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    Adherence to Current COPD Guidelines in Turkey
    (Taylor & Francis Ltd, 2016) Turan, Onur; Emre, Julide Celdir; Deniz, Sami; Baysak, Aysegul; Turan, Pakize Ayse; Mirici, Arzu
    Introduction-objective: Despite the availability of national and international guidelines, chronic obstructive pulmonary diseases (COPD) treatment is not always prescribed according to these recommendations. We aimed to see if COPD patients in Turkey have been treated appropriately according to COPD guidelines. Methods: This is a cross-sectional study carried out in six different chest diseases clinics. The COPD outpatients were categorized by spirometry classification (SC) and the combined classification (CC) of COPD. The treatment protocols were evaluated to check whether they were suitable for both classifications. Results: Overall, 307 patients were included in the study. Of the treatment protocols, 40.4% were suitable for both classifications: 30.9% for CC and 20.8% for SC. A total of 51.8% of the patients were reported to be using an unsuitable therapy for SC and 38.4% for CC. Ninety-eight per cent of the unsuitable treatment was overtreatment. Fifty-eight per cent of the patients were using LABA+LAMA+ICS. Improper ICS usage was identified in 97.1% in CC, 93.1% in SC. The cost savings of all patients in one year would be 17,099$ with an appropriate treatment protocol following COPD guidelines. Conclusion: The most common type of inappropriate COPD treatments is overtreatment, generally with ICS. As treatment protocols following COPD guidelines change over time, there is still a low rate of adherence by clinicians in their clinical practice to guideline recommendations. Awareness of these guidelines by pulmonary specialists should be improved.
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    Changes in inhalation therapy after combined assessment of COPD
    (European Respiratory Soc Journals Ltd, 2015) Turan, Muzaffer Onur; Emre, Julide Celdir; Deniz, Sami; Baysak, Aysegul; Turan, Pakize Ayse; Mirici, Arzu
    [Anstract Not Available]
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    Evaluation Of Vitamin B12 and D, Folic Acid and Homocystein Levels In Stable COPD Patients
    (European Respiratory Soc Journals Ltd, 2020) Turan, Muzaffer Onur; Sarioglu, Nurhan; Turan, Pakize Ayse; Ozdemir, Ozer; Fazlioglu, Nevin; Koseoglu, Mehmet; Ozkanay, Hayat
    [Anstract Not Available]
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    Parameters affecting inhalation therapy adherence in elderly patients with chronic obstructive lung disease and asthma
    (Wiley, 2017) Turan, Onur; Turan, Pakize Ayse; Mirici, Arzu
    AimOne of the most significant problems in the treatment of elderly patients is incorrect use of inhaler devices. The purpose of the present study was to assess the parameters affecting treatment adherence among elderly patients. MethodsSpirometry, the Mini-Mental State Examination for cognitive impairment and the Morisky Medication Adherence Scale-4 were carried out in 121 (88 chronic obstructive lung disease patients according to the Global Initiative for Chronic Obstructive Lung Disease, 33 asthma patients according to The Global Initiative for Asthma (GINA) criteria) participants aged over 65years. ResultsThe patients with cognitive impairment, low socioeconomic status, a high number of admissions to an emergency service in past year and the presence of dyspnea or sputum had significantly lower inhalation device use scores (P=0.017, 0.03, 0.025, 0.03 and 0.02). The patients with high Mini-Mental State Examination scores and forced expiratory volume in 1s (as liter and percentage) were found to be more successful in using inhaler devices (P=0.005, 0.007 and 0.022). There was a negative correlation between number of hospitalizations and inhalation device score (P=0.021).The participants without education/training by a doctor about the inhaler device had a significantly poorer treatment adherence (P<0.001). ConclusionsOlder chronic obstructive lung disease and asthmatic patients have more difficulty with the correct use of inhaler devices. Cognitive impairment might be an important parameter that can affect inhalation device technique. Socioeconomic status, smoking, pulmonary symptoms and admissions to hospital were also thought to have effects on the adherence to inhalation therapy. The type of chronic respiratory disease (chronic obstructive lung disease/asthma) is not a major factor influencing therapy adherence. Assessment of cognitive functions, choosing suitable inhalation devices and educational programs for inhaler use could improve the success of inhaler technique in elderly patients. Geriatr Gerontol Int 2017; 17: 999-1005.
