Modification of albumin use pattern after an educational intervention

Objective: To determine whether an educational programme could reduce the inappropriate use of albumin. Study design and setting: A hospital albumin working group (San Carlos Clinical Hospital, Madrid, Spain) developed local guidelines for albumin prescribing. After the guidelines were disseminated, all albumin prescriptions were analysed according to these guidelines. Physicians who prescribed albumin for indications other than those in the guidelines were selected for a personalised face-to-face educational programme with a clinical pharmacologists. Adherence to the guidelines was then evaluated compared with an observational period with success being measured in terms of quality of prescribing and economic consequences. The effects of the intervention were assessed again during the intervention (7 months) and after the intervention tin the first 5-month period and in the subsequent year). Main outcomes measures and results: in the observational period, consumption was centralised in medical services and nearly 76% of prescriptions for albumin were inappropriate. During the intervention, the percentage of inappropriate albumin prescribing decreased to 38.8%. Albumin consumption decreased from 444 vials/month during the observational period to 249 vials/month during the intervention, and although the average monthly consumption increased slightly during the 17 months following the intervention, it was similar to that immediately after the intervention. Differences in albumin consumption and quality improvement between the observational period and during the intervention were statistically significant (p < 0.00001). These results led to cost savings of nearly 30% during the intervention and in the follow-up period. Conclusions: This educational programme improved the quality of albumin pre scribing and controlled local expenses related to albumin use in a general hospital.