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OBJECTIVES: Appropriateness of the geriatric outpatients’ medications needs special attention due to risks of falls, fractures, depression, hospital admissions and mortality. This study aimed to identify current practice on medication usage by using the 2(nd) version of “Screening Tool of Older People’s Potentially Inappropriate Prescriptions” and “Screening Tool to Alert Doctors to Right Treatment” criteria and affecting factors for the Turkish population. MATERIALS AND METHODS: This cross-sectional study was conducted between September 2015 and May 2016 at a university research and training hospital’s geriatric outpatient clinic. Patients aged ≥65 years and had ≥5 different prescribed medications (considered as polypharmacy) were recruited. The main outcome measure was the frequency of inappropriate medications identified by clinical pharmacist in the outpatient clinic according to the 2(nd) version of the criterion sets. RESULTS: A total of 700 patients (440 female) were included in this study. According to the results, 316 patients (45.1%) with at least one potentially inappropriate medication and 668 patients (98.3%) with at least one potential prescription omission were detected. Potentially inappropriate medications were associated with the number of medications used per patient [odds ratio (OR): 1.20 p

With prolonged pandemic conditions, and emerging evidence but persisting low awareness of the importance of nutritional derangements, ESPEN has promoted in close collaboration with World Health Organization-Europe a call for papers on all aspects relating COVID-19 and nutrition as well as nutritional care, in the Society Journals Clinical Nutrition and Clinical Nutrition ESPEN. Although more COVID-related papers are being submitted and continue to be evaluated, ESPEN and WHO present the current editorial to summarize the many published findings supporting major interactions between nutritional status and COVID-19. These include 1) high risk of developing the disease and high risk of severe disease in the presence of pre-existing undernutrition (malnutrition) including micronutrient deficiencies; 2) high risk of developing malnutrition during the course of COVID-19, with substantial impact on long-term sequelae and risk of long COVID; 3) persons with obesity are also prone to develop or worsen malnutrition and its negative consequences during the course of COVID-19; 4) malnutrition screening and implementation of nutritional care may improve disease outcomes; 5) social and public health determinants contribute to the interaction between nutritional status and COVID-19, including negative impact of lockdown and social limitations on nutrition quality and nutritional status. We believe the evidence supports the need to consider COVID-19 as (also) a case of malnutrition-enhanced disease and disease-related malnutrition, with added risk for persons both with and without obesity. Similarities with many other disease conditions further support recommendations to implement standard nutritional screening and care in COVID-19 patients, and they underscore the relevance of appropriate nutritional and lifestyle prevention policies to limit infection risk and mitigate the negative health impact of acute pandemic bouts.

BACKGROUND: In this study, we aimed to evaluate enteral nutrition (EN), parenteral nutrition (PN) and supplemental parenteral nutrition (SPN) in terms of achieving nutritional goals. METHODS: Patients receiving either EN, PN, or SPN treatment followed up by the clinical nutrition team between January and December 2017 at the university research and training hospital were included in the study. Daily nutritional requirements were calculated according to the recommendations. Total energy intake during nutritional treatment (NT) and all metabolic, mechanical, technical complications of NT were recorded. RESULTS: A total of 603 inpatients were included in the study. The nutritional goal was achieved in the majority of the SPN group patients (87.5%) statistically significant relation was found between the achievement of the target (or not) and PN access route (peripheral or central) (P < .001). However, none of the complications found statistically related to achieving the target, including gastrointestinal complications of EN (P = .46), metabolic complications of EN (P = .07), mechanical complications of EN (P = .79), metabolic complications of PN (P = .89), gastrointestinal complications in SPN group (P = .45), and metabolic complications in SPN group (P = .68). CONCLUSION: Nutritional goals could be achieved with SPN without increasing complications in the majority of patients. Commencement of SPN should be considered for positive outcomes in patients who failed to achieve desired nutritional outcomes.

