Person: OKUYAN, BETÜL
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OKUYAN
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BETÜL
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Publication Metadata only Evaluation of potentially inappropriate medication utilization in elderly patients with cancer at outpatient oncology unit(SAGE PUBLICATIONS LTD, 2019) OKUYAN, BETÜL; Paksoy, Ceylan; Ozkan, Oznur; Ustaalioglu, Bala B. O.; Sancar, Mesut; Demirtunc, Refik; Izzettin, Fikret V.; Okuyan, BetulBackground The aim of the study was to evaluate potentially inappropriate medication use in elderly patients with cancer. Method This study was conducted at outpatient oncology clinic from December 2014 to March 2015 among elderly cancer patients. Screening Tool of Older Person's Prescriptions/Screening Tool to Alert doctors to Right Treatment criteria were used to identify potentially inappropriate medication in elderly patients. Results Among 114 cancer patients 55.26% of them were male and the mean age of them was 71.78 +/- 5.50 (years). The most common concurrent diseases were hypertension in 45 (39.47%) and diabetes in 26 (22.81%) patients. Polypharmacy (>= 5 medications) was seen in 94.73% of them. Eighteen patients (15.79%) utilized medications inappropriately according to Screening Tool of Older Person's Prescriptions criteria. Medication omissions were identified in 112 patients (98.25%) with Screening Tool to Alert doctors to Right Treatment criteria. Conclusions Clinical pharmacists could improve the current prescribing practices in elderly patients with cancer by assessing potentially inappropriate medications.Publication Metadata only The effect of pharmacist-led education on inhaler use skills in hospitalised patients with chronic obstructive pulmonary disease(BMJ PUBLISHING GROUP, 2015) OKUYAN, BETÜL; Sancar, Mesut; Sirinoglu, Yasemin; Okuyan, Betul; Karagoz, Turan; Izzettin, Fikret VehbiObjective To assess patient inhalation skills and the effect of pharmacist-led education on these skills in chronic obstructive pulmonary disease (COPD) patients using inhalers in a hospital setting. Methods Pre- and 1month post-intervention were evaluated by scoring essential steps during inhaler use for each inhaler device. Results 41 patients participated in the study (mean age 64.3611.78 years, range 29-83 years). The female-male ratio was 7:34. Patients' inhaler administration skills were found to be improved by pharmacist-led education (p<0.05). Conclusions Evaluation of accurate inhaler device usage in patients with COPD should be performed periodically, and training regarding the inhaler device should be reconsidered according to the needs of patients.Publication Open Access Validation of the Turkish version of the DOSE-Nonadherence measure among patients with cardiometabolic conditions(2022-10-01) AY, NADİYE PINAR; OKUYAN, BETÜL; Yagmur M., Ay P., Sancar M., Voils C. I., Okuyan B.What is known and objective There are no validated self-report measures to assess extent of and reasons for medication nonadherence in the Turkish language. The aim of this study is to evaluate validity and reliability of the Domains of Subjective Extent of Nonadherence Scale, which assesses extent of and reasons for nonadherence in Turkish patients with hypertension, diabetes mellitus and/or dyslipidaemia in community pharmacy settings. Methods The Turkish version of the DOSE-Nonadherence scale was developed through translation and cultural adaption. Psychometric properties of the scale were evaluated in a cross-sectional study among 203 patients who visited six community pharmacies located in Istanbul, Turkey between November 2020 and March 2021. For the extent of nonadherence domain, reliability was estimated through Cronbach\"s alpha, and convergent validity was evaluated with Spearman\"s rank correlation with the validated Turkish version of the Medication Adherence Report Scale (MARS). Reasons for nonadherence were characterized among participants reporting nonadherence to the extent of nonadherence items. The measure was administered at baseline and 2 weeks later to 30 patients to estimate stability of extent scores using the Wilcoxon test and intraclass correlation coefficient. p < 0.05 was set as the level