Background Clinical pharmacists have important roles in implementing scientifically valid knowledge and advice on safe, reasonable use of pharmaceuticals. Clinical pharmacy services were introduced and evaluated in oncology clinic in a tertiary university hospital. Methods A prospective interventional study was conducted from November 2017 to March 2018. Drug-related problems were classified using the Pharmaceutical Care Network Europe drug-related problem classification tool v8.01. The main outcome measure is the proposed interventions aimed at identification of the drug-related problems, the role of the pharmacists in the resolution, and the rate of acceptance of these recommendations by physicians. Results A total of 102 patients were included in the study, who were treated with at least two cycles of any cancer type and stage. A total of 55 (53.9%) patients had 251 drug-related problems. Drug-related problems mainly involved antihypertensive (31.6%), antidiabetic (17.8%), and herbal agents (31.6%). Treatment effectiveness was the major type of drug-related problems (50.2%) followed by treatment safety (29.1%). A total of 211 (100%) interventions were accepted and regarded as clinically relevant. Prescriber informed only were the most common types of intervention at the prescriber level. Eighty-six point four percent identified drug-related problems were solved, 9.8% of the problems were partially solved, 2.3% problems were unsolved. Conclusion Clinical pharmacy services may have optimized therapy effectiveness, prevent adverse effects and unclear/compliant problems. The pharmacist interventions were highly acknowledged by oncologists and patients; this may indicate the presence of a great convenience and need to implement Clinical pharmacy services in alternative hospitals in Northern Cyprus.
Background Multiple factors have been reported to affect adherence to medication, including beliefs about medicines, while specifically tailored pharmaceutical care services for patients may improve adherence. The aim was to assess the impact of counselling by an oncology pharmacist on patients' medication adherence and beliefs. Methods An interventional prospective study was performed in the oncology department at a tertiary hospital in Northern Cyprus from November 2017 to April 2018. The Beliefs about Medicines Questionnaire was used to evaluate the balance between beliefs about necessity and concerns and medication beliefs before and after an educational intervention. The Morisky Green Levine Test 2018 was used to evaluate adherence. Results In total, 81 patients (65.4% females; mean age: 59.1 ± 11.34 years; 34.6% hypertensive; 19.8% with diabetes) were analysed before and after receiving counselling from an oncology pharmacist. Pharmacist education significantly enhanced the mean patient necessity-concern balance scores by two-fold (MT0(baseline) = −3.1 ± 8.6; MT1(posteducation) =3.0 ± 7.3; p < 0.0001), with patients who received counselling for the first time experiencing the greatest benefit. Multivariate analysis showed that patients who had a negative balance between their beliefs about the necessity of the medication and their concerns were less likely to adhere to the medication (0.138 (0.025–0.772)). Conclusion Counselling by an oncology pharmacist was effective in decreasing patient concerns and increasing their understanding of the necessity of the medication, thus enhancing their adherence and consequently improving the care they received.
Background: Drug interactions in oncology are of clinical importance owing to the inherent use of multiple medications in cancer treatment which predisposes patients to drug-related problems. Aim: This study aimed to compare two electronic databases based on the frequency, mechanism and severity of drug-drug interactions (DDIs) in cancer treatment at Near East University Hospital. Method: A retrospective observational study of hospitalized cancer patients who had received more than one chemotherapy and/or supportive-care drugs from April 2017 to April 2019. Lexi-interact tool by Lexicomp and Drugs.com databases were used to check (DDIs and all detected interactions were categorized based on the severity-level and mechanism of interaction. Results: A total of 681 prescriptions were evaluated and the median medication per patient was 4 (IQR 3-6). Drugs.com identified potential DDIs in 129 (84.9%) patients while Lexicomp identified potential DDIs in 113 (74.3%) patients. Drugs.com reported DDIs of 394 pairs while Lexicomp reported DDIs of 313 pairs. More than 50% of the potential DDIs were classified as pharmacodynamic interactions in both databases. There were varied reports of severity of potential DDIs, but the test of agreement using kappa index was 0.592 (95% CI: 0.502-0.682, P = 0.0001) and this was interpreted as a moderate agreement between the two databases. Conclusion: Lexicomp documented more detailed information relevant to clinical practice. However, Drugs.com with more sensitivity, detected more potential DDIs. Therefore, we suggest the use of at least two drug databases for quality screening, especially for patients predisposed to polypharmacy.
Background and Aims: The Patients diagnosed with cardiovascular disease are strongly recommended to adopt healthier behaviors and adhere to prescribed medication. The role of patients' illness perceptions in patient care and impact on health outcomes was studied previously in a wide range of health conditions. However, among patients with cardiovascular diseases, this has not been well examined. Purpose of this study was to assess treatment adherence, illness perception, and relationship between illness perception and treatment adherence in patients with cardiovascular disease. Study Design: A cross-sectional descriptive study. Place and Duration of Study: The study was conducted from November 2018 to January 2019 to all patients who admitted to the cardiology department of Near East University Hospital in North Cyprus. Methodology: A survey form of three sections were used to gathered data; a socio-demographic section, Brief Illness Perception Scale, and Brief Morisky Adherence Scale. Data were analyzed using Statistical Package for Social Science (SPSS) for window version 20.0 software. P-value less than 0.05 were statistically significant. Results: The patients who participated in the study involved 49 (61.2%) male and 31 (38.8%) female. The mean ± SD age of the sampled group was 61.16 ± 12.60, with 15 (47.5%) being older than 65 years old. The Median (Max-Min) of the total Illness Perception Questionnaire positive perceptions shows significantly higher scores in males compared to female’s illness perception 52.0 (73.0 – 20.0) Vs. 41.0 (74.0 – 18.0), z=-2.297; p < 0.05, respectively. Also, university graduate patients had significantly higher positive perception scores compared to patients who graduated from only high schools or less 57.0 (71.0-40.0) Vs. 45.0 (74.0-20.0) and 43.0(68.0-18.0) df=2; p=0.013, respectively. Conclusion: There is a significant positive correlation between different subscales of perception scale, while higher positive perception scores were identified in adherent patients and males. It is crucial to strengthen patients' illness perceptions, with especial consideration to emotional responses besides personal, treatment control, and disease understanding. We recommend an educational intervention in order to improve adherence.
Introduction The role of a community pharmacist is well recognized in the literature as the most accessible health care provider that promotes health wellness and disease prevention. Evidence supports their role in cancer health promotion though this is not seen yet in practice. The aim of the study was to assess community pharmacists’ preparedness in terms of knowledge, role perception and barriers for providing cancer health promotion in North Cyprus. Methods A cross-sectional face-to-face questionnaire-based study was carried among a randomly selected representative sample of community pharmacists in North Cyprus between June 2020 and August 2020. A pre-validated 31-item questionnaire tool was revised by an expert panel and adopted for purpose of this study. Results 200 (64.5%) out of 310 approached community pharmacists’ have accepted and responded to the questionnaire of which 183 were fully answered. The community pharmacists’ awareness of cancer was moderate, as 70% answered correctly. Most respondents (93.4%) agree that pharmacists should be involved in cancer health promotion. Most respondents (> 90%) agree that pharmacist's lack of interest in oncology, lack of educational material and pharmacist's hesitancy about their knowledge of cancer are respectively the most important barriers for cancer health promotion. Conclusion The study shows that community pharmacist well perceives their role in cancer health promotion despite moderate awareness of cancer related facts and hesitancy of their knowledge necessary for assuming their role. Lack of interest, motivation and cancer educational materials availability are also major barrier to address.
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