| Background: Albumin is an expensive protein colloidal solution with various
indications, especially in critically ill patients. The vast use of albumin in
health care centers (particularly ICUs), the theoretical danger of contaminant
transmission (as with any blood derivative), and the existence of more
economical alternatives of equal efficacy evidence the importance of
conducting a drug-utilization evaluation. The objective of this study was to
assess the usage of albumin in patients at a hospital in Iran.
Methods: Albumin administration was evaluated in 210 patients from
different wards on randomly selected days during one year. Reasons for the
prescription, the consumed dose, length of administration, and related
laboratory tests were recorded.
Results: Albumin was prescribed inappropriately in 76.2% and appropriately
in 23.8% of inpatients. The most frequent inappropriate prescribing motives
were hypoalbuminemia (35.6%), nutritional support (32.5%), and edema
(24.4%), while the most appropriate prescriptions were edema (46%),
nephrotic syndrome (18%), and plasmapheresis (16%). The total amount of
albumin used for 210 patients was 68930 g, from which 51290 g costing
$274607.1429 was administered for inappropriate indications.
Conclusion: Despite the many valid guidelines defining the appropriate
indications of albumin, this study demonstrated the extensive inappropriate
use of this expensive preparation in one of the largest university-affiliated
hospitals in northwestern Iran. It seems advisable to have the consumption of
albumin continuously monitored. |