Person: AKICI, AHMET
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AKICI
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Publication Metadata only Prescription audit adjunct to rational pharmacotherapy education improves prescribing skills of medical students(SPRINGER HEIDELBERG, 2005) AKICI, AHMET; Akici, A; Goren, MZ; Aypak, C; Terzioglu, B; Oktay, SObjective: To assess the impact of a rational pharmacotherapy (RP) teaching program during clinical pharmacology clerkship by analyzing the results of prescription audits (PAs) of the medical students. Collectively, we intended to observe the possible improvement of the students in their prescribing, problem solving and self-directed learning skills. Design: At the beginning and end of the clerkship, the students were presented with cases of uncomplicated osteoarthritis to assess their prescribing skills; format and rationality were scored. Setting: A medical school in Turkey that teaches RP to the fourth-year students in clinical pharmacology clerkship. Participants: There were 94 students of the 2002-2003 academic year in three groups and a single group of students belonging to the previous academic year tested. Of those students from the previous academic year, 26 were also analyzed a year later to demonstrate the long-term impact of the training. Main outcome measures: Prescribing skills of medical students and their opinions about PA. Results: Direct assessment via PA demonstrated that the scores for post-clerkship prescriptions were far better than those for pre-clerkship prescriptions in terms of format and rationality. Long-term assessment showed that the scores declined within a year following clerkship, but they were still higher than those of their pre-clerkship scripts. Analysis of the questionnaires revealed that the students were satisfied with PA. The majority of the students stated they had learned the general principles of RP and gained better prescribing skills, and they intended to apply most of the principles learned to their future professional lives. The script format scores of a retrospectively created PA-exempted group were significantly lower than those of the students to whom an established PA education was given. Conclusion: PA sessions were shown to be an easy and a useful method of both evaluating and reinforcing prescribing skills gained though problem-based RP education.Publication Metadata only An error in the article by Oteri et al: 'Prescribing pattern of antipsychotic drugs during the years 1996-2010'(WILEY, 2017-06) AKICI, AHMET; Akici, Ahmet; Kirmizi, Neriman Ipek; Aydin, VolkanPublication Metadata only “Akılcı ilaç kullanımı bilincini teşvik etmeye” yönelikyürütülen bir etkinliğin sonuçlarının değerlendirilmesi(2015-09-07) SUR ÜNAL, ÜLKÜ; AKICI, AHMET; KIROĞLU A., ERYAR K., SUR ÜNAL Ü., AKICI A.GİRİŞ VE AMAÇ: Kullanılmayan ilaçların evde bulundurulması, ilaç israfı sorununun somut göstergelerinden birisidir. Bu sorun çeşitli bilinçlendirme faaliyetlerine ihtiyaç duymaktadır. Çalışmada özel bir iletişim şirketinde “çalışanların ilaç israfının önlenmesi ve akılcı ilaç kullanımı (AİK) bilincinin geliştirilmesi kapsamında” yürütülen etkinliklerin değerlendirilmesi amaçlanmıştır. YÖNTEM: Proje, Turkcell Global Bilgi özel iletişim şirketi tarafından 2013’te kurum çalışanlarına yönelik hayata geçirildi. 20 Haziran 2015’e kadar sürdürülen proje, toplam 9 ilde gerçekleştirildi. AİK bilincini geliştirmeyi teşvik etmeye yönelik kurum çalışanlarına eğitim verildi, anket uygulandı, evdeki kullanılmayan ilaçlar toplandı, bunlardan işe yarar bulunanlar hayvan barınaklarının kullanımına sunuldu, kalan ilaçların imhası sağlandı, proje süreci katılımcılar ve kamuoyuyla paylaşıldı. Projenin çıktıları, tüm etkinliklerin genel değerlendirmeleri; katılımcıların anket yanıtları; evdeki kullanılmayan ilaçların dağılımları olmak üzere 3 ayrı başlıkta ele alındı. İlk bölümünün verilerine bu sunumda yer verildi. Özetle 2 yıldan beri sürdürülen projede yürütülen etkinliklerin genel değerlendirmeleri üzerinde duruldu. BULGULAR: Kurumun sağlık temsilcilerine 2013’te İstanbul’da AİK