AUTHOR=Ibrahim Dina Mohamed , Shawki May Ahmed , Solayman Mohamed Hassan , Sabri Nagwa Ali 

TITLE=The Impact of Clinical Pharmacist Implemented Protocol on Albumin Utilization and Cost in an Intensive Care Unit in Egypt

JOURNAL=Frontiers in Pharmacology

VOLUME=13

YEAR=2022

URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2022.825048

DOI=10.3389/fphar.2022.825048

ISSN=1663-9812

ABSTRACT=<p><bold>Introduction:</bold> Albumin is an expensive non-blood plasma substitutes with limited availability that has been reported to be inappropriately used in healthcare settings. Hence, interventions are recommended to control its misuse.</p><p><bold>Objective:</bold> To evaluate the impact of clinical pharmacist implemented dispensing protocol on optimization of albumin use in an intensive care unit (ICU).</p><p><bold>Design:</bold> A retrospective prospective 3-phase interventional study was conducted in an ICU in a tertiary Egyptian hospital over a period of 2 years.</p><p><bold>Methods:</bold> The study included three phases; a preparation phase where a local albumin dispensing protocol and a restriction dispensing form were prepared by clinical pharmacists and was approved by the local Drugs and Therapeutics Committee, a retrospective pre-implementation phase in which the medical records of all ICU patients receiving albumin were evaluated for appropriateness of albumin use according to the developed protocol, and a prospective implementation phase where the dispensing protocol and restriction dispensing form were applied. The pattern of albumin consumption and cost were recorded and compared between the retrospective and prospective phases.</p><p><bold>Results:</bold> In the retrospective phase, 190 ICU patients received albumin of whom 83.6% was considered inappropriate indications for albumin compared to only 44 patients in the prospective phase of whom 16% was considered inappropriate (<italic>p</italic>-value &lt;0.001). Clinical pharmacists’ interventions significantly decreased the inappropriate albumin consumption from 4.7 vials/patient in the retrospective phase to 2.7 vials/patient in the prospective phase (<italic>p</italic>-value &lt;0.001) with a total cost savings of 313,900 Egyptian Pounds (19,930 US Dollars).</p><p><bold>Conclusion:</bold> The current study showed that clinical pharmacists’ interventions led to a significant control on albumin use and consequently reduced the cost associated with its consumption.</p>