Assessment of Irrational Use of Albumin and Determination of Associated Risk Factors, Along with Evaluation of the Effectiveness of Clinical Pharmacist Interventions in Reducing Prescription Errors

Document Type : Original Article(s)

Authors

1 Department of Clinical Pharmacy and Pharmaceutical Sciences Research Center, Faculty of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Isfahan, Iran

2 Assistant Professor, Department of Clinical Pharmacy, Faculty of Pharmacy, Isfahan University of Medical Sciences, Isfahan, Iran, Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

3 Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

4 Associate Professor, Department of Clinical Pharmacy and Pharmaceutical Sciences Research Center, Faculty of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Isfahan, Iran

10.48305/jims.v43.i830.1099

Abstract

Background: Given the importance of rational albumin prescribing, this study was designed to investigate the extent of irrational albumin use at Shahid Chamran heart center in Isfahan and to evaluate the acceptance of clinical pharmacist interventions in reducing the inappropriate prescription of this medication.
Methods: All patients receiving albumin during the study period were assessed to evaluate the prescribing and consumption patterns of albumin. Additionally, analyses were conducted to examine the relationship between the hospital ward, reason for admission, and the specialty of the prescribing physician with irrational albumin prescribing. The effectiveness of the clinical pharmacist's intervention was evaluated by comparing the prescribing rates before and after the intervention.
Findings: In this study, 264 patients receiving albumin (982 vials) were analyzed, revealing that 84% of the patients and 80.1% of the vials prescribed were deemed irrational. The results indicated that the reason for admission, the specialty of the prescribing physician, and the hospital ward had a significant relationship with irrational albumin prescribing. Furthermore, the clinical pharmacist's intervention led to a reduction of over 50% in albumin consumption within the hospital.
Conclusion: The majority of albumin prescriptions at Chamran Heart Center were found to be empirical, primarily due to the lack of valid guidelines for albumin use, especially in pediatric and neonatal populations. Therefore, it is essential to implement serious programs for albumin prescribing to reduce healthcare system costs and minimize the adverse effects associated with irrational albumin use.

Highlights

Sepehr Boroumandpour: Google Scholar

Mehrnoush Dianatkhah: Google Scholar, PubMed

Faezeh Tabesh: Google Scholar

Shadi Farsaei: Google Scholar, PubMed

Keywords

References

  1. Abedi F, Zarei B, Elyasi S. Albumin: a comprehensive review and practical guideline for clinical use. Eur J Clin Pharmacol 2024; 80(8): 1151-69.
  2. Callum J, Skubas NJ, Bathla A, Keshavarz H, Clark EG, Rochwerg B, et al. International Collaboration for Transfusion Medicine Guidelines Intravenous Albumin Guideline Group. Use of Intravenous Albumin: A Guideline From the International Collaboration for Transfusion Medicine Guidelines. Chest 2024; 166(2): 321-38. 
  3. Jug R, Callum J, Ruijs T, Liu Y, Barty R, Thompson T. Intravenous albumin utilization audit at a large community hospital. Transfusion 2024; 64(1): 39-46.
  4. Rozga J, Piątek T, Małkowski PJAT. Human albumin: old, new, and emerging applications. Ann Transplant 2013; 18(1): 205-17.
  5. Jug R, Callum J, Ruijs T, Liu Y, Barty R, Thompson T. Intravenous albumin utilization audit at a large community hospital. Transfusion 2024; 64(1): 39-46.
  6. Caraceni P, Tufoni M, Bonavita ME. Clinical use of albumin. Blood Transfus 2013; 11(Suppl 4): s18-s25. 
  7. Tanzi M, Gardner M, Megellas M, Lucio S, Restino M. Evaluation of the appropriate use of albumin in adult and pediatric patients. Am J Health Syst Pharm 2003; 60(13): 1330-5.
  8. Ala S, Salehifar E, Chalaki V. Evaluation of albumin use in a teaching hospital [in Persian]. J Mazandaran Univ Med Sci 2015; 25(129): 137-41. 
  9. Rezapour A, Javan-Noughabi J, Salehiniya H, Kassani A, Ahmad Sadeghi A. Albumin usage in Iran. Arch Iran Med 2019; 22(12): 722-7.
  10. Rahimi V, Fahimi F, Ghasemian Yadegari J, Hayati Abbarik H, Karimi Rouzbahani A, Heydari Z, et al. Evaluation and determining of the Pattern of the Human Albumin Utilization at Shahid Rahimi Hospital, Khorramabad, Iran. Adv Life sci 2023; 9(4): 595-602.
  11. Lee TH, Kuo G, Chang CH, Huang YT, Yen CL, Lee CC, et al. Diuretic effect of co-administration of furosemide and albumin in comparison to furosemide therapy alone: An updated systematic review and meta-analysis. PLoS One 2021; 16(12): e0260312. 
  12. Talasaz AH, Jahangard-Rafsanjani Z, Ziaie S, Fahimi F. Evaluation of the pattern of human albumin utilization at a university affiliated hospital. Arch Iran Med 2012; 15(2): 85-7.
  13. Jahangard-Rafsanjani Z, Javadi MR, Torkamandi H, Alahyari S, Hajhossein Talasaz A, Gholami K. The evaluation of albumin utilization in a teaching university hospital in Iran. Iran J Pharm Res 2011; 10(2): 385-90.
  14. Bignall S, Bailey PC, Bass CA, Cramb R, Rivers RP, Wadsworth J. The cardiovascular and oncotic effects of albumin infusion in premature infants. Early Hum Dev 1989; 20(3-4): 191-201.
  15. Oca MJ, Nelson M, Donn SM. Randomized trial of normal saline versus 5% albumin for the treatment of neonatal hypotension. J Perinatol 2003; 23(6): 473-6.
  16. Arrahmani I, Ingelse SA, van Woensel JBM, Bem RA, Lemson J. Current Practice of Fluid Maintenance and Replacement Therapy in Mechanically Ventilated Critically Ill Children: A European Survey. Front Pediatr 2022; 10: 828637.
  17. McCaffrey J, Lennon R, Webb NJ. The non-immunosuppressive management of childhood nephrotic syndrome. Pediatr Nephrol 2016; 31(9): 1383-402.
  18. Parisi A, Cafarotti A, Salvatore R, Pelliccia P, Breda L, Chiarelli F. Protein-losing enteropathy in an infant with rotavirus infection. Paediatr Int Child Health 2018; 38(2): 154-7.
  19. Dharmaraj R, Hari P, Bagga A. Randomized cross-over trial comparing albumin and frusemide infusions in nephrotic syndrome. Pediatr Nephrol 2009; 24(4): 775-82.
  20. Mollazadeh S, Tavanaei Tamanaei T, Oghazian S, Oghazian S, Oghazian MB. The Pattern of Albumin Consumption in Teaching University Hospitals in Northeastern Iran. Albumin Consumption. Iranian Journal of Pharmaceutical Sciences 2021; 17(4): 97–106.
Journal of Isfahan Medical School
Volume 43, Issue 830
2nd Week, November
November and December 2025
Pages 1099-1105

Files

History

  • Receive Date: 19 February 2025
  • Accept Date: 13 September 2025

Share

How to cite

Statistics