of statistical significance. Results Among the 203 participants (65 male), the median (25th-75th percentiles) age was 59.0 years [51.0-67.0]. Cronbach\"s alpha for the extent of nonadherence scale was 0.86. A moderate negative correlation (r = -0.58; p < 0.001) was found between the extent of nonadherence scores and MARS, supporting convergent validity. The most common reasons for medication nonadherence were forgetfulness (22.5%) and mismatch between the patients\" daily routine and medication taking (17.5%). The intraclass correlation coefficient was 0.97 for extent of nonadherence scores at baseline and 2 weeks (p < 0.001). What is new and conclusion The DOSE-Nonadherence Scale could be used to identify nonadherent patients and their reasons for nonadherence in Turkish patients with chronic cardiometabolic conditions. This scale can be used to evaluate clinical pharmacist-led services to reduce medication nonadherence. Nonadherence could be recorded longitudinally in electronic health records to provide a more accurate picture of medication use. Pharmacists or other providers could administer interventions tailored to patients\" reasons for nonadherence.Publication Metadata only Protective effect of ferulic acid on cisplatin induced nephrotoxicity in rats(ELSEVIER, 2017) OKUYAN, BETÜL; Bami, Erliasa; Ozakpinar, Ozlem Bingol; Ozdemir-Kumral, Zarife Nigar; Koroglu, Kutay; Ercan, Feriha; Cirakli, Zeynep; Sekerler, Turgut; Izzettin, Fikret Vehbi; Sancar, Mesut; Okuyan, BetulThis study aims to determine the potential protective effects of ferulic acid against cisplatin-induced nephrotoxicity and to compare its effect with curcumin, a well-known protective agent against cisplatin- induced toxicity in rats. Administration of cisplatin resulted in high BUN (Blood Urea Nitrogen), creatinine, MDA (Malondialdehyde), MPO (Myeloperoxidase), TOS (Total Oxidative Status), PtNT (Protein Nitrotyrosine) levels (p < 0.05). Histological observations showed abnormal morphology of kidney; in addition with appearance of TUNEL positive cells indicating apoptosis in cisplatin administered group. HO-1 (Heme Oxygenase-1) levels measured by RT-PCR (Real Time Polymerase Chain Reaction), and TAS (Total Antioxidative Status) revealed antioxidant depletion due to cisplatin toxicity in animals (p < 0.05). All parameters showed improvement in groups treated with ferulic acid (p < 0.05). Ferulic acid treatment was found significant in preventing oxidative stress, increasing antioxidative status and regaining histological parameters to normal, indicating nephroprotective and antioxidant effects of this phenolic compound.Publication Open Access A survey of the European Society of Clinical Pharmacy members' research involvement, and associated enablers and barriers(SPRINGER, 2020-08) OKUYAN, BETÜL; Stewart, Derek; Paudyal, Vibhu; Cadogan, Cathal; Hazen, Ankie; Okuyan, Betul; Lutters, Monika; Henman, Martin; Fialova, DaniellaBackground Building research capacity of European Society of Clinical Pharmacy (ESCP) members aligns to the organisation's aim of advancing research. Objective To determine members' aspirations and needs in research training and practice, and to explore ways in which ESCP could provide support. Setting ESCP's international membership. Method Cross-sectional survey of members in 2018, followed by focus groups with samples of respondents attending an ESCP symposium. Survey items were: research activities; interests, experience and confidence; and Likert statements on research conduct. Principal component analysis (PCA) clustering of Likert statements from a previous study was used, with scores for each component calculated. Focus groups discussed barriers to research and how ESCP could provide support. Data analysis involved collating and comparing all themes. Main outcome measures Research interest, experience and confidence; attitudinal items; barriers to research; ESCP support. Results The response rate was 16.7% (83/499), with 89.2% (n = 74) involved in research and 79.5% (n = 66) publishing research in the preceding 2 years. While overwhelmingly positive, responses were more positive for research interest than experience or confidence. PCA component scores (support/opportunities, motivation/outcomes, and