The appropriate use of human albumin in a Brazilian University Hospital: therapeutic indication and dosage regimen

Abstract

The objective of the study was to evaluate the use of human albumin in a Brazilian university hospital, in compliance with the institutional protocol and other clinical guidelines, taking into account the therapeutic indications and the dosage regimens. Data was obtained from the pharmacy dispensing records of human albumin, the requests for use it and, when available, the patient's records between January and October 2017. After evaluation the therapeutic indications and the dosage regimens were classified as "appropriate" and "inappropriate". The analysis of 98 requests showed that, when compared to the institutional protocol, 54 (55.1%) requests had an inappropriate therapeutic indication. However, when a comparison was made between 25 medical records (54 requests) and other clinical guidelines, it was observed that the therapeutic indication had none classified as inappropriate. In addition, 16 (29.7%) requests were considered inappropriate in relation to dosage regimens. From these results, it was possible to conclude that although the use of human albumin in the hospital was associated to a clinical protocol, it was outdated. Thus, it is possible to affirm that not only the adoption of a clinical protocol, but its periodical updating is an important strategy to promote the rational use of drugs.

The Impact of Clinical Pharmacist Implemented Protocol on Albumin Utilization and Cost in an Intensive Care Unit in Egypt

“…These include; management of malnutrition in critically ill patients, nephrotic syndrome not associated with hypovolemia and/or pulmonary edema, ascites responsive to diuretic therapy and pancreatitis (Liumbruno et al, 2009;Caraceni et al, 2013;Farasatinasab et al, 2018). Several studies have reported albumin misuse in the literature, showing its negative clinical and economic impacts (Lyu et al, 2016;Zolfagharian et al, 2017;Dastan et al, 2018;Ishida et al, 2018;Javan-Noughabi et al, 2020). This misuse could be attributed to absence of collective protocols defining appropriate albumin indications to guide healthcare providers, and also the lack of restrictive dispensing in the clinical setting (Buckley et al, 2020).…”