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Changing use patterns of plasma volume expanders through educational intervention.

Y Y Wong, P W Abramowitz, J M Mansur

    American Journal of Hospital Pharmacy
    |January 1, 1987
    PubMed
    Summary
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    An educational program successfully shifted hospital use from albumin to hetastarch, reducing plasma volume expander costs. Clinicians must monitor hetastarch for adverse effects, especially in patients with coagulopathies.

    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.

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  • 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.