International Journal of Clinical Pharmacy

, Volume 39, Issue 4, pp 704–711 | Cite as

Drug utilization evaluation of albumin in a teaching hospital of Mashhad, Iran: an interventional pre–post design study

  • Farzaneh Zolfagharian
  • Saba Ghazanfari
  • Sepideh Elyasi
  • Paria Iraji
  • Mohammad Reza Saberi
  • Nasser Vahdati-Mashhadian
  • Amir Hooshang MohammadpourEmail author
Research Article


Background Albumin is a protein colloidal solution with limited availability and high cost. It should be used in such approved indications as paracentesis, extensive burn, spontaneous bacterial peritonitis, and nephrotic syndrome. Objectives The aim of this study was to evaluate and compare the appropriateness of albumin usage before and after an evidence-based guideline. Setting Four wards of Imam Reza Hospital, Mashhad, Iran. Method An interventional pre–post design study was performed on 2 groups of patients; in gGroup 1 as a preparation phase group in 6 months from February 2015 to July 2015 and Group 2 as an interventional group from September 2015 to February 2016. A guideline for proper indications of albumin, designed and finalized based on the physicians’ comments, was implemented in Group 2. Main outcome measure The pattern of albumin consumption. Results Fifty patients were evaluated in each group. The implementation of the guideline resulted in reduction of improper albumin use from 62 to 57.5%, which was not statistically significant; however., it reduced inappropriate dose and duration of albumin therapy (55.5–16.7%), the number of consumed albumin vial, and the average cost for each patient (317.78 ± 3.15–149.81 ± 1.91 USD) significantly, as well. Conclusion This study illustrated that in this hospital in most cases, albumin was used inappropriately and at an alarming rate. This improved after the introduction of an evidence-based guideline. Moreover, guideline implementation resulted in significant cost reduction.


Albumin Cost reduction Drug use evaluation (DUE) Inappropriate use Intervention Iran Teaching hospital 



This study is part of a research thesis for a Pharm.D. degree at Mashhad University of Medical Sciences. The authors are thankful for the funding of this study by the Research Council of Mashhad University of Medical Sciences.


Mashhad University of Medical Sciences.

Conflicts of interest


Supplementary material

11096_2017_458_MOESM1_ESM.pdf (369 kb)
Supplementary material 1 (PDF 368 kb)
11096_2017_458_MOESM2_ESM.pdf (173 kb)
Supplementary material 2 (PDF 172 kb)


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Copyright information

© Springer International Publishing 2017

Authors and Affiliations

  • Farzaneh Zolfagharian
    • 1
  • Saba Ghazanfari
    • 2
  • Sepideh Elyasi
    • 3
  • Paria Iraji
    • 3
  • Mohammad Reza Saberi
    • 4
  • Nasser Vahdati-Mashhadian
    • 5
    • 6
  • Amir Hooshang Mohammadpour
    • 3
    • 7
    Email author
  1. 1.Department of Pharmacology, School of MedicineMashhad University of Medical SciencesMashhadIran
  2. 2.DUE Center, Imam Reza HospitalMashhad University of Medical SciencesMashhadIran
  3. 3.Department of Clinical Pharmacy, School of PharmacyMashhad University of Medical SciencesMashhadIran
  4. 4.Medical Chemistry Department, School of PharmacyMashhad University of Medical SciencesMashhadIran
  5. 5.Medical Toxicology Research CenterMashhad University of Medical SciencesMashhadIran
  6. 6.Department of Pharmacodynamics and Toxicology, School of PharmacyMashhad University of Medical SciencesMashhadIran
  7. 7.Pharmaceutical Research CenterMashhad University of Medical SciencesMashhadIran

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