Browsing by Author "Yilmaz, Zekiye"

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    Deprescribing for all: a narrative review identifying inappropriate polypharmacy for all ages in hospital settings
    (BMJ PUBLISHING GROUP, 2021-01-01) Elbeddini, Ali; Sawhney, Monakshi; Tayefehchamani, Yasamin; Yilmaz, Zekiye; Elshahawi, Ahmed; Villegas, Josiah Josh; Dela Cruz, Janelyn
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    Evaluation of a community-based memory clinic in collaboration with local hospitals to support patients with memory decline
    (ELSEVIER, 2022-01-01) Elbeddini, Ali; Tayefehchamani, Yasamin; Yilmaz, Zekiye; Villegas, Josiah J.; Zhang, Eleen Y.
    Objective: This study evaluates the role of a specialised and multidisciplinary healthcare team, including a phar-macist, in providing medication management for patients with mild cognitive impairment (MCI) and dementia, in a memory clinic. Methods: The study analysed the dataset of 102 patients of a geriatric and memory clinic in a rural area of Ontario, Canada. The case histories of the patients were reviewed a week before the clinic day and a pharmacist performed medication reconciliations. During the clinic day, cognitive tests were conducted and outcomes were discussed with the team, to create a care plan and schedule a follow-up within 3, 6 or 12 months. Results: Most patients had an average of 5 prescriptions and 2 non-prescription medications deprescribed, and 57\% of patients were started on memory-related medi-cations. A total of 712 medications (p-value 0.001) were deprescribed, with 510 prescriptions and 202 non -prescription items. Out of the 712 deprescribed drugs, 374 were discontinued with no therapeutic substitutions, 202 were reduced in dosage and 136 were switched to a safer alternative. A total of 43 patients showed improved Activities of Daily Living (ADL) performance after 3 and 6 months and 68 patients showed improvement after 12 months. Conclusion: This study highlights the importance of a multidisciplinary approach in addressing drug-therapy problems, medication optimisation, and deprescription in patients with dementia. The presence of a pharmacist in the multidisciplinary team enables impactful medication optimisation and leads to improved patient outcomes. This demonstrates the value of specialised expertise in medication management for patients with dementia.
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    Impact of an educational training program on pharmacists' documentation practice at a teaching hospital
    (ELSEVIER, 2021-01-01) Elbeddini, Ali; Tayefehchamani, Yasamin; Elshahawi, Ahmed; Yilmaz, Zekiye; Villegas, Josiah J.
    Objectives: This study aims to determine the impact of an educational training program on the quantity and quality of the pharmacists' documentation practice at the Winchester District Memorial Hospital. Methods: This study is a part of an evaluation for continuous quality improvement, performed applying a pre-and post-test model. The primary endpoint was the number of Pharmacists' Patient-Care Records in patient charts with the listed action codes. Charts of 80 patients were surveyed at three points (two months before and one and three months after the sessions) for 240 charts. Additionally, a pre-and post-educational questionnaire was administered using case scenarios and the Pharmacists' Patient-Care Record code system. Results: The number of charts containing Pharmacists' Patient-Care Records with Action Codes listed is 70\%, 73\%, and 64\% in the first, second, and third chart review rounds, respectively. According to the pre-and post educational session questionnaire, the average score per pharmacist is 47\% and 73\%, respectively. Conclusion: The initial estimate of the documentation practice is 50\% or less, which is an underestimation. Furthermore, the quantity of pharmacists' documenta-tion is not significantly affected by the educational ses-sions