Community Pharmacists In Lebanon Research Articles

Knowledge and attitude of community pharmacists toward biosimilar medicines: A cross-sectional study in Lebanon

ObjectivesPharmacists are drug experts who can play a significant role in promoting the use of biosimilar medicines. Therefore, the aim of this study was to assess community pharmacists' knowledge and attitude toward biosimilars in Lebanon, as well as potential factors influencing their knowledge. MethodsA descriptive, cross-sectional study involving licensed community pharmacists in Lebanon was conducted using random sampling between January and July 2022. An electronic survey consisting of 30-closed ended questions was used, it included 10 questions to assess participants knowledge towards biosimilars and 10 attitudinal statements. A knowledge score was then calculated. A multivariable analysis was conducted to determine predictors of knowledge using binary logistic regression including all variables with p < 0.20 on univariate analysis. Statistical significance was set at p value < 0.05. Key findingsIn total, 354 community pharmacists completed this survey. The majority of participants 261 (73.7%) were knowledgeable, with only 54 (15.3%) answering all the questions correctly. The results of the multivariable analysis showed only a statistically significant association between knowledge and pharmacists who had taken a course or post-graduate training course about biosimilar drugs (OR = 2.213, 95% CI = 1.088–4.500, p-value = 0.028). The majority of pharmacists 314 (88.7%) agreed with the statement “Healthcare professionals should be further educated to eliminate potential misconceptions and integrate biosimilars into routine clinical practice.” ConclusionsOverall, community pharmacists in Lebanon had a good knowledge about biosimilars that was significantly associated with post-graduate training courses. Additionally, our participants had a generally favorable attitude toward biosimilars.

Complementary and alternative medicine use during the COVID-19 pandemic: Community pharmacists' knowledge, attitudes, and practices.

The challenges in COVID-19 treatment have driven patients to seek Complementary and Alternative Medicine (CAM) for the prevention and/or treatment of the disease. Pharmacists are uniquely positioned to promote the effective and safe use of CAM. Assess the beliefs, practices, and knowledge of community pharmacists in Lebanon about existing evidence for the use of CAM for the prevention and/or treatment of COVID-19. A national cross-sectional survey was conducted among community pharmacists during the COVID-19 pandemic in Lebanon (n=310 respondents). Participants completed an online questionnaire addressing, in addition to the socio-demographic characteristics; the beliefs, practices, and knowledge of pharmacists regarding the existing evidence of CAM use for COVID-19 prevention and/or treatment. Pharmacists (70%) received frequent inquiries about CAM for COVID-19 prevention or treatment. Only 25.5% of the pharmacists reported having enough time to get information about CAM and COVID-19. Almost all participants believed that pharmacists have a major role in the fight against COVID-19 (98%) and that they have enough information to counsel patients in that regard (75%). For practices, the majority of pharmacists reported counseling their patients on proper use (98%) and possible adverse reactions (93%) of CAM, but only 51% reported toxic or undesirable effects. Regarding knowledge, although most pharmacists answered correctly the questions on the role of CAM in preventing COVID-19, few knew about its role in treating the infection. Pharmacists who trust the WHO website as a credible source had a higher knowledge score (β=0.52, 95%CI: 0.05-0.986). The positive beliefs and practices of pharmacists towards CAM during the pandemic were coupled with a few gaps, especially in their knowledge about existing evidence for CAM use. Concerted efforts ought to be dedicated to supporting pharmacists in playing a more prominent role during health crises such as the COVID-19 pandemic.

A grounded theory approach to exploring the experiences of community pharmacists in Lebanon to a triple whammy of crises: The Lebanese financial crisis, COVID-19 pandemic, and the Beirut port explosion

BackgroundCommunity pharmacists like other health care professionals in Lebanon have been grappling with a series of multifaceted, country-wide and ongoing challenges that have formed the impetus for this research. We aimed to explore experiences of community pharmacists in Beirut, Lebanon, during three concurrent crises in 2020: the Lebanese financial crisis, COVID-19 pandemic and the Beirut Port explosion. MethodsA qualitative approach using a constructivist grounded theory methodology was employed. Between October 2020 and February 2021, semi-structured interviews were conducted with purposefully recruited community pharmacists working in Beirut. All interviews were conducted virtually, and data collected were analysed using inductive reasoning, with open coding and concept development. ResultsThirty-five participants (63% female, mean age 30) were interviewed online. Emergent categories and theoretical concepts included 1. painting the picture - pharmacists describing the context/setting; 2. impact of the crises - on community pharmacists, the profession, patients and the system; 3. response to the crises - of community pharmacists, the profession (+ practice), patients and the system; and 4. need for advocacy and leadership. A theory was developed about “unsustainable resilience” in the scheme of ongoing crises. ConclusionsThe findings revealed a shared sense of futility and despair among pharmacists collectively as a profession, as well as a sense of unsustainable healthcare systems in Lebanon, and environments impacting on the resilience of pharmacists at an individual level. A call for action is needed for urgent sustainable structural and financial reforms, advocacy and planning for future resilient systems, as well as a resilient pharmacy profession and protection of pharmacists' wellbeing and livelihood.

