Pharmacoepidemiology of Cardiovascular Medicines Used Among Inpatients at a Tertiary Care Hospital in Tanzania, 2016-2022

IntroductionCardiovascular diseases remain a major cause of morbidity and mortality in sub-Saharan Africa; however, little is known about inpatient cardiovascular medicine utilisation in Tanzania. This study quantified cardiovascular medicine utilisation patterns at a national cardiac referral centre using the standardised WHO ATC/DDD methodology. MethodsA retrospective longitudinal pharmacoepidemiological study was conducted using inpatient prescription data from the Jakaya Kikwete Cardiac Institute (JKCI) for the fiscal years 2016/2017 to 2021/2022. Non-medicinal items and topical formulations were excluded from the analyses. Utilisation was expressed as Defined Daily Doses (DDD) per 100 bed-days using the WHO ATC/DDD methodology. Descriptive statistics and non-parametric tests were performed using SPSS version 26. ResultsOf the 290,591 prescription records screened, 224,290 were eligible following the exclusion of 64,781 non-medicinal items and 1,520 topical agents. Cardiovascular medicines (ATC class C) accounted for 99,634 (44.4%) of all prescriptions, followed by alimentary tract and metabolism agents (18.1%). The prescribing volumes increased annually and peaked in 2021/2022. Furosemide (C03CA01), spironolactone (C03DA01) and paracetamol (N02BE01) were the three most frequently prescribed medicines. The 12 most commonly used medicines represented approximately half of all the prescriptions. ConclusionCardiovascular medicines accounted for nearly half of all inpatient prescriptions, reflecting the substantial clinical demand and disease burden associated with cardiovascular conditions. Utilisation was dominated by loop and potassium-sparing diuretics, highlighting their central role in inpatient cardiac care. Routine surveillance using ATC/DDD metrics should be institutionalised to guide procurement, prescribing audits, and patient safety monitoring. Trial registration number Not applicable. What is already known on this topicO_LIThe incidence of cardiovascular diseases is increasing globally, with increasing medicine use in both high-and low-income settings. C_LIO_LIEvidence of inpatient cardiovascular medicine consumption in sub-Saharan Africa is limited to a few studies. C_LIO_LIPrevious pharmacoepidemiological studies from SSA have mainly focused on antibiotics rather than medicines for chronic noncommunicable diseases. C_LI What this study adds"O_LIThis is the first longitudinal analysis of inpatient cardiovascular medicine use in Tanzania based on ATC/DDD. C_LIO_LINearly half of all inpatient prescriptions at the national cardiac referral centre were cardiovascular agents, predominantly diuretics. C_LIO_LIThese findings establish a baseline for stewardship, informed procurement decisions, and future national monitoring efforts. C_LI