Use of albumin in three French university hospitals: is prescription monitoring still useful in 2004?
OBJECTIVE
Use of albumin (indications and quantities involved) has not been assessed in France since major changes occurred after the publication of Cochrane group meta-analysis. The objectives of this study were to measure the repartition of albumin indications in three French university hospitals in 2004 and to assess the feasibility and usefulness to implement a prescription-monitoring program.


METHODS
Exhaustive record of albumin prescription during 2 months in three French university hospitals of Marseille. Inclusion of all patients with a first prescription of albumin between 15 March 2004 and 15 May 2004. Indication, formulation and quantity prescribed were recorded for each prescription.


RESULTS
One hundred and eighty-seven patients received a total of 426 prescriptions for a total quantity of 21 094 g of albumin during the study. The first indications were hypoalbuminemia (33% of total quantity), plasmapheresis (30.2%) and ascites or hepatorenal syndrome (13.7%). Fifty per cent of total quantity was used by 14 patients (7.5% of included patients).


CONCLUSIONS
Most of albumin consumption in our study is concentrated on recognized indications or indications without alternative to albumin. The different levels of analysis (number of patient treated, number of prescription and quantities used) must be taken into account when analyzing medications such as albumin. Only a marginal proportion of consumption is expected to be saved with close monitoring of indications.
Pradel
Vincent
V
Assistance Publique des Hôpitaux de Marseille, France.
Tardieu
Sophie
S
Micallef
Joëlle
J
Signoret
Anne
A
Villano
Philippe
P
Gauthier
Laurence
L
Vanelle
Patrice
P
Blin
Olivier
O
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000418:Albumins / Q000008:administration & dosage* / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D016903:Drug Monitoring / Q000379:methods / Q000706:statistics & numerical data; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005602:France; D006757:Hospital Units / Q000706:statistics & numerical data; D006785:Hospitals, University / Q000706:statistics & numerical data*; D006801:Humans; D034141:Hypoalbuminemia / Q000188:drug therapy; D020896:Hypovolemia / Q000188:drug therapy; D007223:Infant; D007231:Infant, Newborn; D007297:Inpatients / Q000706:statistics & numerical data; D008875:Middle Aged; D009404:Nephrotic Syndrome / Q000188:drug therapy; D015203:Reproducibility of Results; D016896:Treatment Outcome
D000418:Albumins