A nationwide assessment of community pharmacists’ attitudes towards dispensing errors: A cross-sectional study

ObjectivesDispensing errors (DEs) are common causes of preventable harm to patients. Interestingly, very little is known about their prevalence and types in the community pharmacy setting in Lebanon due to the lack of an effective reporting system. Therefore, this study aims to explore the perceptions of community pharmacists about the types of these errors in Lebanon, the factors behind their occurrence, the reasons for underreporting, and the current practices for reducing them. MethodsA cross-sectional survey was conducted through a self-administered questionnaire, using a scale of 0–4, distributed among a sample of community pharmacists in Lebanon. ResultsA total of 171 pharmacists responded to the survey, of whom 68% reported that DEs were common, and 52% believed that they were increasing. The main reported contributing factors to DEs were unreadable and incomplete prescriptions (≈3.0 ± 1.0 out of 5), workload, multitasking, interruptions, similarity in names of medications, and fatigue (≈2.5 ± 1.0). Moreover, the perceived strategies to limit the risks of DEs were collaboration with physicians, improving handwriting, double-checking, proper patient counselling, encouraging reporting, and issuance of guidelines (≈3.2 ± 1.0). Finally, the main reasons for underreporting DEs were the lack of obligation to report and the lack of reporting systems (59% and 56%, respectively). ConclusionsDEs may be very prevalent in Lebanon because they are unmonitored by the authorities. Electronic prescription and fair reporting systems are highly recommended, along with follow-up studies.

A national study on the resilience of community pharmacists in Lebanon: a cross-sectional survey

BackgroundCommunity pharmacists are among the most accessible healthcare professionals and are likely to experience the full brunt of public health crises. In Lebanon, the COVID-19 pandemic, added to a severe economic meltdown, have significantly disrupted an already suffering profession.MethodsThe objective of this study was to determine the level of resilience and its relationship to burnout, job satisfaction, intention to quit, and changes in practice. The study utilized a cross-sectional design to survey community pharmacists using an online questionnaire that included the Connor-Davidson Resilience Scale and the Copenhagen Burnout Inventory. All community pharmacists were invited to participate. Multiple logistic regression identified variables significantly associated with the resilience of pharmacists.ResultsA total of 459 community pharmacists completed the questionnaire. Respondents had a relatively low resilience level (68.0 ± 13.37). They also had higher scores on the client-related burnout (58.06 ± 17.46), followed by the personal burnout (56.51 ± 16.68) and the work-related burnout (55.75 ± 13.82). In this sample, 52.3% of pharmacists indicated that they are dissatisfied with their job and 41.1% indicated an intention to quit in the coming year. According to multivariate analysis, marital status (ß = 0.38; 95% CI 0.16–0.91; p = 0.03), intention to quit (ß = 0.384; 95% CI 0.149–0.987; p = 0.047), workload (ß = 0.275; 95% CI 0.096–0.783; p = 0.016), perception of safety (ß = 0.267; 95% CI 0.078–0.909; p = 0.035), and personal burnout (ß = 0.321; 95% CI 0.152–0.677; p = 0.003) were independent influencing factors for resilience.ConclusionsMultiple challenges and crises have culminated to the low job satisfaction, high burnout, and high the intention to quit of community pharmacists. This seriously destabilized the labor market of pharmacists which could negatively affect public safety. Effective interventions are essential to enhance the well-being and job satisfaction of pharmacists during public health crisis.

Oral contraceptives: knowledge and counselling practices of Lebanese community pharmacists.

