Person: RABUŞ, ŞULE
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RABUŞ
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ŞULE
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Publication Metadata only Effect of pharmacist-led patient education on adherence to tuberculosis treatment(AMER SOC HEALTH-SYSTEM PHARMACISTS, 2007) RABUŞ, ŞULE; Clark, Philip M.; Karagoz, Turan; Apikoglu-Rabus, Sule; Izzettin, Fikret VehbiPurpose. The purpose of this study was to assess the effect of a clinical pharmacist-directed patient education program on the therapy adherence of first-time tuberculosis (TB) patients and to identify the major pharmaceutical care needs and issues of first-time TB and multidrug-resistant (MDR)-TB patients. Methods. In the first part of the study, first-time TB patients were randomized either to the No EDU group (n = 58) where patients received routine medical and nursing care or to the EDU group (n = 56) where patients were also provided with clinical pharmacist-directed patient education. The patient's adherence to treatment was evaluated by attendance at scheduled visits, medication counting, and urine analysis for the presence of isoniazid metabolites. In the second part of the study, the pharmaceutical care needs and issues were determined for first-time TB patients and for MDR-TB patients (n = 40). Results. The adherence of patients who received pharmacist-directed patient education was greater than that of patients who did not. The attendance at scheduled visits and urine analysis for the presence of isoniazid metabolites yielded better results in respect to adherence for the EDU group (p < 0.05), while medication counting did not differ between the two groups. The major pharmaceutical care needs of first-time TB patients were for pain control, nutrient replacement, appropriate prescribing, respiratory control, and diabetic control. Similar findings were recorded for MDR-TB patients. Conclusion. Patients' adherence to TB treatment improved when a pharmacist provided patient education on medication use and addressed patients' pharmaceutical care issues.Publication Open Access Evaluation of awareness and knowledge of antibiotic use of patients applying to a community pharmacy(2022-06-01) RABUŞ, ŞULE; Tezcan S., Bilgin S., Sari H., Apikoglu-Rabus S.Background and Objective: Infectious diseases constitute a large share of the diseases in the world. The use of irrational antimicrobial treatments causes failure in the treatment and toxic side effects in the patient.The aim of our study is to evaluate the knowledge level and attitudes of the patients who applied to the community pharmacy with an antibiotic prescription regarding the use of antibiotics. Setting and Method: This cross-sectional study was conducted in one community pharmacy in Istanbul (Turkey) between November 2021- February 2022. Each patient’s profile was recorded and a selfstructured questionnaire consisted 14 questions was administered to the patients who applied to the pharmacy with an antibiotic prescription. The questionnaire, which was prepared by the researchers on the basis of the relevant literature studies (1,2) and the answer options were determined as ‘‘true, false, I do not know’’. The questionnaire results were scored according to the relevant articles. All data were analyzed using the Statistical Package for the Social Sciences (SPSS Inc., Chicago, IL, USA) version 13. Main outcome measures: To evaluate the knowledge level and attitudes of the patients regarding the use of antibiotics. Results: Of the 39 patients 66.7% were female, and the mean age was 35.2 ± 1.6. Sixty-one percent of the patients were not working in any job. The majority of the patients (79.5%) applied to the pharmacy with the diagnosis of upper respiratory tract disease. The mean awareness score of the patients regarding the use of antibiotics was determined as 7.8 ± 0.4, and it was found to be higher in those who were actively employed than in those who did not (8.8 ± 0.5 vs. 7.1 ± 0.4; p = 0.022). It was determined that 77% of the patients had a moderate level of knowledge about antibiotics. Conclusion: According to the results of the study, awareness, and knowledge regarding the use of antibiotics were insufficient. Community pharmacists as specialist health professionals have a vital role in the rational use of antibiotics via patient education and monitoring. References: 1. Ling Oh A, Hassali MA, Al-Haddad MS, Syed Sulaiman SA, Shafie AA, Awaisu A. Public knowledge and attitudes towards antibiotic usage: a cross-sectional study among the general public in the state of Penang, Malaysia. J Infect Dev Ctries. 2011;5(5):338–347. Published 2011 May 28. doi:10. 3855/jidc.1502 2. Zaidi SF, Baroom MW, Ibrahim Hanbashi A, et al. Cross-Sectional Survey among General Population Regarding Knowledge and Attitude toward Antibiotic Usage in Western Saudi Arabia. Pharmacy (Basel). 2021;9(2):98. Published 2021 May 1. doi:10. 