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SANCAR, MESUT

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Eczacılık Fakültesi

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SANCAR

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MESUT

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Open Access
Investigation of drug-related problems in patients hospitalized in chest disease wards: A randomized controlled trial
(2023-01-10) SANCAR, MESUT; BEKTAY M. Y., SANCAR M., OKYALTIRIK F., DURDU B., İZZETTİN F. V.
Copyright © 2023 Bektay, Sancar, Okyaltirik, Durdu and Izzettin.Objective: According to the World Health Organization (WHO), chest diseases are among the 10 diseases that cause the highest mortality worldwide. Drug-related problems (DRPs), readmission, and antimicrobial resistance are critical problems in chest disease wards. Active involvement of clinical pharmacists (CPs) who are focused on reducing the risks of potential problems is needed. The aim of this study is to investigate the effects of pharmaceutical care (PC) services on the pulmonology service. Method: A randomized controlled trial at a university hospital in Istanbul was conducted between June 2020 and December 2021. The participants were randomized into the control group (CG) and intervention group (IG). In the CG, CPs identified and classified the DRPs according to Pharmaceutical Care Network Europe v9.0 (PCNE) and provided solutions to DRPs for the IG. The effect of PC services was evaluated by the number and classification of DRPs, and readmissions within 30 days were compared between the two groups. Results: Out of 168 patients, 82 were assigned to the IG. The average number of medicines administered per patient in the CG and IG was 14.45 ± 7.59 and 15.5 ± 6.18, respectively. In the CG and IG, the numbers of patients with DRPs were 62 and 46, respectively. The total number of DRPs was 160 for CG and 76 for IG. A statistically significant difference was found in favor of the IG, in terms of the number of patients with DRPs, the total number of DRPs, and readmission within 30 days (p < 0.05). Conclusion: In this study, CP recommendations were highly accepted by the healthcare team. Pharmaceutical care services provided by CPs would decrease possible DRPs and led to positive therapeutic outcomes. Cognitive clinical pharmacy services have beneficial effects on health care, and these services should be expanded in all settings where patients and pharmacists are present.
Open Access
Pediatric patients with COVID-19: A retrospective single-center experience
(2022-01-01) SANCAR, MESUT; Sahin A., Dalgic N., SANCAR M., Congur E. C., Kanik M. K., Ilgar S. D., Bayraktar B., Ozdemir H. M.
Objectives: The pandemic of coronavirus disease 2019 (COVID-19) is still effective all over the world. Compared to adults, data on pediatric patients are limited. In this study, we aimed to retrospectively examine the demographic, clinical, and laboratory characteristics of pediatric patients who were followed up with the diagnosis of COVID-19 in the first 3 months of the pandemic in our hospital. Methods: A total of 190 patients, aged 1 month–18 years, who were followed up with a definite/probable diagnosis of COVID-19, who were treated in the Pediatric Infection Clinic, were included in the study. The demographic features, clinical characteristics, and laboratory findings of the patients were retrospectively analyzed from their electronic medical records. Results: Eighty (42.1%) of the patients were laboratory confirmed (Polymerase chain reaction positive in nasopharyngeal swab). Mean age was 72 (2–216 months) and 102 (53.7%) patients were female. Family contact history was present in 115 (60.5%) patients. The patients were classified as asymptomatic (5.8%), mild (73.2%), moderate (18.4%), and severe/critical (2.6%) according to the severity of the disease. The most common symptoms were cough (71.1%) and fever (51.1%). Hydroxychloroquine alone or in combination was the most commonly used agent. Conclusion: In our study, in which we examined the pediatric COVID-19 patients, most of the patients had a mild clinical course, but there were applications with different clinical pictures such as acute appendicitis. Therefore, COVID-19 infection, which is still very unknown, will continue to surprise us with both changing treatment protocols and clinical presentations such as multisystem inflammatory syndrome in children.
Open Access
Interventions in internal medicine wards with scope of clinical pharmacy residency program: A retrospective study
(2023-01-01) AYHAN, YUNUS EMRE; SANCAR, MESUT; AYHAN Y. E., SANCAR M.
