Investigating the Prescribing of Human Albumin in a Teaching Hospital in Thailand

Abstract

Background and objective: Human albumin is a high cost medication and the rational use of it is in question. In Thailand, the national guideline for albumin use has not been established so that the criteria-based guideline was developed for promoting the rational use of human albumin in individual institutions including Srinagarind hospital. The aim of this study was to assess the rationale of human albumin prescribing in our hospital.

Methods: Data was retrospectively collected from human albumin prescriptions and patient medical record at Srinagarind hospital during November 2015 to February 2016. The appropriateness of prescribing was assessed in the aspects of indication, process indicator and contra-indication. All data were analyzed and reported using descriptive statistics.

Results: There were 221 human albumin prescriptions from 154 patients during the study period. It was mostly used as fluid resuscitation (48.9%), followed by abdominal paracentesis (15.4%) and nephritic syndrome (13.6%). Process indicator measurement composed of albumin level (82.5%), central venous pressure (50%) and both (72.7%). Anemia which was contra-indication was found in 12.2% of patients. The appropriateness of prescribing in the aspects of indication, process indicator and contra-indication were 99.5, 90.9 and 87.7%, respectively.

Conclusion:  Prescribing of human albumin was usually complied with the hospital control measure but albumin used in patients with contra-indication should be diminished.