Matos Guacira Corrêa de, Rozenfeld Suely
Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.
Cad Saude Publica. 2005 Jul-Aug;21(4):1224-33. doi: 10.1590/s0102-311x2005000400025. Epub 2005 Jul 11.
Human albumin is frequently used without regard for the relationship between its pharmacological properties and the respective disease. We investigated the prescription of human albumin in a Brazilian public hospital with emphasis on adherence to international guidelines. Data were gathered from pharmacy and medical records. From March to August 2001, 99 patients (>or= 15 years) received 1,475 units of human albumin, ordered in 498 prescriptions. The reason for prescribing human albumin was independently collected from medical records by two health professionals, and agreement was assessed by kappa statistics (95%CI: 0.72-0.85). According to different guidelines, prescriptions were classified as appropriate (33.1%), inappropriate (61.8%), controversial (4.6%), or undetermined (0.4%). Two probable cases of adverse reactions were identified. The proportion of inappropriate prescriptions is worrisome due to the product's high cost and its potential to cause adverse reactions. An appropriate strategy would be to encourage the application of guidelines issued by the national regulatory agency to promote rational use of human albumin and maximize patient safety.
人血白蛋白的使用常常未考虑其药理特性与相应疾病之间的关系。我们调查了巴西一家公立医院人血白蛋白的处方情况，重点是对国际指南的遵循情况。数据来自药房和病历。2001年3月至8月，99名（≥15岁）患者接受了1475单位的人血白蛋白，这些人血白蛋白分498张处方开出。开具人血白蛋白的原因由两名卫生专业人员从病历中独立收集，并通过kappa统计量评估一致性（95%可信区间：0.72 - 0.85）。根据不同指南，处方被分类为适当（33.1%）、不适当（61.8%）、有争议（4.6%）或未确定（0.4%）。确定了两例可能的不良反应病例。由于该产品成本高且有引发不良反应的可能性，不适当处方的比例令人担忧。一项合适的策略是鼓励应用国家监管机构发布的指南，以促进人血白蛋白的合理使用并最大限度地保障患者安全。
