Assessment of Albumin Usage Patterns and Appropriateness in a Comprehensive Cancer Centre: A retrospective study in Jordan

Abstract

Objectives: Albumin is commonly used for various indications. However, conflicting data exists regarding its appropriate use in different clinical cases. In this study we aim to determine the pattern and appropriateness of albumin use among cancer patients treated at a comprehensive cancer center in Jordan. Methods: A retrospective analysis was conducted on adult cancer patients who were prescribed albumin between January 2019 and July 2020, in the outpatient and inpatient settings. Patient- and albumin-related data were collected, which included demographics, prescribing services, indications, and dosing regimens. We conducted thorough research using PubMed, and reviewed the related guidelines, drug information resources and the package insert to evaluate the appropriateness of albumin's indications and dosing regimens. Results: Albumin was prescribed to 1,361 patients during the study period. Each patient received an average of 74.4 ± 89 (SD) grams of albumin for an average of 2.6 ± 1.8 (SD) days. Albumin use was considered appropriate in 69% of the patients. The critical care service had the highest albumin consumption, with 37% of the prescribing being for the indication of septic shock. Inappropriate use was observed among the medical solid tumor service (40.8 % of their prescriptions) and was most commonly prescribed for edema (28%). Conclusion: To our knowledge, this study represents the first to evaluate a large cohort of oncology patients. In about one third of the cases albumin prescribed indications were considered inappropriate. Continuous education on appropriate usage and regular evaluations of guideline implementation is necessary to ensure appropriate utilization.

Keywords: Albumins*/therapeutic use, drug utilization review, neoplasms, cancer care facilities, Jordan.