To examine the extent of Lebanese pharmacists' knowledge about oral contraceptives (OCs), the characteristics influencing their knowledge and the factors that may predict their counselling practices. A cross-sectional descriptive study was conducted between January and June 2020 in which a random sample of community pharmacists in Lebanon was asked to complete a self-administered questionnaire. The survey was divided into three sections including demographic information, pharmacists' knowledge and counselling practices, and their perceptions about OCs. Of the 300 pharmacists invited to participate, 240 (80%) responded. The majority of the pharmacists (255; 85%) had satisfactory general knowledge about the indications, side effects, contraindications and drug interactions of OCs. However, only 173 (57.5%) participants had satisfactory knowledge about the proper use of OCs. Older pharmacists and those who have been in practice for more than 10 years achieved lower knowledge scores; however, those with postgraduate degrees had significantly higher scores. Pharmacists with a postgraduate degree and male pharmacists were less likely to counsel patients compared with their counterparts. Conversely, pharmacists with postgraduate OC training and those who had a private area for consultation presented better counselling practices. More than half of the participating pharmacists appeared to have satisfactory knowledge about OCs and their proper use; however, limited counselling and key misconceptions were observed in this study.

Community pharmacists' perceptions and role in the management of common dermatological problems in Lebanon: a cross-sectional study.

To explore the types and frequency of dermatologic disorders routinely encountered by community pharmacists in Lebanon, identify their educational preparedness and confidence, reasons for referrals to dermatologists and their attitude toward the potential pharmacist role in the treatment of dermatologic disorders. A cross-sectional descriptive study was conducted between June and October 2017. It involved the use of a self-administered questionnaire, distributed to a randomly selected sample of 500 community pharmacists from all Lebanese districts. A total of 456 pharmacists completed the questionnaire. Sixty-four per cent of participants had received a dermatology course at university and 38.7% had undertaken some form of postgraduate education in dermatology. Pharmacists believed that the most commonly encountered disorders were sunburn (22.6%) and acne (15.6%) during spring/summer and skin dryness (18.8%) followed by head lice (13.1%) during autumn/winter. Additionally, more than half of respondents reported that skin-related advice requests were 6-15% of the total advice offered to patients. Sixty-four per cent were confident or extremely confident in advising patients with dermatological complaints. Pharmacists ranked 'unsure of diagnosis' as the most common reason for patient referral to dermatologists. Pharmacists who received postgraduate dermatology training had higher self-reported confidence in tackling skin diseases and their treatments (P < 0.05). Our study revealed that community pharmacists in Lebanon commonly encounter a limited number of dermatologic disorders and the majority believed that they can confidently advise and manage patients. Nonetheless, they admitted a gap in their dermatology education at both undergraduate and postgraduate levels.

Views of community pharmacists in Lebanon on the unified prescription: a mixed method study.

The unified prescription was introduced in Lebanon in 2011; an aim was to save on medication expenditure. The aim of this study was to evaluate the views of community pharmacists on the effect and usefulness of the unified prescription. A cross-sectional telephone survey of community pharmacists from all governorates of Lebanon was conducted. A questionnaire was used to collect demographic data, pharmacists' views on the effect of the unified prescription on their work, the percentage of prescriptions in which the prescriber had indicated that the medicine should not be substituted with a generic equivalent and the percentage needing clarification from the prescriber. Face-to-face interviews were held with 12 pharmacists to explore their views further. Of 251 pharmacists interviewed, 56.8% did not think the unified prescription was useful, 34.8% thought it complicated their work and 24.0% that it reduced their autonomy. The in-depth interviews showed that autonomy was perceived to be restricted because of the difficulty in convincing patients to accept a substitute generic medicine, which the unified prescription allowed. The unified prescription complicated pharmacists' work because of increased paperwork and the need for more storage. Pharmacists felt that the large number of prescriptions in which the prescriber had indicated that the medicine should not be substituted undermined the purpose of the unified prescription. The implementation of the unified prescription was not considered a success by community pharmacists in Lebanon. Efforts are needed to improve communication with prescribers and educate the public about pharmacists' role and generic medicines.

