Person: SANCAR, MESUT
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SANCAR
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MESUT
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Publication 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.Publication 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.Publication Metadata only Assessment of medication literacy in breastfeeding women: preliminary data(2022-12-01) SANCAR, MESUT; OKUYAN, BETÜL; Ucar N., SANCAR M., Sezerol M. A., Buyukkayh D., Tasci Y., OKUYAN B.Publication Metadata only Medication adherence barriers in Turkish patients with chronic diseases(2022-12-01) SANCAR, MESUT; AY, NADİYE PINAR; OKUYAN, BETÜL; Yagmur M., SANCAR M., Ay P., Abdi A., Samuelyan N., OKUYAN B.Publication 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.Publication 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.Publication 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.Publication Metadata only Development of a theory planned behavior based scale to assess turkish clinical pharmacists' intention to provide pharmaceutical care(2022-12-01) SANCAR, MESUT; OKUYAN, BETÜL; ÖZDEMİR N., Tecen-Yucel K., KARA E., Demirkan K., SANCAR M., OKUYAN B.Publication 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.Publication Metadata only Therapeutic drug monitoring in pediatric patients treated with anti-tuberculosis medications by high performance liquid chromatography(2022-01-01) OKUYAN, BETÜL; TOK, FATİH; KARAKUŞ, SEVGİ; KAYMAKÇIOĞLU, BEDİA; SANCAR, MESUT; OKUYAN B., TOK F., KARAKUŞ S., Dalgiç N., ÇAKIR E., Midyat L., Koçyiğit-Kaymakçioğlu B., Berk U. E. , İZZETTİN F. V. , Rollas S., et al.© 2022 Marmara University Press.The aim of this study is to perform therapeutic drug monitoring for isoniazid (INH), rifampicin (RIF), and pyrazinamide (PZA) in pediatric tuberculosis patients. The study was carried out in 3 different training-research hospitals in Istanbul, Türkiye between 2011 and 2012. The pediatric patients (aged ≤14 years) who initiated the standard primary anti-tuberculosis therapy were included in this study. The serum samples were collected 3 hours after the first medication doses were given on the 5th day of treatment. Chromatographic experiments were performed on an Agilent 1100 High-Performance Liquid Chromatography (HPLC) system, and the separation was carried out on a Nova-Pak C18 (3.9x150 mm, 5 μm, Merck) analytical column. In this HPLC method, the gradient elusion delivered 3% to 40% (v/v) acetonitrile in phosphate buffer was used, and diode array detector. Twenty-three children (60.9% male) patients were included with a mean age of 111.70 ± 59.94 months. Plasma levels were measured sub-therapeutically for INH in 14, RIF in 10, and PZA in 5 patients, according to the normal range of adult patients. Maximum plasma concentrations after three hours were found between 0.53-14.02 mg/L for INH, 11.17-60.39 mg/L for PZA, 2.15-16.75 mg/L for RIF. In conclusion, this method has been successfully applied to simultaneously determine RIF, INH, and PZA plasma levels in pediatric tuberculosis patients. RIF and INH plasma levels were found to be lower in pediatric patients with tuberculosis compared to target range of adult patients.