Background: Critically ill patients treated in the intensive care units (ICUs) often suffer from side effects and drug-related problems (DRPs) that can be life-threatening. A way to prevent DRPs and improve drug safety and efficacy is to include clinical pharmacists in the clinical team. This study aims to evaluate the classification of drug-related problems and the implementation of clinical pharmacy services by a clinical pharmacist in the ICU of a university hospital in Turkey. Methods: This study was carried out prospectively between December 2020 and July 2021 in Gazi University Medical Faculty Hospital Internal Diseases ICU. All patients hospitalized in the intensive care unit for more than 24 h were included in the study. During the study, the clinical pharmacist's interventions and other clinical services for patients were recorded. DRPs were classed according to the Pharmaceutical Care Network Europe V.8.02. Results: A total of 151 patients were included during the study period corresponding to 2264 patient-days. Patients with DRPs had a longer hospital stay and a higher mortality rate (p < 0.05). 108 patients had at least one DRP and the total number of DRPs was 206. There was an average of 1.36 DRPs per patient, 71.5% of patients experienced DRP and 89.22 DRPs per 1000 patient-days. A total of 35 ADEs were observed in 32 patients. ADE incidence was per 1000 patient-days 15.45. ADEs were caused by nephrotoxicity (48.57%), electrolyte disorders (17.14%), drug-induced thrombocytopenia (17.14%), liver enzyme increase (8.57%) and other causes (8.57%). Drug selection (40.29%) and dose selection (54.36%) constituted most of the causes of DRPs. Dose change was the highest percentage of planned interventions with a rate of 56.79%. Intervention was accepted at a rate of 90.8% and it was fully implemented. Conclusion: In this study, the importance of the clinical pharmacist in the determination and analysis of DRPs was emphasized. Clinical pharmacy services like the one described should be implemented widely to increase patient safety.

Background: Continuing professional development (CPD) continues to gain acceptance as a model for health care professionals to engage in lifelong learning (LLL). Many pharmacy schools have not adopted yet specific programs targeting the development of LLL skills, though LLL is widely accepted as an essential competence. This paper examines the effectiveness and utility of a longitudinal CPD training program. Methods: A CPD simulation course was introduced to a cohort of fifth year students in Northern Cyprus in the 2018–2019 academic year. The program was delivered as an interactive orientation course in one semester; meanwhile, in the second semester, the students applied the CPD cycle and completed their portfolios during their final experiential practice. A mixed-methods approach was used to evaluate the outcomes of the intervention using students’ preparedness for lifelong learning (SPLLL) self-administered questionnaire delivered pre-post program, focus group sessions for students to reflect on the course experience, and instructors’ evaluations of portfolios. Results: Following the implementation of the course, students’ assessment scores were significantly higher overall and for all scale domains, including “knowledge, skills, attitude and practice”, compared to the baseline assessment. Additionally, compared to fifth year students who responded to the second SPLLL questionnaire, the intervention group students’ assessment was significantly higher in knowledge, skills, and practice. The qualitative analysis reported high student satisfaction and achievement of the course objectives. Nineteen of the students scored high on their portfolios. Conclusion: The CPD simulation course provided students with opportunities to practice and develop self-assessment and self-management skills that are all desirable for lifelong learning and prepared them for CPD.