Factors associated with empathy among community pharmacists in Lebanon

IntroductionEmpathy is the cornerstone of the relationship between the healthcare provider and the patient. In Lebanon, no studies have investigated the factors associated with empathy among community pharmacists. Hence, the importance of this research to better understand empathy and help community pharmacists with this vital aspect of their practice.ObjectiveThis study aimed to evaluate empathy and possible factors associated with it among Lebanese community pharmacists.MethodsThis cross-sectional study was carried out between March and July 2018. It enrolled a proportionate random sample of 435 community pharmacists from all Lebanese districts. The Epi info software calculated the minimum sample size, based on a total number of 3762 community pharmacists, with an expected frequency of 50% of pharmacists with low empathy, and a 95% confidence interval. The minimal sample size required was 350 community pharmacists; our sample size was 435 to account for missing values.ResultsOur results revealed that 228 (53.4%) pharmacists had low empathy. Lower empathy was significantly associated with more physical (Beta = − 0.331) and mental (Beta = − 0.126) work fatigue, higher age (Beta = − 0.125) and a practice experience between 3 years and less than 6 years compared to less than 6 months (Beta = − 2.440).ConclusionThis study shed the light on some factors associated with empathy among Lebanese community pharmacists. Low empathy levels were significantly associated with factors such as age, practice experience, and mental and physical work fatigue, all of which impact the practice, as the accepted model of pharmacy practice requires that pharmacists establish effective communication and use interpersonal skills. Therefore, developing empathetic communication skills is considered essential. Furthermore, increased mental and physical work fatigue should not hinder community pharmacists’ access to self-care, whether for their mental or physical health.

Knowledge, attitude and practice of Lebanese community pharmacists with regard to self-management of low back pain

Purpose: To determine the knowledge, attitude and reported practice of Lebanese community pharmacists who advise persons who present with low back pain.Methods: This was a multi-center cross-sectional study conducted in over 300 community pharmacies across Lebanon from December 2017 to May 2018. Pharmacists working at a community pharmacy were considered eligible, and those who volunteered to participate completed the questionnaire. The questionnaire was designed for self-completion by the pharmacist and included demographic questions about the respondent, questions that assessed knowledge and attitude toward low back pain, and questions about treatment to reflect and characterize the nature of practice. The primary outcome was to determine the knowledge, attitude and reported practice of the Lebanese pharmacists advising people who presented with low back pain. The secondary outcome was to assess factors that affect knowledge, attitude, and practice.Results: The response of 320 community pharmacists was analysed. The proportion of pharmacists with good knowledge about low back pain (51. 7 %) was slightly higher than those with poor knowledge (48. 3 %). Oral therapy was the most prescribed dosage form for back pain compared to local patch and cream. Among oral dosage forms, non-steroidal anti-inflammatory drugs were the most prescribed medications (42 %). Of the patients’ referral to the physician if necessary, 73.1 % of the referrals were by pharmacists.Conclusion: Community pharmacists in Lebanon demonstrate an acceptable level of knowledge of back pain, yet major gaps still exist, particularly in terms of the quality of advice. Hence, more education is needed to provide better quality of advice.&#x0D; Keywords: Attitude, Knowledge, Low back pain, Reported practice, Quality of advice

Good pharmacy practice assessment among community pharmacies in Lebanon.

Objective:This study aims to assess good pharmacy practice (GPP) aspects and compare GPP scores among community pharmacies in Lebanon, using a tool developed jointly by the International Pharmaceutical Federation (FIP) and the World Health Organization (WHO) to improve and maintain standards of pharmacy practice.Methods:Data collection was carried out between July and October 2018 by a team of 10 licensed inspectors who work at the Lebanese Order of Pharmacists (OPL) and visited community pharmacies across Lebanon. The questionnaire was adapted to the Lebanese context and included 109 questions organized under five sections: socio-demographics, Indicator A (data management and data recording), Indicator B (services and health promotion), Indicator C (dispensing, preparation and administration of medicines), and Indicator D (storage and facilities). The value of 75% was considered as the cutoff point for adherence to indicators.Results:Out of 276 pharmacies visited, a total of 250 (90.58%) pharmacists participated in the study with one pharmacist being interviewed in every pharmacy. Results showed that 18.8% of pharmacists were generally adherents to GPP guidelines (scores above the 75% cutoff): 23.3% were adherent to indicator A, 21.6% to indicator B, 14.8% to indicator C and 13.2% to indicator D. Moreover, comparison of GPP scores across geographical regions revealed a higher adherence among community pharmacists working in the Beirut region compared to the North region, the South region, Mount Lebanon, and the Bekaa.Conclusions:Our study shows that community pharmacists in Lebanon do not fulfill GPP criteria set by FIP/WHO, and that this poor adherence is a trend across the country’s geographical regions. Therefore, efforts should be made to raise awareness among pharmacists about the necessity to adhere to GPP guidelines and standards, and train them and support them appropriately to reach that goal. This is the first indicator-based comprehensive pilot assessment to evaluate GPP adherence in community pharmacies across Lebanon. Working on the optimization of this assessment tool is also warranted.