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    The evaluation of psychological status in newly diagnosed chronic obstructive pulmonary disease patients
    (Wolters Kluwer Medknow Publications, 2019) Turan, Onur; Turan, Pakize Ayse; Mirici, Arzu
    BACKGROUND: As chronic obstructive pulmonary disease (COPD) and its symptoms may change psychological attributes, psychiatric disorders may be seen in COPD. AIMS: We aimed to assess the effect of taking diagnosis of COPD and using bronchodilator therapy on the psychological status of COPD patients. MATERIALS AND METHODS: It is a cross-sectional study including newly diagnosed COPD outpatients. Spirometry, Hospital Anxiety and Depression Scale (HADS), Beck Depression Inventory (BDI), and St. George's Respiratory Questionnaire (SGRQ) were performed at the first visit (date of new diagnosis) and 6 months later as the second visit. RESULTS: Ninety new diagnosed COPD patients (71 men and 19 women) with a mean age of 61.7 +/- 9.8 were included. There were high scores of anxiety in 23.5% and depression in 38.2% (HADS)-52.9% (BDI) patients at the first visit. The symptoms about anxiety reduced to 19%, depression to 33.3% (HADS)/47.6% (BDI) six months later. All the participants who were active smokers had lower spirometric levels (42.9%) at the second visit compared with the first visit levels. There was an improvement in psychological status and quality of life (QOL) (P < 0.001). There was a negative correlation between SGRQ score and forced expiratory volume in 1 s levels (P = 0.045) and positive correlation of SGRQ score with HAD and BDI scores (P = 0.041 and 0.011). Participants who quitted smoking in 6-month period had statistically lower anxiety and depression scores (P = 0.003 and 0.026). CONCLUSION: Depression and anxiety states are frequent among COPD patients. Pulmonary symptoms may regress with the bronchodilator therapy at newly diagnosed COPD patients, which can cause an improvement in pulmonary functions, psychological status, and QOL. Psychological aspects need to be carefully assessed in patients with new diagnosis of COPD.
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    The Importance of Partner Support and Psychological Status in Smoking Cessation
    (Aves, 2017) Turan, Onur; Turan, Pakize Ayse; Mirici, Arzu
    Objective: The habit of smoking is more common in members of a family living in the same house. People with psychiatric symptoms smoke more cigarettes. We conducted a study to examine whether the psychological status of couples and partner support affects smoking cessation success. Methods: The outpatients who started taking a therapy for smoking cessation between July 2014 and January 2015 in our clinic were included in this prospective, single-center study. Each couple was assessed on the basis of the Marital Adjustment Scale (MAS) and Hospital Anxiety-Depression Scale (HADS). The smoking status of the participants was assessed after 6 months, and they filled out the Partner Interaction Questionnaire (PIQ). Results: Of 141 volunteers, 55% joined the smoking cessation program as couples. A total of 55.3% of the participants managed to quit smoking. Further, 42.3% of couples quitted smoking. Nearly 96.2% of couples had the same result regarding smoking cessation. The smoking cessation rate was significantly lower in couples with high anxiety depression scores (participant: p=0.028 and 0.037; partner: p=0.003 and 0.007), smoker partners (p<0.01), and participants with low marital adjustments (p<0.01). Logistic regression analysis showed that the independent parameters affecting smoking cessation success were support and the smoking status of partners (p<0.001 and 0.021, respectively). Conclusion: Partner support and psychological status were important parameters associated with smoking cessation. The presence of non-smoker partners made quitting smoking easier. Reducing anxiety and depressive symptoms and support of partners may help in smoking cessation.
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    The parameters that may affect inhalation therapy success in elderly COPD and asthma patients
    (European Respiratory Soc Journals Ltd, 2015) Turan, Onur; Kasan, Turgay; Turan, Pakize Ayse; Mirici, Arzu
    [Anstract Not Available]