Modification of albumin use pattern after an educational intervention

Objective: To determine whether an educational programme could reduce the i nappropriate use of albumin. Study design and setting: A hospital albumin working group (San Carlos Clin ical Hospital, Madrid, Spain) developed local guidelines for albumin prescr ibing. After the guidelines were disseminated, all albumin prescriptions we re analysed according to these guidelines. Physicians who prescribed albumi n for indications other than those in the guidelines were selected for a pe rsonalised face-to-face educational programme with a clinical pharmacologis ts. Adherence to the guidelines was then evaluated compared with an observa tional period with success being measured in terms of quality of prescribin g 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, consumptio n was centralised in medical services and nearly 76% of prescriptions for a lbumin were inappropriate. During the intervention, the percentage of inapp ropriate albumin prescribing decreased to 38.8%. Albumin consumption decrea sed from 444 vials/month during the observational period to 249 vials/month during the intervention, and although the average monthly consumption incr eased slightly during the 17 months following the intervention, it was simi lar to that immediately after the intervention. Differences in albumin consumption and quality improvement between the obse rvational 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.