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ORIGINAL ARTICLE
Year : 2018  |  Volume : 7  |  Issue : 3  |  Page : 157-163

Albumin utilization evaluation in a major teaching hospital in Iran: Recommendations for guideline development


1 Department of Clinical Pharmacy, Firoozgar Clinical Research Development Center, International Campus, Iran University of Medical Sciences, Tehran, Iran
2 Department of Nephrology, Firoozgar Clinical Research Development Center, Iran University of Medical Sciences, Tehran, Iran
3 Department of Surgery, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
4 Gastrointestinal and Liver Disease Research Center, Iran University of Medical Sciences, Tehran, Iran
5 Department of Cardiology, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
6 Firoozgar Clinical Research Development Center, Iran University of Medical Sciences, Tehran, Iran
7 Department of Pharmacy, Firoozgar Hospital, Hospital Pharmacy Management (Madad Iran Holding), Iran University of Medical Sciences, Tehran, Iran

Correspondence Address:
Dr. Atefeh Amouzegar
Department of Nephrology, Firoozgar Clinical Research Development Center, Iran University of Medical Sciences, Tehran
Iran
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jrpp.JRPP_18_4

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Objective: Human albumin solution is an expensive colloidal preparation which is commonly used in clinical practice. Due to high cost of albumin, increased rate of the inappropriate use worldwide, and many other reasons, it is imperative to establish a practical protocol to use albumin products and limit its usage. The aim of this study was to identify albumin utilization patterns in a teaching hospital and to demonstrate the importance of the need to reconsider prescribing strategies for albumin administration. Methods: This retrospective cross-sectional study was performed between August 2016 and December 2016 at Firoozgar Hospital affiliated to Iran University of Medical Sciences, Tehran, Iran. All albumin prescriptions for adult patients during the study period were enrolled for appropriateness evaluation according to the latest evidence-based studies and guidelines. Findings: Among 320 albumin prescriptions, 168 (52.5%) were inappropriate according to the current evidence. The most common irrational causes for the albumin usage were hypoalbuminemia (23.4%), nutritional support (13.7%), neuroprotection in subarachnoid hemorrhage (3%), pretreatment for cancer surgery (2.8%), edema (1.6%), hepatic failure (1.6%), and paracentesis (3%). The total amount of albumin used for 320 patients was 52,050 g, from which 28,470 g was inappropriate resulting in $97,398 wastage. Conclusion: These findings, along with aforementioned guidelines, support the requirement for physicians' educational programs and proper strategies for appropriate prescriptions and could also be important in modifying the available guidelines concerning expensive drugs such as albumin.


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