3390/pharmacy9020098 Disclosure of Interest: None Declared.Publication Metadata only Improvement of diabetes indices of care by a short pharmaceutical care program(SPRINGER, 2009) SANCAR, MESUT; Turnacilar, Mertkan; Sancar, Mesut; Apikoglu-Rabus, Sule; Hursitoglu, Mehmet; Izzettin, Fikret VehbiObjective Diabetes mellitus is a serious health problem associated with an increased mortality and morbidity. The association of improved glycemic control with sustained decrease in the rate of complications has been shown in randomized clinical trials. Pharmaceutical care is a relatively new concept in Turkey; yet, there are no recorded routine pharmaceutical care programs. Therefore, we aimed to assess the impact of a short pharmaceutical care program conducted in the community pharmacy setting, on the indices of diabetes care of type 2 diabetic patients, particularly those regarding glycemic control and high blood pressure management. Setting The study was carried out at eight community pharmacies in Pendik district of Istanbul. Method All patients who visited any of the eight pharmacies through the pre-determined 1-week period were questioned for the presence of type 2 diabetes. Patients who reported to be type 2 diabetic (n = 67) were informed about the study and invited to involve. During this prospective longitudinal study, pharmaceutical care was provided to the patients by the same clinical pharmacist. The 3 month pharmaceutical care period consisted of six pharmacy visits. Main outcome measure: The main outcome measures were the improvement in glycemic control and blood pressure control; while, weight control, self-monitoring of blood glucose, compliance and being under physician-control were also assessed. Results The study was conducted on 43 patients who accepted to involve. Fasting blood glucose was lowered by a mean of 23% over 3-months from an initial value of 167.2 mg/dl. Number of patients reaching the desired blood glucose goals increased from 16.3% to 39.5%. Systolic and diastolic blood pressures also significantly fell over 3 months (mean reductions were 10.9 mmHg for the systolic and 9.3 mmHg for the diastolic blood pressure). Number of patients reaching the desired blood pressure goal increased from 30.2% to 51.2%. Conclusion Our short-course pharmaceutical care program yielded measurable improvements in clinical indicators of diabetes and comorbidity management. The results suggest that the pharmacist is a beneficial key component of integrated care for patients with type 2 diabetes. We think that the positive results observed in this first reported pharmaceutical care program on diabetes in Turkey can be motivating and encouraging for all community pharmacists.Publication Metadata only Evaluation of diabetes knowledge of pharmacy students(2023-08-11) TEZCAN, SONGÜL; RABUŞ, ŞULE; AY Z. Y., TEZCAN S., APİKOĞLU Ş.Diabetes is a global health concern. Pharmacists contribute to improving health outcomes by providing pharmaceutical care to patients with Diabetes Mellitus (DM). There are studies showing that pharmacy students need more knowledge in order to competently contribute to diabetes management. The aim of this study is to determine the level of diabetes knowledge of the undergraduate students of Health Sciences University Hamidiye Faculty of Pharmacy. A cross sectional study using online self-administered survey was conducted during 2 weeks among the 4th and 5th year pharmacy students. Sociodemographic characteristics of the students were collected. A structured questionnaire about the definition, causes and symptoms of diabetes (40 items) [1] were applied. The response options were “yes; no; or I do not know”. Each correct answer was scored as 1 point, incorrect or I don't know answers are scores as 0 point. The maximum possible score was 40. Diabetes Knowledge Scale scores and the correlation of the scores with students’ sociodemographic characteristics are main outcome measures. Of the 196 students 77% were female and 43.4% of them had diabetes family history. Forty-one percent of the participants stated that they were involved in the care of at least one diabetes patient. The mean knowledge score was found to be as 34.07 ± 4.13. The subscale scores were found to be as follows; diabetes general knowledge 7.04 ± 1.15 (8 items), diabetes risk factor 2.88 ± 0.37 (3 items), diabetes symptoms 2.70 ± 0.53 (3 items), diabetes diagnosis 3.46 ± 0.91 (4 items), diabetes treatment 7.64 ± 1.62 (10 items), diabetes complications 3.81 ± 0.58 (4 items), and diabetes diet and exercise 3.78 ± 1.19 (5 items), and diabetes control 2.76 ± 0.48 (3 items). The Cronbach's alpha value of the scale was found to be 0.767. Students were found to have adequate background knowledge regarding diabetes diagnosis, symptoms, and risk factors. However, knowledge deficits in areas such as diet in diabetes and treatment in gestational diabetes have been identified among participants.Publication Metadata only In vitro effects of nitric oxide donors on apoptosis and oxidative/nitrative protein modifications in ADP-activated platelets(SAGE PUBLICATIONS LTD, 2013) ŞENER, AZİZE; Sener, A.; Egemen, G.; Cevik, O.; Yanikkaya-Demirel, G.; Apikoglu-Rabus, S.; Ozsavci, D.Nitric oxide (NO) is an important physiological signaling molecule. However, when produced in excessive amounts, NO can also have toxic effects. The aim of this study is to investigate the effects of exogenous- and endogenous-derived NO on oxidative modifications of proteins and apoptosis in activated platelets. Washed platelets were incubated with L-arginine or nitroso-glutathione (GSNO) in the presence of adenosine diphosphate (ADP). After incubation, caspase-3 activity, phosphatidylserine (PS) externalization and the potential of mitochondrial