Objective: Drug-related problems are a common health problem in hospitalized patients, affecting optimal patient outcomes. The aim of the study is to classify the drug-related problems detected by clinical pharmacy resident in hospitalized patients during their rotations and evaluate their interventions to the healthcare team. Material and Method: This is a retrospective study in which the drug-related problems of the patients hospitalized in the internal medicine wards between April and November 2018 were examined during the rotations of the clinical pharmacy resident. Patients’ demographics, prescribed medicine, laboratory findings were recorded. Drug-related problems are classified with the Pharmaceutical Care Network Europe Version 9.1 system. Result and Discussion: Ninety-two patients were included in the study. The median age of patients was 60.5 years and 59.8% of them were female. Most of the patients (63%) had three or more comorbidities. The most frequent comorbidities were hypertension (21.70%) and diabetes mellitus (10.64%). One hundred forty-seven drug-related problems were detected in 57 patients (62%). Potential drug-drug interactions (55.78%), errors in dosing timing instructions (9.52%), and inappropriate drug use according to guidelines (8.16%) were the most common causes of drug-related problems. The acceptance rate of interventions for resolving drug-related problems was 65%. The most common drug-related problems in this study were due to drug selection. The acceptance rate of recommendations for drug-related problems was lower than in the literature. However, this initial acceptance rate can be considered successful in a center where clinical pharmacy services have not been established.
Open Access
The effect of the clinical pharmacist in minimizing drug-related problems and related costs in the intensive care unit in Turkey: A non-randomized controlled study
(2022-10-01) AYHAN, YUNUS EMRE; KARAKURT, SAİT; SANCAR, MESUT; AYHAN Y. E. , KARAKURT S., SANCAR M.
What is known and objective:Drug-related problems (DRPs) are common inhospitalized patients in intensive care unit (ICU). The aim of the study is to reduceDRPs and associated costs with clinical pharmacist's (CP) recommendations.Methods:The study is a prospective, non-randomized controlled study conducted inthe ICU for a total of 6 months (1 January 2021–30 June 2021) in 2-month con-trol, 2-month study, and 2-month control periods. Patients who were hospitalizedfor more than 24 h and used more than one medication were included in thestudy. The PCNE V9.1 Classification system was used in the classification ofDRPs. During the intervention period, CP recommendations for DRPs wereproposed to the healthcare team.Results and discussion:A total of 146 patients were included in the study. A total of1061 DRPs from all periods were detected. The most common causes of DRPs werepotential drug–drug interactions (31.76%), high dose (12.44%), and dose timinginstruction errors (9.24%). For 347 DRPs identified during the study period, 259 inter-ventions (74.63%) were recommended, and 238 (91.89%) were accepted by physi-cians. Interventions were mostly made as interrupting/discontinuing the drug(28.02%), changing the dose (25.27%), changing the instructions for use (20.32%),and starting a new drug (15.93%). Cost savings were achieved with CP recommenda-tions applied.What is new and conclusion:The CP's recommendations were highly accepted bythe healthcare team. With the CP's participation in routine patient rounds in thehealthcare team of the ICU, drug-related costs would also decrease.
Open Access
Medication reconciliation service in hospitalized patients with infectious diseases during coronavirus disease-2019 pandemic: An observational study
(2023-08-01) ENVER, CÜNEYD; ERTÜRK ŞENGEL, BUKET; SANCAR, MESUT; KORTEN, VOLKAN; OKUYAN, BETÜL; ENVER C., ERTÜRK ŞENGEL B., SANCAR M., KORTEN V., OKUYAN B.
Objectives: To determine the prevalence and type of medication discrepancies and factors associated with unintentional discrepancies and identify the rate of hospital readmission and emergency service visit within 30 days after discharge among hospitalized patients with infectious diseases and receiving clinical pharmacist-led medication reconciliation during the coronavirus disease-2019 (COVID-19) pandemic. Materials and Methods: This observational study was conducted in the internal medicine and infectious diseases wards of a tertiary university hospital between July 2020 and February 2021 among hospitalized adult patients with infectious diseases. Medication reconciliation service (including patient counseling) was provided in person or by telephone. The number and type of medication discrepancies detected during the medication reconciliation services, the acceptance rate of pharmacists’ recommendation, and factors associated with having at least one unintentional medication discrepancy at admission were evaluated. At follow-up, hospital readmission and emergency service visit within 30 days after discharge were assessed by telephone. Results: Among 146 patients, 84 (57.5%) had at least one unintentional discrepancy at admission. Only three unintentional discrepancies were determined in three patients at hospital discharge. All the pharmacists’ recommendations for medication discrepancies were accepted by the physicians. Having COVID-19 [odds ratio (OR): 2.25, 95% confidence interval (CI): 1.15-4.40; p<0.05], being at a high risk for medication error (OR: 2.01, 95% CI: 1.03-3.92; p<0.05), and higher number of medications used at home (OR: 1.41, 95% CI: 1.23-1.61; p<0.001) were associated with having at least one unintentional discrepancy at admission. The rates of 30 day hospital readmission and admission to the emergency medical service were 12.3% and 15.8%, respectively. Conclusion: Medication reconciliation service provided by in-person or by telephone was useful for detecting and solving unintentional medication discrepancies during the COVID-19 pandemic.
