adhered to the essential drug list (EDL).Discussion: The findings underscore the prevalence of polypharmacy and its implications for DDIs and therapeutic failure.While rational prescribing practices were evident, the choice of sulfonylureas in IHD patients necessitates re-evaluation due to cardiovascular risks.Sodiumglucose cotransporter-2 (SGLT2) inhibitors may provide a safer alternative.Fixed-dose combinations (FDCs) could enhance adherence and reduce costs, warranting further exploration. Conclusion:This study highlights the importance of optimizing pharmacotherapy for IHD with comorbidities.Regular monitoring, patientspecific interventions, and digital health tools can improve adherence and outcomes.Future research should focus on simplifying regimens and assessing the clinical impact of emerging therapies like SGLT2 inhibitors.