roles/characteristics) were positive. Thirteen members participated in focus groups, identifying barriers of: insufficient collaboration; lack of knowledge, skills, training; unsupportive environment; insufficient time; and limited resources. ESCP could support through mentorship, collaboration, education and funding. Conclusion Study participants were highly active, interested, experienced, confident and positive regarding research. There is an opportunity for ESCP to harness these activities and provide support in the form of mentoring, education and training, and facilitating collaboration.Publication Open Access Impact of a clinical pharmacist-led stewardship program for the appropriate use of acid suppression therapy in older hospitalized patients: a non-randomized controlled study(2022-08-01) OKUYAN, BETÜL; Dumlu H. I., Sancar M., Ozdemir A., Okuyan B.Background The potentially inappropriate use of the proton pump inhibitors is prevalent in older adults. Aim To evaluate the impact of a clinical pharmacist-led stewardship program for the appropriate use of acid suppression therapy in older hospitalized patients. Method This parallel nonrandomized controlled study was conducted at an internal medicine service of a tertiary training and research hospital between September 2019 and August 2021. Older patients (>= 65 years old and received proton pump inhibitors within 48 h of admission) were allocated to two groups according to their number of medical file records, whether odd or even, two groups: control and clinical pharmacist-led stewardship program for the appropriate use of acid suppression therapy (including medication reconciliation and medication review) during the hospital stay. Primary outcome measures were the rate of appropriate use of proton pump inhibitors during hospitalization and potentially inappropriate proton pump inhibitor use at discharge. Results The rate of appropriate proton pump inhibitor use during hospitalization was significantly higher in the clinical pharmacist-led program (n = 100) than in the control group (n = 97) (46.4% vs. 79.0%; P < 0.001). The rate of potentially inappropriate proton pump inhibitor use at discharge was significantly lower (61.7% vs. 35.1%; P < 0.05) in the clinical pharmacist-led program among the older patients discharged with a proton pump inhibitor prescription. Conclusions A clinical pharmacist-led stewardship program for the appropriate use of acid suppression therapy improved the rate of appropriate proton pump inhibitor use and reduced the potentially inappropriate proton pump inhibitor use during the hospital stay.Publication Metadata only Adverse drug reactions due to drug- drug interactions with proton pump inhibitors: assessment of systematic reviews with AMSTAR method(TAYLOR & FRANCIS LTD, 2016) OKUYAN, BETÜL; Yucel, Emre; Sancar, Mesut; Yucel, Aylin; Okuyan, BetulIntroduction: Many systematic reviews resulted in claims on drug-drug interactions (DDIs) with proton pump inhibitors (PPIs). Such a large number begs for consensus on the clinical significance of findings.Areas covered: We critically evaluated the safety of PPI use with respect to DDIs with a meta-review of systematic reviews published between 1978 and 2015. We assessed the evidence by their reliability, repeatability, transparency, and objectivity according to the Assessment of Multiple Systematic Reviews (AMSTAR) criteria.Expert opinion: Clinicians must assess risks for each PPI for certain comorbid conditions. DDIs don't substantiate class effect for PPIs; each PPI could induce unique DDIs. Concomitant use of PPIs with thienopyridines (e.g. clopidogrel) could be justified in patients without strong affinity to cytochrome CYP2C19 and with high risk of bleeding (e.g. patients with prior upper gastrointestinal bleeding, Helicobacter pylori infection, advanced age, steroid treatment, and nonsteroidal anti-inflammatory drug use). DDIs could occur in an AIDS subpopulation treated with highly active antiretroviral therapy (HAART). DDIs exist for cancer patients undergoing targeted therapy. Hypomagnesemia could increase in the setting of advanced age and polypharmacy. Omeprazole poses high risks owing to its pharmacokinetic DDI profile. Future systematic reviews should incorporate