Work fatigue among Lebanese community pharmacists: prevalence and correlates.

Objective:To assess work fatigue and its associated factors among community pharmacists in Lebanon.Methods:This cross-sectional study was conducted between March and July 2018. A proportionate sample of 435 community pharmacists was selected from all regions of Lebanon. A standardized self-administered questionnaire, distributed by trained interviewers, was used to assess the studied variables.Results:The results showed that 50.12% of the pharmacists had emotional work fatigue [95%CI 0.454-0.549], 55.01% had mental work fatigue [95%CI 0.503-0.597], and 54.78% had physical work fatigue [95%CI 0.501-0.595]. Higher mental work fatigue was significantly associated with higher stress (Beta=0.185) and having a master’s degree compared to a bachelor’s degree (Beta=2.23). Higher emotional work fatigue was significantly associated with higher stress (Beta=0.219), working more than 40 hours compared to ≤ 16 hours (Beta=2.742), and having 6 months to less than 1 year of practice compared to less than 6 months (Beta=-5.238). Higher physical work fatigue was significantly associated with higher stress (Beta=0.169) and having better soft skills (Beta=-0.163).Conclusions:Work-related fatigue is high among community pharmacists and touches all aspects: physical, mental, and emotional. In our study, community pharmacists’ fatigue levels were associated with educational level, years of experience, working hours, stress, depression, and soft skills, while no relation was found with gender, age, position in the pharmacy, and economic status. Interventions are recommended to tackle this public health problem that affects pharmacists, and eventually, patients.

Factors associated with quality of life among community pharmacists in Lebanon: results of a cross-sectional study.

Objective:The objective of this study was to assess the quality of life and the factors associated with it among community pharmacists in Lebanon.Methods:This cross-sectional study was carried out between March and July 2018, enrolling 435 pharmacists, using a proportionate random sample of community pharmacies from all districts of Lebanon. The validated Arabic translation of the Short-Form 12 (SF12v2) was used to derive 2 summary scores: physical and mental component summaries (PCS and MCS).Results:Lebanese community pharmacists scored a mean PCS-12 and MCS-12 of 48.9 (SD 7.1) and 48.8 (SD 8.5), respectively. Higher age (Beta= -0.08), having a PhD degree (Beta= -4.54), higher depression score (Beta= -0.25), higher emotional work fatigue (Beta= -0.13) and higher physical work fatigue (Beta=-0.14) were significantly associated with lower physical QoL (lower PCS-12 scores). Increased stress (Beta= -0.17), higher insomnia (Beta= -0.21), higher depression (Beta= -0.2) and working for over 40 hours per week (Beta= -0.2) were significantly associated with lower mental QoL (lower mental MCS-12 scores).Conclusions:Our research has found a strong correlation between quality of life and psychological factors, including stress, burnout, insomnia, and depression among community pharmacists.

Beliefs, practices and knowledge of community pharmacists regarding complementary and alternative medicine: national cross-sectional study in Lebanon

IntroductionPharmacists are uniquely positioned to provide patients with evidence-based information in order to ensure effective and safe use of Complementary and alternative medicine (CAM) products.ObjectiveAssess beliefs, practices and knowledge related...

Assessment of knowledge, attitude and practice among community pharmacists towards dental care: A national cross sectional survey

BackgroundCommunity pharmacists’ contribution in health maintenance and promotion is significant but more studies are still needed to evaluate their role as healthcare providers. ObjectivesOur primary objective was to assess knowledge, attitude, and practice among community pharmacists in Lebanon towards dental care. Secondary objectives included assessing the barriers to a good dental care practice and assess their educational needs for oral health counseling. MethodsA national cross-sectional study was carried out using an online questionnaire and targeting community pharmacists in Lebanon. Five, three and six questions were used to assess pharmacists’ perceived knowledge, attitude and practice respectively. Stepwise linear regressions were conducted taking each time a different scale score as the dependent variable. Results497 (78.88%) pharmacists completed the survey (62% females). More than half (53.3%) exhibited good perceived knowledge, 39% a positive attitude and 47.3% a good practice regarding oral health. Pharmacists reported a good perceived knowledge regarding common oral conditions (good, very good and excellent knowledge: 73.2%). Most of the pharmacists (86.52%) perceived oral health promotion as an important part of their services. Moreover, 28.77% (n = 143) of pharmacists declared having difficulties in obtaining oral health information. The main barriers to a good practice included limited interaction between dentists and pharmacists and lack of training regarding oral health. The multivariable analyses showed a significant positive intercorrelation between perceived knowledge, attitude and practice. Working in the pharmacy for more than 40 h a week was associated with higher perceived knowledge (Beta = 2.846). Having a PhD degree was associated with lower practice scores (Beta = 3.676), whereas female gender was associated with lower practice scores (Beta = 2.334). ConclusionsPharmacists have the overall required knowledge and attitude to play an important role in the patients’ counseling towards dental care.

