Changing use patterns of plasma volume expanders through educational intervention

Area of Science:

• Pharmacoeconomics
• Hospital Pharmacy Management
• Clinical Therapeutics

Background:

• Albumin and hetastarch are critical plasma volume expanders.
• High costs and shortages of albumin prompted a shift towards hetastarch.
• Hospital drug programs aim to optimize medication use and control expenditures.

Purpose of the Study:

• To evaluate the impact of an educational program on plasma volume expander use.
• To assess changes in albumin and hetastarch purchasing patterns.
• To determine the cost-effectiveness of promoting hetastarch over albumin.

Main Methods:

• Implementation of a target drug program and educational initiatives in a teaching hospital.
• Monitoring of albumin and hetastarch purchases before and after the intervention.
• Development of clinical guidelines for plasma volume expander use with physician input.

Main Results:

• Significant shift in usage patterns: albumin decreased from 325.5 to 195.3 units/month; hetastarch increased from 0.4 to 163.1 units/month.
• Achieved a monthly cost avoidance of $5127, equating to $61,526 annually.
• The educational program demonstrated a statistically significant impact on prescribing behavior (p < 0.05).

Conclusions:

• Educational interventions can effectively control hospital expenditures for plasma volume expanders.
• Promoting hetastarch over albumin can lead to substantial cost savings.
• Awareness of hetastarch's potential adverse effects and appropriate patient selection are crucial for safe use.