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Maram M Alghalbi, Khalid M ALyahya, Abdullah A Alomran, Mohammed I Asiri, Sarah Z Alrawily, Saeed S Alqarni S, Yahya M Mohzari, Ahmed A. Alrashed

Background: Albumin is a colloidal solution that counters the major part of human plasma protein. Since use of Albumin for
hospitalized patients were based on observational studies, there were a need to evaluate the unjustifiable use of albumin which
may have a negative impact on both patient’s clinical outcomes and health care cost.
Method: This is an observational retrospective and prospective study. It was conducted for a two month period to assess the
use of Albumin by using a regular follow-up for albumin prescription at a major tertiary hospital in Riyadh.
Results: In this study which was conducted in 2019 for two month period, one thousand albumins prescriptions were reviewed
retrospectively and prospectively to the implementation of the institutional guideline. Data showed that, albumin 20% was
the most common prescribed concentration, majority of for albumin prescriptions were received from general medicine and
emergency physicians, whereas nephrology and intensive care units physicians have the highest percentage of re-prescribing
albumin. The most common indication for albumin use was under the category "others (O)" by 30% in the retrospective phase
and almost by 50% in the prospective phase. A total of 40% prescriptions were not validated as per the institutional guideline.
There was a significant correlation between category (O) use and inappropriate implementation of the institutional guideline
between age groups in terms of the duration and indications (P = 0.016). There was also a significant association between the
ward use of albumin, specifically intensive care units and oncology, and a lack of implementation of the guideline (P<0.0001).
The estimated cost due to unjustified use of albumin was almost 200000 SR between 5% and 20% of albumin concentrations.
Conclusion: Unjustified albumin use and improper implementation of institutional guideline is prevalent and correlated mainly
with category (O)

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