membrane as markers of apoptosis were measured. In addition, the alterations in protein carbonylation (PCO) and nitrotyrosine (NT) formation as markers of protein oxidation were examined. Platelet activation with ADP (20 p,M) significantly increased PCO and NT levels and apoptotic events. After incubation with L-arginine, platelet NO production increased significantly. This L-arginine-induced increase caused decreases in formerly increased PCO and NT levels associated with ADP-induced platelet activation. Stimulation of NO production with L-arginine protected platelets from apoptosis. GSNO caused an increase in protein NT levels. Despite this change, GSNO was effective in inhibition of P-selectin expression, platelet aggregation, protein carbonylation and apoptosis. The results suggest that L-arginine and GSNO-mediated NO leads to the inhibition of key apoptotic processes including caspase-3 activation, PS exposure and low mitochondrial membrane potential in washed platelets. The inhibitory effect of platelet clearance of L-arginine and GSNO may be a novel useful therapeutic property in clinical application.Publication Metadata only Assessment of chemotherapy-related educational needs of colorectal cancer patients(2022-08-01) TEZCAN, SONGÜL; RABUŞ, ŞULE; TEZCAN S., Tanir G. I., Yilmaz H., Memis S., Yumuk P. F., APİKOĞLU Ş.Aim Aim of our study was to evaluate cancer patients\" knowledge about their chemotherapy regimens in order to assess educational needs of patients. Methods Study was conducted on 58 colorectal carcinoma patients who were treated in an outpatient chemotherapy unit. These patients had received a 2-page information pamphlet about their chemotherapy treatments before the commencement of treatment. During the first interview with patients, pharmacist collected demographic data and evaluated patients\" knowledge about their medications using a standardized questionnaire. Findings Mean age of the patients was 59.6 +/- 1.3 years; 65.5% were male. Majority (77.6%) of patients were graduates of primary school. Sixty-four percent of these had at least one comorbid disease. Median number of chemotherapy courses already received by patients was 4 (1-9). Fifty-nine percent reported that they did not receive any patient education and 43.1% reported that they did not receive any informative document. Twenty-nine percent of patients did not know what actions to take in case of nausea-vomiting; while 53.4% did not know how to react if their body temperature exceeded 38 degrees C and 25.9% had no idea about dietary necessities. About one-third of patients did not pay attention to oral care. Conclusion Our study showed that patients did not understand (or remember) the basic points about their chemotherapy sufficiently, but remembered the adverse effects they experienced occasionally. Pharmacists will have the chance to increase the level of knowledge of the patients receiving chemotherapy by providing patient education and follow-up.Publication Metadata only Turkish pharmacists' counseling practices and attitudes regarding emergency contraceptive pills(SPRINGER, 2012) RABUŞ, ŞULE; Apikoglu-Rabus, Sule; Clark, Philip Martin; Izzettin, Fikret V.Objective The aim of this study is to assess Turkish pharmacists' counseling practices and attitudes regarding emergency contraception pills (ECPs). Setting This cross-sectional observational study was conducted via a web-based survey in Turkey. Methods Pharmacists registered at a professional web site (n = 822) were invited to fill in the study questionnaire; 624 questionnaires were completed and further analyzed. Pharmacists who agreed to participate in the study completed the questionnaire which was structured to elicit their demography, professional experience, counseling practices and attitudes regarding ECP. Attitudes were measured by 18 items under four domains: reproductive health; information and availability; risk behavior and regulatory restrictions. The answer choices consisted of five items as: totally agree, agree, neither agree nor disagree, disagree and totally disagree. Main outcome Measures The rate of counseling on various aspects of the ECPs and the rate of negative/positive attitudes. Results The aspects most frequently counseled on by the pharmacists were dosage, timeframes, efficacy and pregnancy testing. Less frequently counseled aspects were mechanism of action, methods of contraception and side-effects. In general, the pharmacists displayed positive attitudes towards all domains of the survey; while they were negative to the items suggesting that ECP should be sold only to women and only on prescription. Another interesting finding is that 58 % of the pharmacists agreed with the item suggesting limiting the ECP sales to those over 18 years of age. Conclusions Our results showed that the pharmacists served the clients in need of emergency contraception more frequently than the other health-care providers and in general had favorable attitudes towards ECP. Some aspects of their counseling practices need to be improved. This can be accomplished through continuous education programs that would equip them with the competence to provide counseling on emergency contraception which will in turn help prevent unintended pregnancies and reduce abortion rates.Publication Metadata only Severe creatine kinase increase during quetiapine