Person: SANCAR, MESUT
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SANCAR
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MESUT
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Publication Open Access The role of the clinical pharmacist in patient education and monitoring of patients under warfarin treatment(MARMARA UNIV, 2019-11-15) SANCAR, MESUT; Izzettin, Fikret Vehbi; Celik, Sevda; Acar, Rezzan Deniz; Tezcan, Songul; Aksoy, Nilay; Bektay, Muhammed Yunus; Sancar, MesutThis study was carried out on patients who were under anticoagulation treatment with warfarin, at the outpatient cardiology clinic. The aim was to determine the effectiveness of pharmacist consultation, education, and intervention on each patient's therapeutic results. A cross-sectional randomized trial has been done. Twenty-five patients were included in the study. The Oral Anticoagulation Knowledge (OAK) Test, Short Form-36 (SF-36) and Duke Anticoagulation Satisfaction Scale (DASS) were applied. Patients resumed their routine anticoagulation treatment and INR and complications were recorded during the study. Additionally, patients received patient education, consultation on lifestyle and anticoagulant usage issues from a pharmacist. The same tests were applied again to the patients on the 90th day of the study and the results were compared with the initial test. Maintenance of INR within the target range and complication rates were compared before and after the intervention. Pre-test and post-test results of the patients revealed statistically significant improvements on the physical and mental score components of the SF-36 (p = 0.001; p = 0.001), OAK test scores (p <= 0.001) and the (negative) limitations and burdens and positive effects components of the DASS (p = 0.005; p < 0.001; p = 0.001). The successful maintenance of INR within target range was significantly higher (p = 0.027). The positive effects of pharmacist consultation and education on therapeutic results were demonstrated.Publication Open Access Determination of Potential Drug-Drug Interactions Using Various Software Programs in a Community Pharmacy Setting(TURKISH PHARMACISTS ASSOC, 2019-03-01) OKUYAN, BETÜL; Sancar, Mesut; Kasik, Aksa; Okuyan, Betul; Batuhan, Sevda; Izzettin, Fikret VehbiObjectives: The aim of the present study was to compare various software programs in detecting potential drug-drug interactions in a community pharmacy setting. Materials and Methods: Details of prescriptions were collected from 50 community pharmacies located in Istanbul in March and April 2015 (two days per week). From each pharmacy, the first 20 prescriptions that included more than one drug were collected to evaluate potential drug-drug interactions. The following software programs were utilized to detect potential drug-drug interactions: micromedexsolutions.com , medscape.com , and drugs.com . The number of potential interactions detected by the software programs was determined. Results: At least one potential drug-drug interaction was detected in 39.2% of the 1000 prescriptions by one of the software programs. According to the rates of total drug-drug interactions gathered from various software programs, these programs gave the following results: medscape.com 33.3%, drugs.com 31.3%, and micromedexsolutions.com 21.2%. Conclusion: After comparing different software programs, the potential drug-drug interactions found by the programs proved to be different. Therefore, we recommend that pharmacists confirm with a different program before making a decision when they detect clinically significant potential drug-drug interactions.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 The effect of a multispecies synbiotic mixture on the duration of diarrhea and length of hospital stay in children with acute diarrhea in Turkey: Single blinded randomized study(SPRINGER, 2013) SANCAR, MESUT; Dinleyici, Ener Cagri; Dalgic, Nazan; Guven, Sirin; Ozen, Metehan; Kara, Ates; Arica, Vefik; Metin-Timur, Ozge; Sancar, Mesut; Kurugol, Zafer; Tanir, Gonul; Ozturk, Didem; Aydogdu, Selime; Tutanc, Murat; Eren, Makbule; Vandenplas, YvanProbiotics have been successfully used for the treatment of acute diarrhea in children and this effect depends on the strains and dose. The aim of this study was to assess the effect of a synbiotic mixture on the duration of diarrhea and the length of hospital stay in children with acute watery diarrhea. This is a prospective randomized, multicenter single blinded clinical trial in hospitalized children with acute watery diarrhea. All children were treated with