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OKUYAN, BETÜL

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Eczacılık Fakültesi

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OKUYAN

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BETÜL

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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.
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, Daniella
Background 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.
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.
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 OKUYAN
Antimikrobiyal 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.
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 Vehbi
Objectives: 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.
Open Access
Development and evaluation of a turkish scale to assess medication literacy for adults
(2023-05-09) OKUYAN, BETÜL; Torun O., Memiç İ., Ay P., Sancar M., Selcuk A., Balta E., Ozcan V., Okuyan B.
Open Access
Clinical pharmacist-led medication reconciliation service in patients with infectious disease during COVID-19 pandemic
(2021-10-29) ERTÜRK ŞENGEL, BUKET; SANCAR, MESUT; OKUYAN, BETÜL; KORTEN, VOLKAN; ENVER C., ERTÜRK ŞENGEL B., SANCAR M., KORTEN V., OKUYAN B.
Open Access
Determination of CYP2C19 Polymorphism, Side Effects, and Medication Adherence in Patients Who have Utilized Selective Serotonin Reuptake Inhibitors
(KURE ILETISIM GRUBU A S, 2016-06) OKUYAN, BETÜL; Deniz, Semanur; Sancar, Mesut; Okuyan, Betul; Ata, Pinar; Ozakpinar, Ozlem Bingol; Talas, Anil; Gunes, Tufan; Caliskan, Mecit; Izzettin, Fikret Vehbi
Objective: The aim of this study is to determine relationship of cytochrome P-450 2C19 (CYP2C19) enzymes polymorphism, side effects, and medication adherence in patients who have been diagnosed with major depression and have utilized selective serotonin reuptake inhibitors. Methods: Fifty-three major depression patients (mean of age: 33.25 +/- 11.29 years old; male/female: 7/46) were included in this study. Polymorphisms were determined from genomic DNA by using the 'Real-Time Polymerase Chain Reaction' method. Side effects and medication adherence levels were assessed by using the 'Toronto Side Effects Scale' and the four items medication adherence scale (Morisky, Green and Levine), respectively. Results: The most common side effects that patients reported were drowsiness/daytime somnolence (54.7%), malaise or fatigue (43.4%), sweating (43.4%), nausea (41.5%) and dry mouth (41.5%). Only nine (17%) patients were found to be highly adherent to their medication. When evaluating the CYP2C19 polymorphisms of patients, 37.7%, 24.5% and 20.8% of the patients were classified as intermediate, extensive and ultra-rapid metabolizers, respectively. Allele frequencies of CYP2C19*17 and CYP2C19* 2 was calculated as 24.5% and 27.4%, respectively. Although there were some differences in side effect scores and medication adherences among the polymorphism groups, these relationships were not found to be statistically significant. Conclusion: This study shows that patients who utilized antidepressants frequently experienced side effects and had low medication adherence. Another interesting finding is the high rate of ultrarapid metabolizers of CYP2C19.
Open Access
Investigation of beta-lactoglobulin derived bioactive peptides against SARS-CoV-2 (COVID-19): In silico analysis
(ELSEVIER, 2021-01) OKUYAN, BETÜL; Cakir, Bilal; Okuyan, Betul; Sener, Goksel; Tunali-Akbay, Tugba
The coronavirus disease of 2019 (COVID-19) outbreak caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which started in late 2019 in Wuhan, China spread to the whole world in a short period of time, and thousands of people have died due to this epidemic. Although scientists have been searching for methods to manage SARS-CoV-2, there is no specific medication against COVID-19 as of yet. Two main approaches should be followed in the treatment of SARS-CoV-2; one of which is to neutralize the virus, and the other is to inhibit the host cell membrane receptors, where SARS-CoV-2 will bind. In this study, peptides derived from beta-lactoglobulin, which inactivates both the virus and its receptors in the host cell, were identified using computer-based in silico analysis. The beta-lactoglobulin derived peptides used in this study were obtained by the treatment of goat milk whey fraction with trypsin. The structure of the peptides was characterized by the liquid chromatography quadrupole time-of-flight mass spectrometry (LC-Q-TOF/MS), and six beta-lactoglobulin derived peptides were selected as candidate peptides. Subsequently, the effects of peptides on SARS-CoV-2 and host cells were identified using virtual screening. According to the results of this in silico analysis, Ala-Leu-Pro-Met-His-Ile-Arg (ALMPHIR) and Ile-Pro-Ala-Val-Phe-Lys (IPAVFK) peptides were evaluated as potential candidates to be used in the treatment of SARS-CoV-2 after the future in vitro and in vivo studies.
Open Access
Factors associated with intention of clinical pharmacists and candidates to provide pharmaceutical care: application of theory planned behaviour
(2023-09-20) OKUYAN, BETÜL; Tecen-Yucel K., Ozdemir N., Kara E., Demirkan K., Sancar M., Okuyan B.
Abstract Background Postgraduate education programs in clinical pharmacy have become widespread in Türkiye. This study aimed to identify factors associated with the intention of Turkish clinical pharmacists and candidates (who were graduates and students of postgraduate clinical pharmacy programs) to provide pharmaceutical care. Methods This prospective observational study was conducted between June 2021 and May 2022. After searching relevant studies, an expert panel discussion, translation, cultural adaptation, and a pilot study developed a 52-item Turkish scale based on the Theory of Planned Behavior (TBP). Cronbach alpha for each construct was calculated after an explanatory factor and test–retest reliability analysis. An online survey link was sent to all graduates or candi‑ dates of postgraduate clinical pharmacy programs in Türkiye. After univariate regression analysis, the multiple linear regression model was performed. Results One hundred ffty-six participants completed the survey (response rate: 59.1%). The Cronbach’s alpha for atti‑ tude (9 items), subjective norm (6 items), perceived behavioural control (5 items), self-efcacy (6 items), intention (11 items) and past behaviour (15 items) were 0.945, 0.720, 0.751, 0.864, 0.934 and 0.955 respectively. The multiple linear regression analysis found a higher score of the subjective norm (p=0.016), a higher score of self-efcacy (p<0.001), younger age (p<0.001) and having PhD (p=0.038) were associated with increased intention score. Conclusions It was shown that higher self efcacy and positive beliefs of their peers and other healthcare profes‑ sionals were associated with their higher intention score for providing pharmaceutical care. Younger age and having a PhD were other factors associated with their intention to provide pharmaceutical care.