and mirtazapine treatment(SPRINGER, 2006) RABUŞ, ŞULE; Rabus, SA; Izzettin, F; Rabus, M; Bilici, MIn the literature, there have been several publications reporting creatine kinase (CK) increases associated with the use of atypical antipsychotic drugs. In this letter, I would like to present a case in which there was a massive increase in serum CK levels together with relatively modest increases in serum CK myoglobin-band (CK-MB), lactate dehydrogenase (LDH), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels during quetiapine and mirtazapine treatment, without the presence of neuroleptic malignant syndrome (NMS).Publication Open Access Evaluation of attitudes of patients regarding vaccine hesitancy during COVID-19: community pharmacy setting(2022-06-01) RABUŞ, ŞULE; Tezcan S., Koc G., Sari H., Apikoglu-Rabus S.Background and Objective: Vaccine hesitancy leads to decreases in vaccination rates and causes an increase in preventable epidemics and diseases. The aim of this study is to evaluate the attitudes of patients applying to a community pharmacy regarding vaccine hesitancy during COVID-19. Setting and Method: This study was conducted in one community pharmacy for any reason between September and December 2021, Istanbul, Turkey. The ‘‘Scale of Vaccine Hesitancy’’ (1) (consisted of 12-items) was applied to the patients face to face. Sociodemographic characteristics of the patients were recorded. The results of the questionnaire were calculated according to the scale guideline. The higher score represents the higher vaccine hesitancy. Main outcome measures: Scores obtained from the scale of vaccine hesitancy and correlation of the scores with patients’ parameters such as chronical diseases, Covid-19 disease and vaccination history. Results: Of the 43 patients 90% were female. The mean age was 37.5. Thirty-five percent of the participants had COVID-19 and 69.8% had a family history of COVID-19. About 79.1% have had the COVID-19 vaccine and 76% of those were vaccinated with BioNTech and the rest with Sinovac. The mean of the vaccine hesitancy score was calculated as 27.4 (min 12-max 50). Vaccine hesitancy score was higher for patients who were not vaccinated than who were vaccinated (41.0 vs 24.2; p \0.001). The vaccine hesitancy score was higher in patients with chronic disease (28.1), in chronic medication users (28.8), in those who had COVID-19 history (29.5), and those with a family history of COVID-19 (28.2). Cronbach alpha value of the scale is 0.846. Conclusion: It was determined that unvaccinated patients had higher vaccine hesitancy scores. In addition, vaccine hesitancy score was higher in the patients with chronic disease and who had COVID-19. It is very important to have a high rate of vaccination, especially in a pandemic or life-threatening disease. Therefore, educating and relieving patients can be an important step in overcoming this problem. As pharmacists, the closest position to patients, we have a great responsibility in order to change the perspective on vaccination. References: 1. Kılınc¸arslan MG, Sarıgu¨l B, Toraman C¸, S¸ ahin EM. Development of valid and reliable Scale of Vaccine Hesitancy in Turkish language. Konuralp Medical Journal. 2020;12(3):420–429. doi: 10. 18521/ktd.693711 Disclosure of Interest: None Declared.Publication Open Access Drug-related problems and pharmacist interventions in a cohort of patients with asthma and chronic obstructive pulmonary disease(W B SAUNDERS CO LTD, 2016-11) RABUŞ, ŞULE; Apikoglu-Rabus, Sule; Yesilyaprak, Gozde; Izzettin, Fikret VehbiBackground: Asthma and chronic obstructive pulmonary disease are preventable and treatable chronic airway diseases with high incidence and prevalence. Pharmacists and clinical pharmacy based pharmaceutical care services have positive impact on therapy outcomes. Objective: The aim of this study is to describe drug related problems in a cohort of patients with asthma and chronic obstructive pulmonary disease and to assess interventions provided by the pharmacist to address these problems in a community pharmacy. Method: Study population consisted of patients with asthma and chronic obstructive pulmonary disease older than 18 years who visited the study pharmacy during the pre-determined six-month period. The patients whose disease control states were not fully controlled were included in our study for further steps. On the first interview, present and potential drug related problems were addressed, interventions were provided. Follow-up interviews were held one month and two months later than the first interview. Results: For the 44 patients with asthma, 59 drug-related problems and 134 causes for these problems were identified. Eighty-four interventions were made to resolve the problems; and 54.2% of the problems were resolved. For the 37 patients with chronic obstructive pulmonary disease, 60 drug-related problems and 128 causes for these problems were identified. Ninety-five interventions were made to resolve the problems; and 63.3% of the problems were resolved. Conclusion: Pharmacists taking part in therapy and management of asthma and chronic obstructive pulmonary disease can help patients be more educated about their disease and medications; and improve disease control and therapy outcomes. (C) 2016 Elsevier Ltd. All rights reserved.
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