Good Pharmacy Practice Standardized for Community Pharmacists: The Lebanese Order of Pharmacists Initiative.

Objective:The community pharmacist's role is in constant evolution. It shifted from compounding and dispensing to patient-centered services. To guarantee that all pharmacists are providing a service of appropriate quality to every patient, the Lebanese Order of Pharmacists (OPL) took the initiative of developing good pharmacy practice (GPP) guidelines to be applied by community pharmacists for services' quality improvement.Methods:Within the OPL, a Scientific Committee, the executive authority to organize scientific and educational activities, is appointed. It decided, in January 2018, to elaborate GPP guidelines for community pharmacists and created the Community Pharmacy Practice Subcommittee, which was in charge of this project. The GPP standards suggested by the OPL were inspired by the ones published by international organizations, namely the International Pharmaceutical Federation and WHO, American, European, and regional countries.Findings:The GPP standards comprised 15 sections that tackled the following topics: settings of a pharmacy, handling of stock, extemporaneous compounding, provision of medicines, supply of nonprescription medicines, interaction and communication, documentation systems, equipment, resources, health promotion, diagnostics, pharmacotherapy monitoring, research and professional development, trainees, and para-pharmaceuticals.Conclusion:The OPL was able to implement a first draft of the GPP standards for community pharmacists in Lebanon, a developing country with many constraints. The starting project will need to be consolidated by raising awareness and changing misconception among community pharmacists as a first step. Amendments to these guidelines will follow based on the pharmacists' feedback and results of an ongoing national survey conducted by the OPL and academia.

Knowledge of and readiness for medication therapy management among community pharmacists in Lebanon.

Background To follow international standards, the Lebanese Order of Pharmacists would like to start to implement the medication therapy management in community pharmacies. Objective The objective of this study is to evaluate community pharmacists' knowledge of and readiness for medication therapy management. Setting Community pharmacists from all Lebanese regions. Method A cross-sectional observational descriptive study was conducted. Pharmacists at their workplace completed self-administered anonymous standardized questionnaires between June and December 2016, with no compensation in return. Statistical analysis was conducted using bi-variate and multi-variable methods. Main outcome measure The major dependent variable of interest was the willingness to engage in medication therapy management activities. Results While only 376 (46%) of the interviewed pharmacists declared to be familiar with this concept, the majority of interviewed pharmacists 646 (78.8%) agreed on the importance of patient-centered care. Although this service will not be remunerated at this stage, 529 (64.5%) were willing to attend advanced training sessions to become actively engaged in medication therapy management, particularly those who had adequate workflow, staff and time at their workplace (aOR = 1.51; p = 0.045) and those agreeing to review a patient's medication profile and provide interventions as part of their role (aOR = 6.10; p < 0.001). Conclusion Lebanese pharmacists have adequate knowledge and a positive attitude towards medication therapy management services implementation; however, barriers could arise such as inadequate time, workflow and physical space. Efforts should be exerted by the Lebanese Order of Pharmacist to extend the role of the pharmacist and its positive effect on patient outcome.

