Evaluation of Serum Albumin Utilization in Inpatient at a Private Hospital in Bangkok

Abstract

Serum albumin is widely used for the treatment of hypovolemia, shock, hyperbilirubinemia or acute liver failure. However, serum albumin itself may have a signicant eect on the action, elimination or distribution of other medica tions in blood which may aect the outcome of the treatment. Besides, it is also expensive and, most important, can be a carrier for many lifethreatening diseases such as AIDS. The objective of this study is to evaluate the serum albumin utilization in inpatient at a private hospital in Bangkok, Thailand. Descriptive, retrospective study was designed to mo nitor the 25 w/v serum albumin orders over a fourmonth period. The background information, doses and rational of serum albumin orders, other medication orders, side eects, the interaction between serum albumin and other medica tions, the laboratory results and also clinical outcome of the patients were recorded. From the medication orders of 74 inpatients, there were 104 orders of serum albumin for 9 indications. The most common indications were hypoalbumine mia (48) and cirrhosis (9). From the total number of serum albumin orders, there were only 67 orders (64.4) prescribed with rational dose and duration under appropriate indications. Totally about 35.6 of serum albumin orders were prescribed with improper indications such as edema, anemia or coronary artery bypass grafting. Out of 35.6, 14 of the orders were prescribed to contraindicated patients. No side eect of serum albumin infusion was found during this study. The result indicates the overutilization of serum albumin and specic guideline for using this agent should be set in every hospital.

Pharmacy contribution to the prescription and rational use of human albumin at a large hospital

“…As to the distribution of non-supported indications during the period of January 2007 to December 2008, it was observed that albumin was mainly used to correct hypoalbuminemia, which is consistent with the findings of other studies on the indications of albumin use (12)(13)(14) .…”

“…The clinical pharmacist performs several activities aiming to maximize the effects of therapeutics and to minimize treatment risks and costs (14)(15)(16)(17) . The work developed shows that the participation of the clinical pharmacist was essential for the success of projects linked to safe and rational use of medicines, promoting the adoption of institutional guidelines by the Hospitals' medical and multidisciplinary teams, thereby increasing patient safety.…”

The Evaluation of Albumin Use in an Iranian University Hospital

“…9 So, it is believed that albumin, featuring water-retention and diuretic properties, can be used to treat edema associated with hypoalbuminemia. 10,11 Although there is undoubtedly some association between edema and low serum albumin, there are many confounding factors which affect the relationship.…”

Managing the Rising Costs and High Drug Expenditures in Critical Care Pharmacy Practice

“…Reducing albumin use is often a challenge for institutions worldwide, as year after year, hospitals struggle with high utilization and often unnecessary use of this costly therapy. [14][15][16][17][18] Several articles of interest were found related to efforts to reduce albumin use. In a novel approach, one group describe a multipronged effort to reduce inappropriate albumin use among eight ICUs in a health system.…”