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DD-014 Evaluation and optimisation of the use of albumin by restricted prescription in a general hospital
  1. MJ Cumbraos Sánchez,
  2. M Merchante Andreu,
  3. E Fernández Alonso,
  4. MA Alcácera López
  1. Hospital Clinico Lozano Blesa, Hospital Pharmacy, Zaragoza, Spain

Abstract

Background A number of studies have shown that albumin is used wrongly in hospitals, basically related to its use in hypoalbuminaemia-hypoproteinaemia. Therefore, prescription of albumin should be limited to specific indications. Until recently, pharmacists didn’t know the indication for the use of albumin at the time of dispensing in our hospital.

Purpose To find out what albumin is commonly used for in clinical practice. To design and introduce a permission form bearing specific indications for albumin. To find out whether the implementation of this monitored prescription has affected the amount of albumin dispensed.

Material and methods In order to make the application form, we formed a working group including the main hospital services that use albumin. After introducing it, we examined how much albumin was dispensed during the first 6 months of using the application form, contrasting data with the previous 6 months.

Results This working group reviewed literature recommendations for the use of albumin, developed a permission form, including data about the physician and the patient, and the indications authorised for albumin: bacterial peritonitis, paracentesis, hepatorenal syndrome, hyponatraemic hypervolemia, multiple myeloma and hypoalbuminaemia associated with other factors. It was decided that only three days of treatment would be dispensed.

The most common indications were: paracentesis and hypoalbuminaemia.

The amount of albumin dispensed was reduced to 37.9% of the use over the previous 6 months, when the permission form had not yet been introduced.

Conclusion Up to now, in our hospital we dispensed albumin without knowing the indication for which it was prescribed. Since the introduction of pharmaceutical validation of the prescription by the permission form, there has been a decrease in and optimisation of its use.

References and/or acknowledgements 1 The SAFE Study Investigators, Finfer S, McEvoy S, et al. Impact of albumin compared to saline on organ function and mortality of patients with severe sepsis. Intensive Care Med 2011;37:86–96

No conflict of interest.

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