Author/Authors :
Dastan, Farzaneh Pharmacovigilance Department - National Research Institute of Tuberculosis and Lung Diseases (NRITLD) - Shahid Beheshti University of Medical Sciences, Tehran, Iran , Jamaati, Hamidreza Chronic Respiratory Diseases Research Center (CRDRC) - NRITLD - Shahid Beheshti University of Medical Sciences, Tehran, Iran , Emami, Habib Tobacco Prevention and Control Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD) - Shahid Beheshti University of Medical Sciences ,Tehran, Iran , Haghgoo, Rodabeh Pharmacovigilance Department - National Research Institute of Tuberculosis and Lung Diseases (NRITLD) - Shahid Beheshti University of Medical Sciences, Tehran, Iran , Eskandari, Raha Pharmacovigilance Department - National Research Institute of Tuberculosis and Lung Diseases (NRITLD) - Shahid Beheshti University of Medical Sciences, Tehran, Iran , Hashemifard, Shadab School of Pharmacy - Shahid Beheshti University of Medical Sciences, Tehran, Iran , Khoddami, Fatemeh School of Pharmacy - Shahid Beheshti University of Medical Sciences, Tehran, Iran , Mirshafiei Langari, Zahra Pharmacovigilance Department - National Research Institute of Tuberculosis and Lung Diseases (NRITLD) - Shahid Beheshti University of Medical Sciences, Tehran, Iran
Abstract :
Albumin is known as a human blood product, with high cost and limited availability.
Several studies have demonstrated the extent in which albumin is being utilized in controversial
indications not supported or weakly supported by the available literature. To rationalize the use
of albumin and to decrease the inappropriate cost of this expensive drugˏ a two phase study,
with equal length of 66-days, comprising an observational drug utilization evaluation and a
pharmacist-led audit and feedback interventional study, was conducted in a tertiary referral
hospital in Tehran, Iran. The results of the interventional phase including the introduction of
evidence-base guideline for albumin via a pharmacist-led audit and feedback intervention was
compared to the ones from the observational phase. A total of 90 and 45 patients were included
in the phase one and phase two of the study respectively. During the initial phase, 1870 albumin
vials were used, of which 1467 (78.4%) vials were prescribed inappropriately. Inappropriate use
of albumin was decreased significantly by 79.3% (p < 0.001) through the interventional phase,
leading to 38,800 USD reduction in inappropriate costs of albumin. Introduction of evidence
based guideline in conjugation with pharmacist-led audit and feedback can significantly
decrease the inappropriate use of albumin. These results also demonstrate shifting towards a
more evidence-based practice, which can increase patient’s safety and enhance quality of care.
Keywords :
Inappropriate prescribing , Albumin , Intervention study , Drug utilization evaluation , Clinical pharmacy , Cost Saving
