preprint · medRxiv
Cardiovascular diseases represent a major global cause of morbidity and mortality, making regular quantification of cardiovascular drug use critical for procurement and formulary management. A retrospective longitudinal study evaluated outpatient prescriptions at the Jakaya Kikwete Cardiac Institute in Tanzania between 2017 and 2022. Using the Anatomical Therapeutic Chemical and Defined Daily Dose system, researchers tracked medicine utilisation trends and concentration metrics across multiple levels. Cumulative consumption over the period reached 360.55 Defined Daily Doses per 100 outpatient days, peaking in the 2018/2019 fiscal year. Prescription patterns were heavily concentrated in a small group of drugs, with five specific molecules accounting for half of all utilisation: amlodipine, candesartan, clonidine, furosemide, and atorvastatin. Analysis showed a gradual overall increase in use over time without month-specific seasonality. Routine institutional surveillance using these metrics could assist prescribing stewardship and resource planning.
Cardiovascular conditions demand sustained medical treatment, placing significant pressure on hospital resources and healthcare budgets. By mapping which heart medicines are most frequently prescribed over several years, healthcare managers can prevent stockouts, control spending, and ensure consistent supply. Establishing routine tracking methods helps hospitals design evidence-based formularies and deliver more dependable care to outpatients.
The findings provide applied evidence that hospital procurement planners, health system administrators, and pharmaceutical suppliers can use immediately. By identifying the specific medicines that dominate demand, this analysis helps hospital formularies and distributors refine inventory forecasting and supply chain planning. While the work itself is operational research rather than a standalone commercial product, routine surveillance frameworks of this type represent practical, near-market inputs for healthcare resource management.
AI-generated from the published abstract. Always read the original work before citing.
Abstract Background Cardiovascular diseases are among the leading causes of morbidity and mortality worldwide. Routine quantification of cardiovascular medicine utilisation is essential for stewardship, formulary decision-making and procurement planning. Objective To describe outpatient utilisation of cardiovascular medicines at the Jakaya Kikwete Cardiac Institute (JKCI) using ATC/DDD methodology. Methods This was a retrospective longitudinal analysis of outpatient prescriptions (2017/2018-2021/2022). Medicines were classified according to the ATC system and quantified as Defined Daily Doses (DDD) per 100 outpatient days. The analyses progressed hierarchically from ATC levels 1 to 5. DU metrics (DU50/DU90) were used to assess the concentration. Monthly utilisation was examined using Seasonal Trend decomposition using Loess (STL). Statistical analyses were performed using SPSS (version 26). Results Across the study period, the cumulative utilisation of cardiovascular medicines totalled 360.55 DDD per 100 outpatient days. Annual intensity peaked in 2018/2019 (82.92 DDD per 100 outpatient-days), was the second-highest in 2020/2021 (82.39), and was lowest in 2017/2018 (55.68). At ATC level 5, amlodipine (C08CA01), candesartan (C09CA06) and clonidine (C02AC01) were the principal contributors. The DU50 segment comprised five molecules (amlodipine, candesartan, clonidine, furosemide, and atorvastatin), whereas DU90 ranked 18th, indicating concentrated utilisation within a small number of agents. The STL showed a gradual secular rise with no statistically significant month-specific seasonality. Conclusion Outpatient cardiovascular medicine utilisation at JKCI was concentrated within a narrow set of anti-hypertensive agents, with a cumulative burden of 360.55 DDD per 100 outpatient-days and a fiscal-year peak in 2018/2019. Institutionalising routine outpatient DDD surveillance may support stewardship, rational prescribing, and more equitable access to high-impact cardiovascular medicines in Tanzania.
This page summarises published work. The authoritative version sits with the publisher.
DOI: 10.64898/2025.11.30.25341295
Is something wrong with this record? Report it or request removal.
Discussion
Have you built on this work, tried to replicate it, or seen it applied in practice? Share what you know. Verified researchers and MARATTO™ domain experts can open a discussion, and any member can reply. Contributions are reviewed before they appear.
No discussion yet. Open the first thread.
New to MARATTO™? Create a free account.
