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to conclude that although the use of human albumin in the hospital was associated to a clinical protocol, it was outdated.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.
Highlights
Human albumin (HA) is the major serum protein, accounting for about 50% of the total plasma circulating proteins
Considering that the national guideline that orientate the use of HA was published in 2004, the high cost of the drug and its relevance in clinical practice, this study aims to evaluate the appropriateness of requests for albumin use in a hospital, according to the institutional protocol and other clinical guidelines published in the last years (2007 – 2017)
The Pharmacy Division received 98 requests in this period, with the request average number per patient being 2.1 ± 1.5, ranging from 1 to 7 requests per patient. This variation was observed because some patients received HA on more than one occasion, which is reported in other studies (Matos, Rozenfeld, 2005)
Summary
Human albumin (HA) is the major serum protein, accounting for about 50% of the total plasma circulating proteins. It is the main responsible for maintaining intravascular oncotic pressure, accounting for at least 70% of it in healthy individuals (Valerio et al, 2016; Bernardi, Ricci, Zaccherini, 2014). Because HA is a blood derivative, it has limited availability and a manufacturing process with strict health and safety regulations. It is considered a safe product, the potential risk of micro-organisms transmission or severe allergenic effects cannot be ruled out. As a consequence of these factors, HA is a product that has a high cost
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