Background: Human albumin solution (HAS) is an expensive colloidal preparation that is commonly used in clinical practice. Given the high cost of albumin and its rising worldwide use, it is imperative to establish a practical protocol to improve the rational use of albumin products. This study aimed to identify albumin utilization patterns in a teaching hospital and to demonstrate the importance of revisiting strategies for albumin administration.
Objectives: This study aimed to identify albumin utilization patterns in a teaching hospital and to demonstrate the importance of revisiting strategies for albumin administration.
Methods: This retrospective study was conducted between March ۲۰, ۲۰۲۳, and March ۱۹, ۲۰۲۴, at Imam Khomeini Educational Hospital, an affiliated hospital of Mazandaran University of Medical Sciences, Sari City, Iran. All albumin forms completed during the study period were enrolled for appropriateness evaluation in accordance with the protocol developed by the Iranian Food and Drug Administration.
Results: In ۸۲ patients (۳۲.۱%), serum albumin levels were greater than ۲.۵ g/dL at the time of albumin administration, of which ۵۶% were above the recommended cut-off for the indication. Among ۳۱۳ albumin prescriptions, in ۷ cases (۲.۳%), albumin administration was not based on any official indication listed in the protocol.
Albumin level less than ۲.۵ g/dL for ۳ days (۲۵.۴%), ascites or generalized edema (۲۴.۴%), and hepatorenal syndrome (HRS) (۱۳%) were the most common reasons for albumin administration. The daily albumin dose ranged from ۱ vial of ۲۰% to ۵ vials, averaging ۱۹ g/d. Only one patient (۰.۳%) had the duration of albumin treatment stated, and no patient had their albumin levels rechecked ۷۲ hours after administration.
Conclusion: This study showed significant deviations from the albumin prescription protocol. Some aspects of albumin prescribing, including the minimum cut-off for starting albumin, the duration of use, and rechecking the albumin level, were not adequately considered by physicians. These findings highlight a more sophisticated focus on albumin prescribing in an attempt to minimize the irrational prescription of this expensive and valuable drug.
