Background Albumin has a significant impact on spending and it poses a risk to economic sustainability. Prescriptions are often inappropriate and corrective actions are required.
Purpose Albumin consumption was analysed in some departments to improve the appropriateness of prescriptions. The Drug Commission in September 2009 approved a new form, which is now used in our Region, with indications of documented effectiveness. The prescription of the specialist must also be approved by transfusion centre doctors to evaluate clinical parameters.
Material and methods Albumin consumption was analysed in the first 8 months from 2009 to 2013 in hospital wards with higher requests (Cardiology, Gastroenterology, Geriatrics, Internal Medicine, Hepato-biliary-pancreatic Surgery, Vascular Surgery). Data were extrapolated from XPharmacy management software and analysed using Microsoft Excel.
Results Introduction of a new form reduced albumin consumption significantly: from 8067 vials in 2009 to 1371 vials in 2013 for the same period (6696 fewer vials, a reduction of 83%). Over the years, consumption has continuously reduced with satisfactory overall results in all the departments examined (performance% reductions 2013/2009: Geriatrics minus 94.83%, Gastroenterology, minus 92.01%, Hepato-Biliary-Pancreatic Surgery minus 84.47%, Internal Medicine minus 75.71%, Cardiology minus 75.53%, Vascular Surgery minus 40.47%). The comparison 2013/2010 presents significant results (down by 40.44% total, Gastroenterology minus 78.21%, Internal Medicine minus 51.72%).
Conclusion Corrective action against inappropriate use of albumin has immediately resulted in a decrease in vials dispensed in all departments.
Hospital pharmaceutical consumption has declined dramatically, with significant savings.
Collaboration with transfusion centre doctors reduced off-label and inappropriate prescriptions: synergy of Pharmacy, Blood Transfusion Centre and departments showed that appropriate pharmacological treatment can also save money.
The steady decline in consumption in years analysed is the result of sustained and careful appropriateness checks even after the introduction of the new model (see comparison 2013/2010), and demonstrates the effectiveness of the measures taken.
References and/or Acknowledgements No conflict of interest.
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