Evaluation and determining of the Pattern of the Human Albumin Utilization at Shahid Rahimi Hospital, Khorramabad, Iran

Vahid Rahimi, Fanak Fahimi, Javad Ghasemian Yadegari, Hadi Hayati Abbarik, Arian Karimi Rouzbahani, Zahra Heydari, Ali Kharazmkia

Abstract


Background: The World Health Organization (WHO) has supported many intervention strategies, including executive, educational, and monitoring proceedings to improve the evaluation of drug use and the drug management system. Since the resources are limited, it is essential to utilize existing resources properly. Serum albumin is the most abundant blood protein produced in the liver. Different forms of albumin are available in the market and employed to treat hypovolemia, Cirrhotic ascites, severe burns, septic shock, hyperstimulation syndrome, etc. Due to the high price of albumin and its importance for saving patient’s lives.

Methods: precisely according to the determined protocols, and it’s unreasonable and irrational medication should be avoided. Statistical analysis was performed in Shahid Rahimi Hospital of Khorramabad, Iran, from March 2018 to March 2019. Albumin administration for randomly selected patients receiving albumin in different wards was evaluated. The main sources to retrieve information were pharmacy drug folders, patient folders (including laboratory information), and nursing folders. Age, sex, weight, ward, albumin level, symptoms, and final dose were recorded for each patient. Contraindications to the administration of albumin or any caution in its use were also considered. Data were analyzed by using SPSS16 and Excel software. Independent T-test and Chi-square test were employed to compare quantitative and qualitative variables. 271 patients were studied, including 160 men and 111 women.

Results: The two male and female surgical wards with 41 patients had the highest percentage of patients admitted with albumin administration. Also, the most common cause of albumin administration in patients was hypoalbuminemia. 55% of albumin prescriptions in Shahid Rahimi Hospital of Khorramabad were irrational, driving a substantial financial burden for the healthcare system and patients. Among all the prescribed cases, only 5.2% were approved by the pharmacist. Finally, 77.1% of patients recovered, and 22.9% died.

Conclusion: Considering that the highest percentage of patients receiving albumin administration, both among patients with irrational administration and in general, were in men's and women's surgical wards, it is recommended that the drugs prescribed in these wards be further investigated and get pre- Approved by a pharmacist to prevent higher medical costs for patients and healthcare system.          

Keywords: Albumin; Hypovolemia; Cirrhotic Ascites; Septic Shock; Hyperstimulation Syndrome     


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