these additional risks for better clinical guidancePublication Metadata only The impact of pharmacist-led smoking cessation program at community pharmacy(2012-01-01) SANCAR, MESUT; OKUYAN, BETÜL; Atalay L., SANCAR M., OKUYAN B., Izzettin F. V.Amaç: Çalışmada, bir serbest eczanede klinik eczacı tarafından yürütülen ‘nikotin replasman tedavisiyle (nikotin sakızı ve nikotin tabletini içeren) sigara bırakma programının bir yıllık sonuçlarının değerlendirilmesi amaçlanmıştır. Yöntem: Çalışma Haziran 2009 - Haziran 2010 tarihleri arasında gerçekleştirilmiştir. İlk görüşmede katılımcıların demografik ve klinik verileri toplanmış ve her bir katılımcıya ‘Fagerstrom Nikotin Bağımlılık Testi’ uygulanmıştır. Daha sonra klinik eczacı tarafından katılımcılar sigaranın zararları hakkında bilgilendirilmiş ve her bir katılımcının bağımlılık derecesine göre uygun OTC (tezgah üstü ilaç- reçetesiz ilaç) nikotin replasman ürünü tavsiye edilmiştir. Katılımcılar klinik eczacı tarafından on iki ay boyunca yüz yüze veya telefonla yapılan düzenli görüşmelerle takip edilmiştir. Bulgular: Çalışmaya katılan 33 katılımcının yaş ortalaması 41.57±11.90 (aralık: 24-66 yıl) olarak hesaplanmıştır. Fagerstrom Nikotin Bağımlılık Testi sonuçlarına göre katılımcıların onbeşinde düşük nikotin bağımlılığı, dokuzunda orta bağımlılık ve kalan dokuz katılımcıda ise yüksek nikotin bağımlılığı saptanmıştır. Hastaların ikisi bir yıllık takipte kaybedilmiş, çalışma 31 hasta ile tamamlanmıştır. Çalışma sonunda, klinik eczacı danışmanlığında serbest eczanede yürütülen sigara bırakma programıyla bir yıl boyunca takip edilen otuz bir katılımcının yirmisinin (%64.5) sigara kullanmayı bıraktığı görülmüştür. Sonuç: Bu bilgiler ışığında, eğitimli ve kolay ulaşılabilir sağlık mensupları olan eczacıların sigara bırakma programlarında aktif rol almaları gerekmekte olduğu sonucuna ulaşılmıştır. Anahtar sözcükler: Sigara bırakma, klinik eczacılık, nikotin replasman tedavisiPublication Open Access Eczacının Yer Aldığı Antimikrobiyal Yönetim_x000D_ Programlarının Klinik ve Ekonomik Sonuçları(2019) OKUYAN, BETÜL; Mesut SANCAR;Zeynep SAYIN;Sercan CANKATAR;Nazan DALGIÇ;BETÜL OKUYANAntimikrobiyal yönetim programı, antimikrobiyal ilaç tedavisinin iyileştirilmesine yönelik düzenlemeleri kapsayan, multidisipliner bir yaklaşımdır. Son yıllarda, özellikle antibiyotik direncinin azaltılmasında önemli yeri olduğu kabul edilen antimikrobiyal yönetim programlarında öncelikle doktor, klinikeczacı ve klinik mikrobiyologlardan oluşan bir ekibe yer verilmesi önerilmektedir. Eczacının, antimikrobiyallerin uygulama zamanı ve veriliş sıklığı konusundaki danışmanlığının yanı sıra, bu ilaçlara bağlı ilaçilaç, ilaç-besin ve ilaç-hastalık etkileşimleri, ilaç istenmeyen etkileri gibi alanlarda da katkı yapabilecekleribilinmektedir. Bu çalışmada, enfeksiyon hastalıklarının kontrolünde ve tedavisinde önemli yeri olan antimikrobiyal yönetim programlarında sağlık ekibinin önemli bir parçası olarak bulunan eczacıların olası etkilerinin klinik ve ekonomik boyutlarının irdelenmesi amaçlanmıştır. Bu amaca yönelik olarak, Pubmedveri tabanında 01.01.2010 - 31.12.2015 yıllarını kapsayan 5 yıllık bir literatür taraması yapılmıştır. Uygunsözcükler kullanılarak doğrudan eczacı katkısını araştıran çalışmalar seçilmiştir. Bu çalışmanın amacınauygun olarak 34 orijinal makale incelenmiştir. Bu çalışmalarda, eczacı müdahalelerinin yer aldığı antimikrobiyal yönetim programlarının pozitif klinik ve ekonomik sonuçları olduğu görülmüştür. Eczacının buyönetim programlarında antimikrobiyallerin daha akılcı kullanılmasına, antibiyotiklerin daha az sayıda reçete edilmesine, direnç oranlarının azaltılmasına, daha fazla klinik değerlendirme yapılmasına, ilaç dozunun ayarlanmasına, antimikrobiyal ilacın kesilmesi veya başlanması süreçlerine, parenteral kullanımdan oralkullanıma geçiş oranlarının artırılmasına ve nihai olarak bakım kalitesinin iyileştirilmesine fayda sağladıkları sonucuna varılmıştır. Ülkemizde klinik eczacılık uzmanlık eğitiminin başlamış olması, meslek içi eğitim programlarının artırılması ve klinik eczacılık lisansüstü programlarının yaygınlaştırılması, eczacının buçalışmada adı geçen görevleri yerine getirebilmesi için önemli fırsatlardır.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.