Introduction: Pharmaceutical care services (PCs) have evolved significantly over the last few decades, with a greater focus on patient’s safety and proven effectiveness in a wide range of contexts. Many of the evidence supporting this technique comes from the United States, the evaluation and adoption of (PCs) which differ greatly across the globe. Objective: The goal of this study was to identify and assess the efficacy of pharmaceutical care services in various pharmaceutical aspects throughout seventeen Middle Eastern nations. Method: The Arkesy and O’Malley technique was used to conduct a scoping review. It was conducted using PubMed/Medline, Scopus, Cochrane Library, Springer Link, Clinical Trials, and Web of Science etc. The Van Tulder Scale was utilized in randomized trials research, whereas the dawn and black checklists were used in non-randomized trials research. A descriptive and numerical analysis of selected research was done. The scope of eligible PCs, pharmaceutical implementers, study outcomes, and quality were all identified by a thematic review of research. Results: There were about 431,753 citations found in this study, and 129 publications were found to be eligible for inclusion after analysing more than 271 full-text papers. The study design was varied, with 43 (33.3%) RCTs and 86 (66.7%) n-RCTs. Thirty-three (25.6%) of the studies were published in 2020. Jordan, Saudi Arabia, and Turkey were home to the majority of the studies (25.6%, 16.3%, and 11.6%) respectively. Thirty-seven studies (19.7%) were concerned with resolving drug related problems (DRPs), whereas 27 (14.4%) were concerned with increasing quality of life (QOL) and 23 (12.2%) with improving drug adherence. Additionally, the research revealed that the average ratings of the activities provided to patients improved every year. Conclusion: Studies in the Middle East continue to provide evidence supporting the positive impact of pharmaceutical care services on both hard and soft outcomes measured in most studies. Yet there was rare focus on the value of the implemented services. Thus, rigorous evaluation of the economic impact of implemented pharmaceutical care services in the Middle East and assessment of their sustainability is must.

Background: Several regulations for potentially inappropriate medications (PIMs) have been published specifically for elderly patients to rationalize drug use in such vulnerable communities. Objectives: To determine the proportion and characteristics of PIMs in patients receiving one or more drugs according to Beers Criteria 2015. Materials and Methods: A cross-sectional prospective analysis of 451 inpatients admitted between September 25 and October 25, 2016, was conducted in Near East University Hospital, Northern Cyprus. Data were extracted from the patient medical records using special forms. Results: A total of 119 elderly patients were identified (26.4%) and evaluated, of which 107 were eligible and 12 were excluded. Of the 1039 prescribed medicines, 16.9% were PIMs during hospitalization, whereas 12% were at discharge. The most prevalent PIM group during hospitalization was identified as the “medications to be avoided in older adults” (48.8%), whereas it also formed 52% of medications prescribed at discharge. PIMs of the class “drugs used with caution” formed 19.4% of prescribed medicine during hospitalization and 18.4% on discharge. The prevalence of polypharmacy was 79.4%, mainly identified as unpreventable polypharmacy of elders. Conclusion: A significantly higher prevalence of PIMs was observed in hospitalized patients than those discharged, with high prevalence of polypharmacy. These results necessitate a nationwide assessment, and responsible bodies who adopt strategies should act to reduce or overcome the aforementioned high prevalence in Northern Cyprus.

Background and objective: the global prevalence of allergic rhinitis (AR) is rising and yet there is scarce information concerning the diagnosis, management and treatment patterns of AR in Northern Cyprus (NC). This study aims to provide a unique perspective on AR management as well as assessing the effectiveness of the pharmacist-led educational intervention for improving care of AR patients. Methods: across-sectional survey was carried out with community pharmacists (n = 70), patients (n = 138) and ear, nose and throat (ENT) specialists (n = 12) in NC. For a controlled interventional trial, trained pharmacists provided a brief education on management of AR and nasal spray technique for patients while other pharmacists provided the usual care. Quality of life (QoL) and other outcome measures on the perceived symptom severity of the two groups were compared after a 6-week period. Results: only 33.3% of the ear, nose and throat (ENT) specialists and 15.7% of the community pharmacists are aware of the Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines. The majority of patients (63%) self-managed with over-the-counter medications. Nasal congestion (96.4%) is the most bothersome symptom and oral antihistamines are the most commonly purchased medications (51.4%), indicating a pattern of suboptimal management. The pharmacists-led educational intervention has resulted in statistically more significant improvement in regards to nasal congestion and QoL for the intervention group patients (p < 0.05). Conclusion: the current management of AR has not been in accordance with the ARIA guidelines in NC. An educational intervention of the pharmacists can enhance the symptom management and improve the QoL in patients with AR.