Open Access
Evaluation of clinical pharmacist interventions on drug-related problems in the gastroenterology ward
(2022-01-01) SANCAR, MESUT; BECEREN, AYFER; CEYLAN C., SANCAR M., BECEREN A., Demir A., KUŞ C., Omurtag G. Z.
Integrating clinical pharmacists in a multidisciplinary patient care team improves the treatment process by identifying and resolving drug-related problems (DRPs). The aim of the study was to determine the effect of clinical pharmacist intervention for DRPs in the gastroenterology service. The first period of the study was conducted between 15.06.2018 and 15.02.2019. Eighty patients admitted to the gastroenterology ward, who used at least one medication, were included in \"the study group\". The clinical pharmacist participated in ward rounds and made interventions to solve identified DRPs. In the second period of the study, the control group consisted of 80 patients admitted to the same ward between 01.03.2019 and 06.06.2019. DRPs were determined only from the data obtained from the hospital system in the control group. DRPs were classified according to the European Pharmaceutical Care Network (PCNE V9.1). A total of 136 and 46 with an average of 1.7 and 0.57 DRPs per patient (p <= 0.01) were identified in the study and control groups, respectively. Of the DRPs in the study group, 59 were related to treatment effectiveness, while 61 were related to treatment safety. Likewise, 21 DRPs were related to treatment effectiveness in the control group, while 12 were related to treatment (p <= 0.01). 65% of the interventions were made at the physician level and 49% at the drug level. 97% (n=133) of the total interventions were accepted. The number of DRPs was significantly reduced in the control group within the time frame after the clinical pharmacist intervention period. In conclusion, clinical pharmacists\" importance in detecting and preventing DRPs in the gastroenterology ward has been demonstrated.
Open Access
The impact of clinical pharmacist-led hypertension screening at the community pharmacy in Türkiye
(2022-01-01) OKUYAN, BETÜL; SANCAR, MESUT; Demircioglu Akyilmaz C. E. , OKUYAN B., SANCAR M.
© 2022 Marmara University Press.The aim of this study was to evaluate the impact of clinical pharmacist-led hypertension screening program (including referring high-risk individuals who are not aware of being hypertensive or prehypertensive to the physician) at a community pharmacy in Türkiye. This prospective observational pilot study was conducted in a community pharmacy located in Mersin-Türkiye between October 2017 and April 2018. Blood pressure measurements were performed by the clinical pharmacist at baseline and follow-up. The rate of participants who had high blood pressure measurements (≥140 mmHg for systolic and/or ≥90 mmHg for diastolic) was determined at the baseline by clinical pharmacist. According to the guidelines, participants with high blood pressure were referred directly to the physician by the clinical pharmacist. In the follow-up, the number of patients diagnosed with prehypertension or hypertension and the changes in their measurement of blood pressure were identified between baseline and follow-up. According to findings of clinical pharmacist-led blood pressure measurement, 23 (37.1%) out of 62 participants with high blood pressure were referred to the physician by the clinical pharmacist. In the follow-up, it was determined that 12 patients (52.2%) out of 23 participants were diagnosed with hypertension by a physician and eight patients (34.8%) out of 23 participants had prehypertensive. According to the findings of this pilot study, it was determined a positive impact of the clinical pharmacist-led hypertension screening program for high-risk individuals for hypertension.
Open Access
Reliability of high-alert medications questionnaire in Turkish healthcare professionals
(2022-01-01) ALTIPARMAK, ÖZNUR; SANCAR, MESUT; OKUYAN, BETÜL; Ozturk F., Altiparmak O., Torun B., Bektay M. Y., SANCAR M., OKUYAN B.