SUMMARY OBJECTIVE: Parenteral nutrition is an important risk factor for candidemia. In this risk analysis study, the effect of previous antibiotic administration apart from the length of hospital stay, duration of Parenteral nutrition treatment, and Candida score parameters on developing candidemia was evaluated in the non-neutropenic patients receiving Parenteral nutrition treatment. METHODS: In this double center, retrospective, and cross-sectional study, the data of patients who received Parenteral nutrition treatment were collected. Patients with or without candidemia after the initiation of Parenteral nutrition treatment were compared in terms of demographic features, Candida score, length of hospital stay, duration of Parenteral nutrition treatment, and previous use of antibiotics. Then, predictor factors affecting the probability of candidemia during Candida growth time were determined by the Cox regression analysis. RESULTS: A total of 148 patients (59.5% males) were included and 16 (10.81%) of these had candidemia after initiation of parenteral nutrition treatment. The median (min–max) duration of parenteral nutrition treatment was 11 (4–72) days and the Candida growth time was 13 (7–29) days. Statistically significant differences were found between patients with or without candidemia groups in terms of length of hospital stay (p

Detecting drug-related problems (DRPs) is important in pharmaceutical care in for better therapeutic outcomes. Clinical pharmacists-led comprehensive medication management plays a crucial role in the rational use of drugs by preventing, identifying, and resolving DRPs. In this review, we aimed to determine the effect of interventions on patient outcomes performed by clinical pharmacists in Turkey. A systematic literature search was performed on PubMed, Google Scholar, EMBASE, Cochrane Library, and Turkish databases (ULAKBIM, Dergipark). The main categories were "clinical pharmacist", "intervention", and "Turkey". Two reviewers reviewed each article independently. Two independent reviewers screened all records and extracted data; disagreements were resolved through a consensus. Randomized controlled studies, pre- to post-intervention comparison studies, and cross-sectional studies including pharmacist-led interventions were included in the review. This review included 15 articles evaluating clinical pharmacist interventions. Ten studies (66.7%) focused on DRPs and pharmacist interventions to these problems, while the remaining 5 (33.3%) studies focused on patient education and adherence issues. Studies were conducted in oncology (33.3%), geriatrics (20.0%), chest diseases (13.3%), psychiatry (6.7%), cardiology (6.7%), and infectious diseases (6.7%) clinics. When results of studies are reviewed, most of the interventions were made at the prescriber level followed by the drug level and patient level. Problems were solved in 54.2-93.2% of DRPs, and adherence, patient knowledge, or skills were improved in most of the studies. Most of the studies were carried out within the scope of a postgraduate or doctorate thesis and yet various positive outcomes such as the prevention of side effects, increased quality of life, and decreased duration of hospital stay were observed with high positive rates of interventions, which indicate that other healthcare workers are ready to collaborate with the clinical pharmacists in Turkey.

As the oldest cardiac glycoside with a narrow therapeutic index and complex pharmacokinetic profile, digoxin is still used to treat many conditions such as congestive heart failure (CHF), atrial fibrillation or flutter, and certain cardiac arrhythmias.1 Its distribution in the heart and muscles might increase due to hyperthyroidism or hypokalaemia and decrease due to hyperkalaemia or hyponatraemia.1 Digoxin is the minor substrate of cytochrome-P450 (CYP) 3A4 and the major substrate of P-glycoprotein/ABCB1.1 In general, the incidence of toxicity is reported to be about 1% in patients with CHF treated with digoxin.1 Increased intracellular calcium due to inhibition of Na–K transporter is the primary pathway of digoxin toxicity.2 Factors such as renal function, age, lean body weight, cytokine levels and concomitant medications should be …

If the oral suspension dosage form is not available, opening up the oseltamivir capsule is recommended. Since remdesivir is only available in a parenteral dosage form, it cannot be administered via FT.4 Even though hydroxychloroquine with/without azithromycin treatment is not preferred in current clinical practice, it is still recommended in some local treatment algorithms of COVID-19. Total daily sorbitol amount over 20 g might cause diarrhea, therefore if liquid dosage form of any of medication is preferred, the amount of its sorbitol ingredient needs to be considered (2). [...]if clinicians are unaware of sorbitol related diarrhea, this might mislead their clinical judgment.1 None of these medications is confirmed for COVID-19 treatment yet, thus many countries published various treatment algorithms. [...]administration of these medications through FT should be the part of these possible treatment algorithms or guidelines.