The appropriate use of human albumin in a Brazilian University Hospital: therapeutic indication and dosage regimen

The objective of the study was to evaluate the use of human albumin in a Brazilian university hospital, in compliance with the institutional protocol and other clinical guidelines, taking into account the therapeutic indications and the dosage regimens. Data was obtained from the pharmacy dispensing records of human albumin, the requests for use it and, when available, the patient’s records between January and October 2017. After evaluation the therapeutic indications and the dosage regimens were classified as “appropriate” and “inappropriate”. The analysis of 98 requests showed that, when compared to the institutional protocol, 54 (55.1%) requests had an inappropriate therapeutic indication. However, when a comparison was made between 25 medical records (54 requests) and other clinical guidelines, it was observed that the therapeutic indication had none classified as inappropriate. In addition, 16 (29.7%) requests were considered inappropriate in relation to dosage regimens. From these results, it was possible to conclude that although the use of human albumin in the hospital was associated to a clinical protocol, it was outdated. Thus, it is possible to affirm that not only the adoption of a clinical protocol, but its periodical updating is an important strategy to promote the rational use of drugs.

本研究旨在评估某巴西大学医院中人血白蛋白（human albumin）的临床使用情况，研究严格遵循医院内部规程与其他临床指南，同时兼顾治疗适应证与给药方案。研究数据提取自2017年1月至10月期间的人血白蛋白药房发药记录、使用申请单，以及可获取的对应患者病历。经评估后，治疗适应证与给药方案被划分为"适宜"与"不适宜"两类。对98份使用申请的分析显示，相较于医院内部规程，其中54份（55.1%）申请的治疗适应证被判定为不适宜。然而，在将25份对应54份申请的患者病历与其他临床指南进行比对后，未发现有治疗适应证被归类为不适宜的情况。此外，16份（29.7%）申请的给药方案被认定为不适宜。基于上述结果，本研究得出结论：尽管该院人血白蛋白的临床使用配套有临床规程，但该规程已过时。据此可明确，不仅需制定临床用药规程，还需定期对其进行更新，这是促进药物合理使用的重要策略。