Drug utilization evaluation of albumin in a teaching hospital of Mashhad, Iran: an interventional pre–post design study
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Background Albumin is a protein colloidal solution with limited availability and high cost. It should be used in such approved indications as paracentesis, extensive burn, spontaneous bacterial peritonitis, and nephrotic syndrome. Objectives The aim of this study was to evaluate and compare the appropriateness of albumin usage before and after an evidence-based guideline. Setting Four wards of Imam Reza Hospital, Mashhad, Iran. Method An interventional pre–post design study was performed on 2 groups of patients; in gGroup 1 as a preparation phase group in 6 months from February 2015 to July 2015 and Group 2 as an interventional group from September 2015 to February 2016. A guideline for proper indications of albumin, designed and finalized based on the physicians’ comments, was implemented in Group 2. Main outcome measure The pattern of albumin consumption. Results Fifty patients were evaluated in each group. The implementation of the guideline resulted in reduction of improper albumin use from 62 to 57.5%, which was not statistically significant; however., it reduced inappropriate dose and duration of albumin therapy (55.5–16.7%), the number of consumed albumin vial, and the average cost for each patient (317.78 ± 3.15–149.81 ± 1.91 USD) significantly, as well. Conclusion This study illustrated that in this hospital in most cases, albumin was used inappropriately and at an alarming rate. This improved after the introduction of an evidence-based guideline. Moreover, guideline implementation resulted in significant cost reduction.
KeywordsAlbumin Cost reduction Drug use evaluation (DUE) Inappropriate use Intervention Iran Teaching hospital
This study is part of a research thesis for a Pharm.D. degree at Mashhad University of Medical Sciences. The authors are thankful for the funding of this study by the Research Council of Mashhad University of Medical Sciences.
Mashhad University of Medical Sciences.
Conflicts of interest
- 1.Kazemi Y, Hadavand N, Hayatshahi A, Torkamandi H, Gholami K, Hadjibabaie M, et al. Albumin utilization in a teaching hospital in Tehran: time to revise the prescribing strategies. J Pharm Care. 2013;1(4):127–32.Google Scholar
- 2.Bowman I. Drug use evaluation is DUE: healthcare utilization evaluation is over-DUE. Hosp Pharm. 1996;3:5–8.Google Scholar
- 4.Namazi S, Karimzadeh I. Drug utilization evaluation of unfractionated heparin in a cardiac care unit in Iran. J Pharm Res. 2011;4(5):1470–2.Google Scholar
- 8.WHO medicines strategy: framework for actions in essential drugs and medicines policy; 2000–2003. Geneva: World Health Organization. From World Health Organization on the World Wide Web: http://apps.who.int/medicinedocs/pdf/whozip16e/whozip16e.pdf.
- 9.American Hospital Formulary Service® (AHFS™) Drug Information 2009. Bethesda: American Society of Health System Pharmacists. From AHFS on the World Wide Web: http://www.ahfsdruginformation.com/.
- 14.Tanzi M, Gardner M, Megellas M, Lucio S, Restino M. Evaluation of the appropriate use of albumin in adult and pediatric patients. Am J Health Sys Pharm. 2003;60:1330–5.Google Scholar