konusunda eğitim verildi. İstanbul, İzmir, Diyarbakır, Erzurum’daki kurum çalışanlarına anket uygulandı. Kullanılmayan ilaçların toplanması amacıyla hazırlanan AİK broşürleri/etiketleri/afişleri/posterleri bu 4 il ve ilave olarak Ankara, Artvin (2015’te yerine Karaman eklendi), Van, Şanlıurfa, Edirne’de dağıtıldı. Şirket içi internet sayfası, seminerler, İş Sağlığı ve Güvenliği Birimi eğitimleri kanalıyla da kurum çalışanları proje hakkında bilgilendirildi. Proje kapsamında kurumun sağlık biriminde toplam 9607 kutu ilaç toplandı. Bu ilaçlardan uygun koşullarda saklandığı varsayılan ve son kullanma tarihi (SKT) geçmemiş olan 2525 kutu ilaç hayvan barınaklarına iletildi. Bunlar arasında barınakların ihtiyacı olabilecekler yetkililere teslim edildi. Kalan ilaçlar, toplanan ve SKT’si geçmiş diğer ilaçlarla birlikte (toplam 320 kg.) uygun koşullarda imha ettirildi. TARTIŞMA VE SONUÇ: Projeyle, AİK bilinçlendirme faaliyetlerine ve sonuçlarının paylaşımına yoğun ilgi gösterilmiş olması, atık ilaçların yeniden kullanılabilmesine olanak sağlanması, kullanılamayanların da doğru şekilde imha edilmesi vb. olumlu çıktılar, projenin AİK bakımından başarı sağladığına işaret etmektedir. Halka yönelik AİK’i yaygınlaştırma girişimleri açısından başarılı sonuçlar elde eden bu projenin konuya ilişkin benzeri işlerde örnek olabileceği düşünülmektedirPublication Metadata only What should be the age limit for the children to access medications on their own?: Review [İlaca kendilerinin erişimi bakımından çocukların yaş sınırı ne olmalıdır?](Turkiye Klinikleri, 2016) AKICI, AHMET; Poyraz Findik O.T., Akici N., Kirmizi N.İ., Tiplamaz S., Akici A.The questions that when and how children should access medications could not be answered sufficiently in both Turkey and worldwide. In this review, the issue of access to medications for children is discussed through critical age limit to provide drug/product on their own. The article is addressed primarily to the relevant terms and regulations. Medical, social and legal dimensions of the age limit of access to medications are emphasized regarding cognitive development and ability to distinguish in children. Two separate suggestions which can be used have been introduced, considering the children’s complex development process including their cognitive development and their ability to distinguish. In the first suggestion, the critical age limit was set at 16; over this age could be similar to adults in terms of issue of access to medications; in 12-15-age group, access to medications could be determined based on acquired the ability to direct their behaviour; <12-year-old was defended by no means out of reach of drugs on their own. In the second suggestion, with a relatively conservative approach, critical age limit was set at 18; in 16-17-age group, access to medications could be determined based on acquired the ability to direct their behaviour; <16-year-old was defended by no means out of reach of drugs on their own. There will also be need to be taken of other mitigating precautions for distress that may be occur with the adoption one of these alternative suggestions regarding the age limit. © 2016 by Türkiye Klinikleri.Publication Metadata only Birinci basamakta akılcı reçete yazımı. Araştırma serisi:7(T.C. Sağlık Bakanlığı Refik Saydam Hıfzıssıhha Merkezi Başkanlığı, Hıfzıssıhha Mektebi Müdürlüğü. Sağlık Bakanlığı Yayın No: 854., 2011-01-01) AKICI, AHMET; AKICI A., Gürsöz H.Publication Metadata only Hekimlerin akılcı reçeteleme yaklaşımı. Araştırma serisi: 8(T.C. Sağlık Bakanlığı Refik Saydam Hıfzıssıhha Merkezi Başkanlığı, Hıfzıssıhha Mektebi Müdürlüğü. Sağlık Bakanlığı Yayın No: 855, 2011-01-01) AKICI, AHMET; Mollahaliloğlu S., Alkan A., Özgülcü Ş., Öncül H., AKICI A.Publication Open Access Tek enfeksiyon tanili reçetelere hekimlerin yazdigi antibiyotiklerin degerlendirilmesi(2012-01-01) AKICI, AHMETPublication Metadata only Drug utilization and potentially inappropriate drug use in elderly residents of a community in Istanbul, Turkey(Dustri-Verlag Dr. Karl Feistle, 2005) AKICI, AHMET; Ay P., Akici A., Harmanci H.Objective: This