Assessment of prescribing trends and medication therapy problems in heart failure, in a Teaching Hospital in South- South Nigeria

Abstract

Heart failure (HF) remains a major cause of morbidity and mortality globally and continues to pose a significant public health challenge in Nigeria. This retrospective study reviewed 156 HF prescriptions from adult patients attending the cardiology clinic at DELSUTH between January 2020 and December 2024. Most patients were male (64.7%) and aged 50–64 years, with New York Heart Association (NYHA) Class II being the most common diagnosis (42.3%). Diuretics were the most frequently prescribed medications—spironolactone (82.7%) and furosemide (71.2%)—followed by Angiotensin Converting Enzyme (ACE) inhibitors (50.9%), beta-blockers (47.4%), and antithrombotic agents (48.7%). Use of newer guideline-recommended therapies such as Angiotensin Receptor Neprilysin Inhibitors (ARNIs) (8.3%) and Sodium Glucose Cotransporter 2 (SGLT2) inhibitors (8.7%) was low. Medication therapy problems occurred in 7.7% of prescriptions, mainly non-adherence (3.2%) and administration errors (1.9%). Most prescribers (41.7%) followed ACC/AHA guidelines, and all prescriptions involved multidrug therapy issued by cardiologists. The study shows strong adherence to standard HF management but highlights limited access to newer therapies and persistent issues with adherence and minor  edication errors.