Laboratory intervention to improve the request of urinary albumin in primary care patients with arterial hypertension and financial implications.

Authors:
Maria Salinas
Maria Salinas
Hospital Universitario de San Juan
Spain
Emilio Flores
Emilio Flores
Clinical Laboratory
Kapsabet | Kenya
Miguel Ahumada
Miguel Ahumada
Department of Clinical Medicine
Carlos Leiva-Salinas
Carlos Leiva-Salinas
University of Virginia
United States

Clin Biochem 2019 Apr 17. Epub 2019 Apr 17.

Department of Radiology, University of Missouri, Columbia, MO, USA.

Introduction: The request of Urinary albumin in primary care in Spain is insufficient to monitor patients with diabetes and hypertension (HTN). Our aim was to evaluate a strategy designed in consensus with general practitioners (GPs) to improve the request of urinary albumin in primary care patients with HTN according to guidelines, and to study its financial implications.

Materials And Methods: In a meeting with GPs, we decided that the Laboratory Information System (LIS) would automatically register the albumin-to-creatinine ratio (ACR) test in patients with HTN when the former had not been requested in the previous year. We counted the number of ACRs requested by the GPs, those that were automatically added through the intervention, and if they were measured through the strip assay or additionally through quantification. We calculated the economic cost of the additional registered ACR based on reagent cost.

Results: In the 6 months study period, the laboratory received 48,075 requests for primary care patients. For 3816 (7.9%), HTN was the indication that prompted the request. 386 ACR were automatically registered through the intervention. Use of strip analysis cost of 275.8 € but resulted in savings of 1450.3€ in albumin reagent.

Conclusions: By making use of the laboratory technology, the strategy achieved a better adherence to the guidelines at no additional cost.

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Source
https://linkinghub.elsevier.com/retrieve/pii/S00099120193006
Publisher Site
http://dx.doi.org/10.1016/j.clinbiochem.2019.04.012DOI Listing
April 2019
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