Objective: This study aimed to evaluate the reliability of the HighAlert Medications (HAM) Questionnaire in Turkish healthcare professionals. Methods: This methodological study was conducted between December 2017 and January 2018 in a private university hospital. The healthcare professionals, including nurses, health service technicians, and pharmacists, who are older than 18 years old were eligible for this study. After following the appropriate translation and cultural adaptation process, the internal consistency of the HAM Questionnaire using the Kuder-Richardson 20 coefficient and test-retest reliability was evaluated. Results: Among 146 healthcare professionals, the mean age was 25.40±5.16 years, wherein 76% were females. Most participants were nurses (69.9%) and other healthcare professionals were health service technicians (28.1%) and pharmacists (2.0%). The mean total score of the HAM Questionnaire was 70.00±19.50. The KuderRichardson 20 was 0.815. A statistically significant correlation was found between the scores of the HAM Questionnaire at baseline and after 15 days, which confirmed the test-retest reliability (r=0.527; p<0.01). A statistically significant correlation was found between the HAM Questionnaire score and advanced age (r=0.310; p<0.001) and higher professional year (r=0.445; p<0.001). Conclusion: The Turkish version of the HAM Questionnaire could be used to assess healthcare professionals’ knowledge about highalert medications.
Open Access
Medication Review in Turkish Older Adults at Community Pharmacy: A Pilot Study by Using Medication Appropriateness Index
(2022-09-01) ALTIPARMAK, ÖZNUR; SANCAR, MESUT; OKUYAN, BETÜL; Dal S., Ucar N., ALTIPARMAK Ö., SANCAR M., OKUYAN B.
Objective: The study aimed to evaluate medication review in older adults (≥65 years) at a community pharmacy by identifying the prevalence of potentiality inappropriate medication and calculating medication appropriateness index. Methods: This descriptive study was carried out in a community pharmacy for six months. The older adults (≥65 years) using one or more medications were included. During clinical pharmacist-led medication review; the medication appropriateness index was calculated for each medication of older adults. Potentially inappropriate medications were evaluated according to the 2019 American Geriatrics Society Beers Criteria®. Result: Among a hundred older adults, 46.0% were female. The median age of the patients was 75.5 (IQR, 68.0-78.8). The median number of medications was 9.0 (7.0-10.0). Polypharmacy has been detected in 97.0% of the patients. At least one potentially inappropriate medication was detected in 63.0% of them. The median score of medication appropriateness index score was 53.0 (IQR: 38.6-67.9). Conclusion: To best our knowledge, this is the first study of clinical pharmacist-led medication review by calculating the medication appropriateness index carried out at a community pharmacy in Turkey. There was a high rate of potentially inappropriate medication with a higher score of medication appropriateness in older adults. This study highlights the importance of medication review led by the clinical pharmacist at community pharmacy to optimize medication usage in older adults. Keywords: Older adults, clinical pharmacist, medication appropriateness index, potentially inappropriate medication
Open Access
Alendronat tedavisinin senil osteoporozlu hastalarda idrar kalsiyum/kreatinin oranı üze- rine etkisinin değerlendirilmesi
(2011-01-01) OKUYAN, BETÜL; SANCAR, MESUT; Yorukoglu E., OKUYAN B., SANCAR M., Izzettin F. V.
Amaç: Bu çalışmada, alendronat kullanan senil osteoporozlu kadınlarda alendronat tedavisinin idrar kalsiyum/kreatinin oranları üzerine etkisinin değerlendirilmesi amaçlanmıştır. Yöntem: Bu amaçla, tedavi öncesi ve 3 aylık tedavi sonrasında hastaların idrar kalsiyum/kreatinin oranları ölçülmüş ve ayrıca serum kalsiyum, fosfor, alkalen fosfataz (ALP), paratiroid hormon (PTH) değerlerinin sonuçları değerlendirilmiştir. Bulgular: 3 aylık tedaviden sonra idrar kalsiyum/kreatinin oranında ve serum ALP, kalsiyum ve fosfor düzeylerinde istatistiksel olarak anlamlı bir düşüş ve serum PTH düzeyinde de bu değişikliklere cevap olarak anlamlı yükselme görülmüştür (p<0.05). Sonuç: Tedavi başlangıcında osteoporoz hastalarının tedavi etkinliğinin ve uyuncunun değerlendirilmesi için idrar kalsiyum/kreatinin oranının izlem parametresi olarak kullanılabileceği sonucuna varılmıştır.