4CPS-021 Evaluation of human albumin consumption and therapeutic appropriateness after the introduction of a designated prescription form. (March 2019)

• Record Type: Journal Article
• Authors: Lai, SK; Borin, F; Taurasi, F; Vigano', M
• Is Part Of: European journal of hospital pharmacy. Volume 26(2019)Supplement 1
• Page Start: A77
• Page End: A77
• Publication Date: 2019-03
• Subjects: Pharmacy -- Periodicals; Hospital pharmacies -- Periodicals; 615.1
• DOI: 10.1136/ejhpharm-2019-eahpconf.170
• Languages: English
• ISSNs: 2047-9956

Abstract

Abstract : Background: Human albumin has been under discussion for many years because its therapeutic use often goes well beyond clinical evidence and outside its approved indications, giving rise to off-label use and sometimes to abuse. Furthermore, human albumin is a limited resource depending on the number of donations and it is therefore preferable to restrict the usage to ensure a constant supply. Purpose: To evaluate the impact of an internal prescription form for the appropriate use of albumin. Material and methods: From 1 March 2018 albumin prescription arrived at the pharmacy unit exclusively through a designated form prepared by the immuno-haematology and transfusion medicine service, which consists of two sections: the first to be filled in with the patient's personal data and the second with the serum albumin level, the indication of use and the number of bottles. We analysed albumin consumption among all hospital units before and after the introduction of the request form for a 3 month period, focusing on the therapeutic appropriateness. Results: The first analysis showed a 40% reduction in albumin utilisation, from a total number of 1882 bottles to 1143. The main users were the intensive care unit, whose consumption decreased by about 50% (from 500 to 231 bottles), similarly to the general medicine unit that fell from 571 to 283 bottles, while the gastroenterology unit and endoscopy service reduced consumption by only 22%, from 431 to 340 bottles. The results were less positive regarding the correct completion of the request form and the therapeutic appropriateness. Out of a total number of 182 requests, only 163 were correctly filled in by entering serum albumin values. Out of these, 141 prescription were appropriate or occasionally appropriate (46 prescriptions), while the remaining ones were considered inappropriate since they reported serum albumin values>2.5 g/dl or indication use was missing. Conclusion: Despite the decrease in albumin consumption, we considered it necessary to intervene as the pharmacy unit, alongside immuno-haematology and the transfusion medicine service, with monitoring activities, training and meeting with prescribers, in order to improve compliance with the application form and ensure the appropriate use of albumin. References and/or acknowledgements: https://ejhp.bmj.com/content/21/Suppl_1/A88.3 https://ejhp.bmj.com/content/22/Suppl_1/A74.3 No conflict of interest.