Divergent prescribing paradigms in cardiovascular care: a comparative analysis of government and private healthcare settings in Goa, India

BACKGROUND: Cardiovascular diseases (CVDs) are the leading cause of mortality globally and a growing burden in India. This study aimed to assess prescribing patterns for CVDs across government and private healthcare sectors in Goa, India, focusing on rational drug use and safety. RESEARCH DESIGN AND METHODS: A retrospective, cross-sectional prescription audit of 400 CVD-related prescriptions (200 each from government and private facilities) was conducted between February to April 2025. Data were sourced from digitized prescription records and dispensing databases of government and private healthcare pharmacies. All data were extracted in an anonymized and de-identified format to ensure patient privacy. Primary outcomes measured included polypharmacy, National list of essential medicines (NLEM) compliance, generic and branded drug use, fixed dose combination (FDC) frequency, high-risk drugs used, drug-drug interactions (DDI), and prescribing errors. All records were validated by experienced healthcare professionals. Mann-Whitney U test was employed to evaluate the statistical significance between the prescribing patterns across government and private healthcare sectors. RESULTS: sectoral disparities observed in prescribing trends. Government prescriptions exhibited use of generic drugs, and fewer FDCs, but had higher incidence of polypharmacy and prescription errors. Private prescriptions exhibited lower NLEM adherence, fewer drugs per prescription, greater use of branded drugs, fixed dose combinations, high-risk medications and potentially greater drug-drug interactions. CONCLUSION: Substantial sectoral differences in prescribing patterns highlight the need for standard guidelines and prescriber education on rational drug use to optimize patient safety in both healthcare settings.