preprint · medRxiv
Cardiovascular diseases represent a severe and growing health challenge across sub-Saharan Africa. Researchers analysed inpatient prescription data from the Jakaya Kikwete Cardiac Institute in Tanzania between the 2016/2017 and 2021/2022 fiscal years to evaluate medicine consumption patterns. Applying the World Health Organisation Anatomical Therapeutic Chemical and Defined Daily Dose system, the analysis assessed 224,290 eligible prescriptions. Cardiovascular medicines made up 44.4 percent of these prescriptions, showing annual volume increases that reached a peak in the 2021/2022 period. The loop diuretic furosemide and the potassium-sparing diuretic spironolactone were the most frequently prescribed cardiovascular drugs. Together with paracetamol, they led overall hospital consumption. These patterns highlight high inpatient reliance on specific diuretics, providing foundational baseline data to support structured institutional surveillance, routine prescribing audits, and targeted pharmaceutical procurement planning.
Cardiovascular diseases are a leading cause of illness in sub-Saharan Africa, yet data detailing actual hospital medicine use remain scarce. Quantifying consumption trends at a national referral centre provides vital evidence for healthcare managers. Understanding these drug requirements enables hospitals to optimise purchasing budgets, reduce medication stockouts, avoid waste, and build robust patient safety audits using internationally recognised standards.
The findings directly assist hospital procurement teams, public health planners, and pharmaceutical supply chain operators by identifying primary medicine demands for inpatient cardiac care. Although this observational research does not introduce a standalone commercial product, it offers applied clinical intelligence that can immediately guide hospital medicine forecasting, supply management software configurations, and institutional formulary design in Tanzania.
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Abstract Introduction Cardiovascular 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. Methods A 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. Results Of 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. Conclusion Cardiovascular 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 topic The incidence of cardiovascular diseases is increasing globally, with increasing medicine use in both high-and low-income settings. Evidence of inpatient cardiovascular medicine consumption in sub-Saharan Africa is limited to a few studies. Previous pharmacoepidemiological studies from SSA have mainly focused on antibiotics rather than medicines for chronic noncommunicable diseases. What this study adds” This is the first longitudinal analysis of inpatient cardiovascular medicine use in Tanzania based on ATC/DDD. Nearly half of all inpatient prescriptions at the national cardiac referral centre were cardiovascular agents, predominantly diuretics. These findings establish a baseline for stewardship, informed procurement decisions, and future national monitoring efforts.
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DOI: 10.64898/2025.11.30.25341284
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