study investigates drug utilization and estimates the prevalence of potentially inappropriate drug use in a Turkish population aged 70 years or older. Material and methods: A cross-sectional study was carried out on a total of 1,019 participants who accepted face-to-face questionnaires in home interviews in Istanbul. All medications used in the three weeks prior to the study were recorded. Some major risk factors that might influence the use of inappropriate medication such as socio-demographic characteristics and concomitant disease such as depression and dementia were also questioned. Inappropriate drug use was assessed using the Beers criteria. Results: Among the 1,019 participants, 903 (88.6%) had been using at least one medication during the last three weeks. The average number of medications used was 2.9 ± 2.0. The most frequently drugs used were cardiovascular drugs (39.9%), followed by analgesics /anti-inflammatory drugs (16.2%), vitamin/mineral preparations (10.6%) and central nervous system drugs (10.2%). Of the 1,019 participants, 9.8% were using one potentially inappropriate medication and one patient was using two inappropriate drugs. The most common of these drugs were reserpine (23.7%), dipyridamole (21.8%), antihistamines (14.8%), and benzodiazepines (10.9%). Only age and total number of medications were associated with potentially inappropriate drugs in the multivariate analysis. Conclusions: This study revealed that drug utilization and the prevalence of inappropriate medication use in the elderly were lower than in published reports from most developed countries. Furthermore, polypharmacy and higher age were the main risk factors for potentially inappropriate drug use in the elderly. ©2005 Dustri-Verlag Dr. K. Feistle.Publication Metadata only Evde bulundurulan ve son kullanma tarihi geçmiş ilaçların değerlendirilmesi(2015-11-05) SUR ÜNAL, ÜLKÜ; AKICI, AHMET; KIROĞLU A., ERYAR K., SUR ÜNAL Ü., AKICI A.Publication Metadata only Relative risk of tuberculosis in patients with rheumatic diseases managed with anti-tumour necrosis factor-alpha therapy: A nationwide cohort study(WILEY, 2019) AKICI, AHMET; Aydin, Volkan; Akici, Ahmet; Isli, Fatma; Aksoy, Mesil; Aydin, Mehtap; Gursoz, HakkiWhat is known and objective Anti-tumour necrosis factor-alpha (anti-TNF-alpha) therapy is known to raise the risk of granulomatous infections, leading to development of risk management strategies at national or global level. This study aimed to determine the relative risk (RR) of tuberculosis (TB) due to anti-TNF-alpha usage in patients with rheumatologic diseases (RDs) in a nationwide basis. Method This retrospective cohort study included patients with rheumatoid arthritis (RA), ankylosing spondylitis, juvenile idiopathic arthritis or psoriatic arthritis (PsA) that treated with or without anti-TNF-alpha agents, as registered in the national prescription information system between years 2013 and 2015. Two-year RR of TB after anti-TNF-alpha therapy initiation was calculated in this RD population, including main subgroups. Results and discussion The study cohort included 413 500 RD patients, where anti-TNF-alpha(+) arm (n = 2117) had mean age of 41.9 +/- 13.4 years and male distribution of 54.3%. Four patients among anti-TNF-alpha users developed TB compared to 128 patients in anti-TNF-alpha-naive group (189 vs 31 cases per 100 000 patients, respectively), yielding a 2-year RR of 6.07 (95% CI, 2.25-16.42) with an attributable risk of 0.16%. These RRs (95% CI), which were particularly pronounced, were 5.39 (1.69-7.17) in men, 6.12 (2.26-16.55) in adults, and 5.70 (1.41-23.08) in RA and 13.46 (1.58-114.40) in PsA patients. There was no difference between the anti-TNF-alpha users who developed and undeveloped TB regarding drug utilization characteristics, except significantly less immunosuppressive drug exposure in TB patients. What is new and conclusion This study is the first prescription-based nationwide study to suggest an elevated RR of TB in a comparably younger population with a broad spectrum of RDs managed with any approved anti-TNF-alpha drug in Turkey.