Drug Utilisation Evaluation of Human Albumin Solution in Tawau Hospital, Sabah, Malaysia

Human albumin solution (HAS) which is available in government hospitals in Malaysia, mostly are supplied by the National Blood Centre, Ministry of Health (MOH) Malaysia. Due to the high usage of HAS, it is a strain to meet the demands nationwide. Moreover, HAS is very expensive. This study was a retrospective observational study evaluating drug utilisation of HAS in Hospital Tawau, Sabah. A name list of 61 patients who had received HAS between 6 months from 1 January to 30 June 2019 was sent for medical records tracing. Forty-eight prescriptions of HAS were evaluated and later categorised as ‘proven indications’ or ‘unproven indications’ with the aid of an internally prepared guideline. The result of this study indicates that 12 (25%) out of 48 prescriptions were for ‘unproven indications’. Possible wastage due to ‘unproven indications’ was 29 vials which were 20% of the total HAS usage in this study, estimated to cost RM7,804 (USD1,880). Major surgery with a serum albumin level of 20 g/L and above (55.2%), paracentesis with ascitic fluid removed of less than 5 L (24.1%) and hypoalbuminemia without justified comorbid or diagnosis (20.6%) being reasons for possible wastage of HAS in this study. The percentage of possible wastage of HAS reflected in this study was not as high as other published research done in other countries, mainly due to additional steps required for prescribing HAS in our facility (filling Blood Plasma Product Request Form) and also the need to obtain approval from the Director-General of MOH Malaysia if it was prescribed for other than the approved indications.