Appropriateness of albumin treatment in noncritical and non-oncohematological hospitalized patient

• Autores: Roser Juvany Roig, Pablo Latorre García, Erika Esteve, M. Teresa Pérez Maroto, José Luis Pérez Blanco, Ramón José Jódar Masanés, Josep Manuel Llop Talaverón, José Bruno Montoro Ronsano
• Localización: European journal of clinical pharmacy: atención farmacéutica, ISSN 2385-409X, Vol. 20, Nº. 4, 2018, págs. 183-188
• Idioma: inglés
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• Resumen

  • Objective: To evaluate the appropriateness of albumin treatment in non-critical and non-oncohematological patients according to published evidence. Method: Retrospective multicentric observational study of patients treated with albumin during 2013 in four Spanish university hospitals. Data collected were: demographics, albumin indication, albumin daily dose (ADD; g/day), albumin total dose administered during treatment (ATD; g) or (ATD; g/Kg), serum albumin value (SALB) at the beginning (BSALB; g/L) and at the end of albumin treatment (ESALB; g/L), albumin treatment duration (TD; days) and status at discharge (dead or alive). Median (IQR) of age, ADD, ATD, BSALB, ESALB, serum albumin increase (SALBI) and TD was estimated globally and stratified by albumin indication. BSALB values were stratified in three groups for analyzing their evolution during treatment. Results: 475 patients were included. Albumin prescription was inappropriate in 39.6% of patients. The main inappropriate indication was edema refractory to diuretics in non-hepatic pathology with BSALB ≥20g/L (24.8%, 118 of 475). Overall median ADD was 25g/day (20-30) and presented statistically significant differences between albumin indication (F = 6.779; p = 0). Median TD was 4 days (2-6). Only 61% patients had BSALBV and ESALBV. Median SALB increased from 24 g/L (20-28) to 30 g/L (26-34). BSALB subgroup analysis showed that patients with BSALB ≥25 g/L presented lower increments than patients with BSALB <25 g/L (F = 25.98; p = 0). Conclusions: Albumin prescription profile is not consistent with published recommendations. In this study, more than one third of the prescriptions were inappropriate. It is necessary to promote prospective educational programs to improve adherence to the clinical practice guidelines approved in the hospital in order to achieve cost-effective practice