conventional hydration therapy with or without a daily dose of a synbiotic (2.5 x 10(9) CFU live bacteria including Lactobacillus acidophilus, Lactobacillus rhamnosus, Bifidobacterium bifidum, Bifidobacterium longum, Enterococcus faecium, and 625 mg fructooligosaccharide) for 5 days. The primary endpoint was duration of diarrhea and duration of hospitalization was the secondary endpoint. Among 209 eligible children, 113 received the synbiotic mixture and 96 served as a control. The duration of diarrhea was significantly shorter (similar to 36 h) in children receiving the synbiotic group than the controls (77.9 +/- 30.5 vs. 114.6 +/- 37.4 h, p < 0.0001). The duration of hospitalization was shorter in children receiving the synbiotic group (4.94 +/- 1.7 vs. 5.77 +/- 1.97 days, p = 0.002). The effect of synbiotic mixture on diarrhea started after 24th hours and stool frequency significantly decreased after 24th and 48th hours. The percentage of diarrhea-free children is significantly higher in synbiotic group at 48th and 72nd hours of synbiotic group. In conclusion, this study showed a reduction in diarrhea duration by approximately 36 h and a reduction in the duration of hospitalization with approximately 1 day in children with acute diarrhea with this synbiotic mixture.Publication Metadata only Assessment of medication knowledge and adherence among patients under oral chronic medication treatment in community pharmacy settings(WILEY PERIODICALS, INC, 2013) OKUYAN, BETÜL; Okuyan, Betul; Sancar, Mesut; Izzettin, Fikret VehbiPurpose This study aimed to determine whether there is a relationship between the lack of medication knowledge and the self-reported rates of patient medication adherence. Methods Patients eligible to participate in the study had been taking oral medication at least once daily over the course of a minimum of three consecutive months before recruitment to the study. All participants were older than 18 years. The level of each patient's knowledge of his or her medication was randomly assessed by a trained fifth-year pharmacy student through an adapted questionnaire. In addition, patient adherence was evaluated via utilization of the Morisky Medication Adherence Scale. Results Of the 765 study participants (mean +/- SD age = 55.45 +/- 15.05 years, range = 2091 years, 56.2% women), 58.0% reported adherence to their medication regimen and 64.5% professed optimal knowledge of their medication. The mean duration of medication utilization was 26.77 +/- 40.62 months (range = 3504 years). A statistically significant correlation exists between the total medication knowledge score on the questionnaire and the level of medication adherence (r=0.964, p<0.001). Conclusion Improvement in the patient's knowledge of medications taken would bear a positive effect on medication adherence. Copyright (c) 2012 John Wiley & Sons, Ltd.Publication Metadata only Five-year follow-up of drug utilization for secondary prevention in coronary artery disease(SPRINGER, 2008) SANCAR, MESUT; Rabus, Sule Apikoglu; Izzettin, Fikret V.; Sancar, Mesut; Karakaya, Osman; Kargin, Ramazan; Yakut, CevatObjective Despite the availability of various prevention guidelines on coronary artery disease, secondary prevention practice utilizing aspirin, beta-blockers, angiotensin converting enzyme inhibitors and statins still can be sub-optimal. In this study, we aimed to assess the guideline adherence of secondary prevention prescribing and the continuity of adherence for a 5-year period in a small cohort of patients angiographically diagnosed to have coronary artery disease. Method In this prospective study, 73 patients who were angiographically diagnosed to have CAD were followed up for 5 years. The baseline demographic and clinical data were collected just before angiography. The baseline drug data were collected at the day of discharge. The fifth year data were taken from the patients via face-to-face consultations or phone interviews. Results The 'initial prescribing rate' at discharge was found to be 82% for aspirin, 49% for statins, 44% for ACE inhibitors and 55% for beta-blockers. 