Medication safety knowledge, attitudes and practices among community pharmacists in Lebanon

Background: The effectiveness of a national post-marketing surveillance program depends directly on the active participation of all health professionals. There is no current comprehensive and active pharmacovigilance program available in Lebanon.Objectives: To assess the knowledge, attitudes, and practices (KAP) among community pharmacists in Lebanon with respect to potential pharmacovigilance and adverse-drug-reaction reporting in Lebanon.Methods: A cross-sectional descriptive study, using a self-administered KAP questionnaire and conducted between March and July 2016, included 1857 pharmacists practicing in community settings. Statistical analysis included χ2 test for dichotomous or multinomial qualitative variables, and Wilcoxon test for quantitative variables with non-homogeneous variances or non-normal distribution.Results: The majority of responders had good knowledge concerning the concept and purpose of pharmacovigilance as well as adverse drug reactions (how to report these/the importance of reporting adverse events/the definition of an adverse event and pharmacovigilance). Concerning community pharmacists’ attitudes and practice towards pharmacovigilance, the majority described having a positive attitude towards their role in adverse drug reaction reporting and this activity was even seen as one of their core duties. The questionnaire revealed a lack of practice and training regarding pharmacovigilance. Nonetheless, the pharmacists agreed on the Order of Pharmacists in Lebanon and the Ministry of Health’s role in promoting this practice and helping them be more involved in reporting adverse drug reactions (ADRs). The pharmacists thought that they are well positioned regarding patient-safety practice in their pharmacies and the results were not statistically different between pharmacy employers and employees.Conclusion: Lebanese pharmacists have the required knowledge and positive attitude to start reporting ADRs, were aware of ADRs occurring with various medicines post-marketing, yet were currently not able to disseminate this information widely or to record it centrally, emphasizing the importance of establishing a national ADR reporting system.

Pharmacists\u2019 views and reported practices in relation to a new generic drug substitution policy in Lebanon: a mixed methods study

BackgroundGovernments in both developed and developing countries have adopted generic drug substitution policies to decrease pharmaceutical expenditures and improve access to medicine. In August 2015, the Ministry of Public Health (MOPH) in Lebanon introduced generic drug substitution and a unified medical prescription form as policy instruments to promote generic drug use. The objective of this exploratory study was to examine the attitudes of community pharmacists and the reported practices in relation to the implementation of the new generic drug substitution policy.MethodsWe used a cross-sectional mixed methods approach composed of self-administered questionnaires and semi-structured interviews. The study population consisted of community pharmacists in Lebanon. We randomly approached one pharmacy personnel from each selected community pharmacy. We conducted descriptive analyses to assess responses to questionnaire and regression analyses to understand associations between responses and respondent demographics. We analyzed qualitative data thematically.ResultsOut of 204 invited community pharmacies, 153 pharmacies participated (75% response rate). The majority of respondents (64%) were in favor of generic drug substitution; however, less than half (40%) indicated they have substituted brand drugs for generic equivalents. Moreover, 57% indicated that the existing pricing system discourages them from performing generic drug substitution. Most respondents indicated that physicians are overusing the “non-substitutable” option (84%) and that there are technical problems with processing the new prescription form (78%). Less than half (47%) reported that the MOPH is performing regular audits on the forms collected by the pharmacy. While 45% of the respondents indicated that consumers have accepted most of the generic substitutions, 21% perceived the increase in generic drug dispensing to be significant. Findings suggested a potentially significant association between being informed about generic drugs and respondents’ support of the policy. Suggested strategies to address implementation challenges included strengthening stewardship function of MOPH, securing full commitment of health care providers, conducting educational and awareness campaigns about generic drugs and generic drug substitution, and aligning incentive systems of the key stakeholders.ConclusionsThe majority of community pharmacists were supportive of generic drug substitution in general but not of the current implementation of the policy in Lebanon. Findings revealed implementation challenges at the provider, patient, and system level which are hindering attainment of the policy objectives. The key lessons derived from this study can be used for continuous improvement of the policy and its implementation.

Attitudes of Physicians to Professional Roles of Community Pharmacists in Lebanon

Background: Pharmacists involved in patient‐centred clinical services can potentially reduce overall healthcare costs, morbidity and mortality. However, physicians might be ambivalent about pharmacists' capabilities.Aim: To determine the opinions of medical and dental practitioners (physicians) to professional activities which could be provided by community pharmacists in Lebanon.Method: 300 questionnaires were distributed by pharmacy students to registered physicians covering a range of specialties and experience. The questionnaire consisted of 20 closed questions and an open‐ended question to determine the physician's expectations of the pharmacist's role in patient care.Results: 198 questionnaires were analysed and overall the results indicated that physicians have a need for information of the type that pharmacists can supply. However, the healthcare system is fragmented because of unclear and infrequent communication. Physicians believe that increased consensual cooperation and communication between the professions could improve therapeutic outcomes and the quality of advice given to patients.Conclusion: There is a need for collaboration between physicians and pharmacists in Lebanon to improve the quality of pharmaceutical care for patients.