Scopus İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11727/4809
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Item Test Performance Of Self-Report Adherence Tools In Patients With Hypertension: A Systematic Review And A Meta-Analysis(2022) Al-Alaili, Mohammed Khaled; Abdi, Abdikarim Mohamed; Basgut, Bilgen; 000888656300001What Is Known and ObjectivesAdherence has proved to have a positive influence on achieving plausible treatment outcomes. Self-report questionnaires are widely used in evaluating adherence, creating thus a high-powered research field. This review aims to provide an update of scales used in hypertension, which are compared and analysed against reliability and validity. MethodsPubMed, Web of Science and Cochrane Library were searched in May 2022 to identify studies. We extracted the study characteristics and evaluated their quality. A random-effects model with subgroup analysis was used to calculate estimates and heterogeneity parameters as well as regressions, funnel and forest plots. A bivariate model was selected to conduct validity analyses and draw receiver operating characteristic (ROC) curves. Results and DiscussionFifty-five articles were identified and classified into 22 different reliable and validated tools. Pooled analyses predicted an overall good Cronbach's alpha of 0.76 (95%CI:0.67-0.83), a good ICC of 0.8 (95%CI:0.72-0.86) and an excellent correlation coefficient of 0.91 (95%CI:0.86-0.95), which all showed high heterogeneity and slight detection of asymmetry. Regression analyses showed that only time and the number of items/scale type influenced significantly retest and alpha, respectively. Overall validity showed acceptable sensitivity of 0.65 (95%CI:0.53-0.75) and specificity of 0.57 (95%CI:0.47-0.67) with a good Area Under Curve (AUC) of 0.637. Upon comparison, four tools showed superiority over Morisky's scale. What Is New and ConclusionAdherence is a multi-dimensional phenomenon, which deems scales to be highly variable or complex; thus, complicating the selection process. Adherence to Refills and Medications Scale (ARMS) is the most promising free non-inferior alternative to Morisky, the most used scale.Item Potential drug-drug interactions of immunosuppressants in kidney transplant recipients: comparison of drug interaction resources(2022) Pehlivanli, Aysel; Eren-Sadioglu, Rezzan; Aktar, Merve; Eyupoglu, Sahin; Sengul, Sule; Keven, Kenan; Erturk, Sehsuvar; Basgut, Bilgen; Ozcelikay, Arif Tanju; 35235113Background Drug-drug interactions are frequently observed in kidney transplant recipients due to polypharmacy and use of immunosuppressants. However, there is only one study evaluating clinically relevant potential drug-drug interactions of immunosuppressants specially in kidney transplant recipients by means of online databases and Stockleys Drug Interactions, as a gold standard. Aim This study aimed to compare four online databases used frequently to determined clinically relevant potential drug-drug interactions of immunosuppressants in kidney transplant recipients according to the Renal Drug Handbook. Method This was a descriptive cross-sectional study conducted between October 1, 2019, and March 18, 2020, in the nephrology ward of Ankara University School of the Medicine, Ibn-i Sina Hospital. In total, 52 adult patients' discharge prescriptions were retrieved from their medical records and analyzed retrospectively. Micromedex (R), Lexicomp (R), Medscape, and Drugs.com databases were used to evaluate drug interactions. The Renal Drug Handbook was used as a gold standard to do specificity and sensitivity analysis. Results A total of 127 potential drug-drug interactions between the immunosuppressants and co-medications were detected by at least one online database. 32 (25.2%) of these were approved as clinically relevant potential drug-drug interactions by the Renal Drug Handbook. Lexicomp (R) and Drugs.com have exhibited the highest sensitivity (0.72 and 0.75) while Micromedex (R) has shown the highest specifity (0.83). Furthermore, the highest positive predictive value has been observed in Micromedex (R) (0.53). Micromedex (R) and Medscape had the highest negative predictive value (0.83 and 0.82). However, the kappa value of all was low. The values of inter-rater agreement (Kappa index) between online databases and the Renal Drug Handbook were weak (range 0.05-0.36). In addition, only 11 (8.7%) of potential drug-drug interactions were identified by all online databases. Conclusion This study showed that there was a weak compatibility between each database examined and the Renal Drug Handbook to detect clinically relevant potential drug-drug interactions for immunosuppressants in kidney transplant recipients. Therefore, we suggest that although databases might be practical to take a quick glance in detection of potential drug-drug interactions between immunosuppressants and co-medications, the data should be evaluated in detail and interpreted with caution in combination with a reference book like Renal Drug Handbook.