Prescription Patterns and Medication Adherence among Heart Failure Patients at a Tertiary Care Hospital in Southern India: A Cross-sectional Study

Introduction: Heart failure bears a significant health burden globally, particularly in India, where its prevalence is on the rise. There are striking regional variations in the prescription pattern for heart failure. Prescription pattern monitoring will help to understand the trends in drug use, compliance with regional, state or national guidelines and provide feedback information to prescribers. Being a chronic disease, medication adherence also plays a major role in improving clinical outcomes. Aim: To analyse the prescription patterns of heart failure drugs as well as the medication adherence among heart failure patients admitted to a tertiary care hospital. Materials and Methods: A hospitalbased, cross-sectional, observational study was conducted in the inpatient department (IPD) of Medicine in a tertiary care teaching hospital, over a period of six months from August 2024 to January 2025. A total of 204 prescriptions of heart failure patients were analysed using a prestructured proforma. The patients were asked about cardiac rehabilitation practices, and their responses were recorded by using 5-point Likert scale ranging from never to always. Medication adherence was assessed by using a prevalidated questionnaire containing nine questions, and patients were categorised to have low, moderate or high adherence based on their scores. The collected data were analysed by descriptive statistics. Results: Males (61.3%) outnumbered females (38.7%). Most patients were aged 51-60 years, with a mean age of 63.2±12.14 years. Hypertension (60.8%), ischaemic heart disease (60.3%) and diabetes (58.3%) were the most common co-morbidities. Combination therapy was preferred with diuretics (92.7%), beta blockers (57.4%) and vasodilators (44.6%) being the most commonly prescribed drugs. Mineralocorticoid Receptor Antagonist (MRA), sodium-glucose cotransporter-2 (SGLT-2) inhibitors and angiotensin receptor neprilysin inhibitors (ARNI) were also prescribed. Cardiac rehabilitation uptake was poor, only 29% adhered to dietary modifications and 7.3% engaged in regular physical activity. Medication adherence assessment showed that 47.6% of patients had high adherence, while 25.5% had moderate and 27% had low adherence levels. Conclusion: Most of the recommended drugs, including the newer drugs like SGLT-2 inhibitors and ARNI, were observed in the prescriptions. Cardiac rehabilitation and medication adherence were inadequate, highlighting the need for structured and targeted adherence improvement strategies and cardiac rehabilitation programmes.