'Continuity of prescribing' for 5 years was 45% for aspirin, 26% for statins, 17% for ACE inhibitors and 20% for beta-blockers. Conclusions Besides the sub-optimal prescribing of secondary prevention drugs, absence of continuity of prescribing seems to be a challenging issue in pharmaceutical care of coronary artery disease patients.Publication Metadata only Pharmacoeconomic comparison of Helicobacter pylori eradication regimens(SPRINGER, 2006) SANCAR, MESUT; Sancar, Mesut; Izzettin, Fikret Vehbi; Apikoglu-Rabus, Sule; Besisik, Fatih; Tozun, Nurdan; Dulger, GulBackground Helicobacter pylori is the most important etiologic agent for development of peptic ulcer, chronic gastritis and gastric carcinomas. It is now well established that H. pylori eradication treatment is more cost-effective than acid suppressing therapies alone for the treatment of peptic ulcer disease. However, the comparative cost-effectiveness of various H. pylori eradication regimens is still not clear. Objective This study was designed to make a pharmacoeconomic comparison of different H. pylori eradication regimens in patients with peptic ulcer disease or chronic gastritis, using real-world cost and effectiveness data. Setting Istanbul University Hospital and Marmara University Hospital. Method A total of 75 patients diagnosed as H. pylori (+) by endoscopy were randomized to receive one of the seven H. pylori treatment protocols. These protocols were as follows: (LAC) = 'lansoprazole 30 mg bid + amoxicillin 1 g bid + clarithromycin 500 mg bid' for 7 days and (OCM) = 'omeprazole 20 mg bid + clarithromycin 250 mg bid + metronidazole 500 mg bid'; (OAM) = 'omeprazole 40 mg qd + amoxicillin 500 mg tid + metronidazole 500 mg tid'; (MARB) = 'metronidazole 250 mg tid + amoxicillin 500 mg qid + ranitidine 300 mg hs + bismuth 300 mg qid'; (OAC) = omeprazole 20 mg bid + amoxicillin 1 g bid + clarithromycin 500 mg bid'; (OCA) = omeprazole 40 mg bid + clarithromycin 500 mg bid + amoxicillin 1 g bid'; (OAB) = 'omeprazole 20 mg bid + amoxicillin 500 mg tid + bismuth 300 mg qid' each for 14 days. Only direct costs were included in the analysis. Effectiveness was measured in terms of successful eradication. The cost-effectiveness ratios of the regimens were calculated using these effectiveness and cost data. The perspective of the study was assumed as the Government's perspective. Main outcome measures Cost-effectiveness ratios of eradication regimens. Results MARB and OCA regimens were found to be more cost-effective than the other treatment regimens. The eradication rates and cost-effectiveness ratios calculated for these protocols were 90% (EURO158.7) for MARB and 90% (EURO195.8) for OCA regimen. Conclusions This study confirms the importance of using local pharmacoeconomic data. Analyses such as this give decision-makers the tools to choose a better treatment option which is both highly effective yet and has a low cost.Publication Open Access Assessment of the Attitude of Community Pharmacists and Pharmacy Technicians towards Diarrhea: A Simulated Patient Study in Turkey(PHARMACOTHERAPY GROUP, 2015-09-14) OKUYAN, BETÜL; Sancar, Mesut; Tezcan, Elif; Okuyan, Betul; Izzettin, Fikret VehbiPurpose: To evaluate community pharmacists' and pharmacy technicians' counselling practices regarding diarrhea in Istanbul-Turkey using a simulated patient study. Methods: This study was conducted in a total of one hundred community pharmacies located in two different districts of Istanbul, Turkey. Diarrhea cases involving patients of different age groups were designed and assigned to simulated patients who visited the pharmacies. After leaving a neighbourhood pharmacy, the simulated patients answered a list of questions about the content of the consultation services offered by the pharmacist or the pharmacy technician, including whether or not demographic and medication history was taken, if pharmacological and non-pharmacological recommendations were made, and if any patient education was offered. The duration of the counselling services, the total number of questions asked by the community pharmacists and pharmacy technicians, and the cost of the suggested medications were also evaluated. Results: The number of pharmacists and pharmacy technicians who counselled simulated patients was 40 and 60, respectively. Pharmacists and pharmacy technicians made little enquiry about the demographics and medical history of the patients. The most common medications recommended by pharmacists and pharmacy technicians were probiotics, either alone or in combination with other medications. Pharmacists took more responsibility for simulated patients than pharmacy technicians did (p < 0.05). Pharmacists offered more recommendations to simulated patients when compared with pharmacy technicians (90 vs. 68.3 %, p < 0.05). Conclusion: In view of their consultant role regarding patient medication, the attitude of pharmacists and pharmacy technicians towards minor illnesses such as diarrhea needs improvement through professional education programs.