A cross-sectional study of knowledge, attitude, behaviour and preventive measures for COVID-19 infection in Lebanon.

Background: The World Health Organization has often reiterated its recommendations for the prevention of COVID-19, however, the success of these measures largely depends on public knowledge and attitudes. Aims: This study assessed the relationship between knowledge, attitude, behaviour and preventive measures for COVID-19 infection in a Lebanese population. Methods: This cross-sectional study was conducted between September and October 2020 using the snowball sampling technique and an online self-administered questionnaire. The questionnaire had 4 parts targeting sociodemographic characteristics; medical history; knowledge, attitude and practices (preventive measures and behaviours related to COVID-19); and mental health variables such as psychological distress. Two models were derived using multivariable binomial logistic regression to optimize the picture of COVID-19 correlates. Results: Our sample comprised 1119 adults. Being older, female, a regular alcohol consumer, waterpipe smoker, having low level of education, low family income, and having contact with a COVID-19 patient correlated with increased odds of ever having been diagnosed with COVID-19. Participants who had ever been diagnosed with COVID-19 had a significantly better knowledge and a higher risky practice scale [adjusted odds ratio (ORa) = 1.49; 95% CI 1.27-1.74; P < 0.001; and ORa = 1.04; 95% CI 1.01-1.08; P = 0.024, respectively]. Conclusion: The most important predictors of COVID-19 infection appear to be generally well-known among the general population, however, their knowledge and adherence to preventive measures should be continuously re-evaluated. This study highlights the need for greater awareness to improve precautionary behaviours among the public.

The impact of COVID-19 on the mental health of Lebanese pharmacists: A national cross-sectional study

Introduction The COVID-19 pandemic has induced a global mental health crisis with variable consequences. This study aimed to assess the psychological impact of COVID-19 regarding anxiety, insomnia, depression, and response to trauma on pharmacists in Lebanon during COVID-19, and to identify factors contributing to psychological distress. Methods This was a cross-sectional study among pharmacists that involved the use of the 7-item Generalized Anxiety Disorder (GAD-7), 7-item Insomnia Severity Index (ISI), Patient Health Questionnaire 9-item depression module (PHQ-9), and Impact of Event Scale revised (IES-R) subscales. Descriptive statistical analyses were performed to determine the study distribution. The associations between the scores and the participants' characteristics were assessed using the Chi-square test. Four binary logistic regression models were used to evaluate the association between the scores and the potential confounders, followed by four multivariable logistic regressions. An alpha of 0.05 was used to determine statistical significance. Results Participants comprised 311 pharmacists from all Lebanese districts, of whom 251 (80.7%) were females and 181 (58.2%) aged between 26 and 35 years. The majority of the participants were community pharmacists (n = 178, 57.2%). A considerable proportion of participants had symptoms of anxiety (n = 128, 41.2%), insomnia (n = 64, 20.6%), depression (n = 157, 50.5%), and subjective stress (n = 227, 78.8%). Higher anxiety (aOR: 1.73, 95% CI: 1.08;2.78, p-value: 0.02), higher depression (aOR: 3.06, 95% CI: 1.73;5.39, p-value: 0.001), and higher stress (aOR: 1.86, 95 percent CI: 1.11;3.14, p-value: 0.02) scores were significantly associated with pharmacists who reported that their work involves contact with infected/suspected COVID-19 patients. Interestingly, pharmacists who expressed concern about contracting COVID-19 infection had significantly higher anxiety (aOR: 2.35, 95% CI: 1.40;3.94, p-value: 0.001) and higher depression scores (aOR: 2.64, 95% CI: 1.49;4.67, p-value: 0.001) respectively. Conclusion The preliminary results from pharmacists in Lebanon reflect increase in stress, burden, and frustration felt by pharmacists, creating a negative impact on their mental health and well-being during the global pandemic. As frontline healthcare workers, the role of pharmacists in the community should not be overlooked, and their mental health should be well investigated.

The role of pharmacists in providing immunization to the general population: Are Lebanese pharmacists ready for this role?

Background: Vaccination rates remain suboptimal in multiple areas around the world in spite of evidence that immunization is one of the most effective interventions for precluding morbidity and mortality. Non-traditional vaccine providers are proposed to augment immunization coverage. Pharmacists can have multiple vital roles to educate, facilitate and immunize against vaccine-preventable diseases. Limited data are available around the expertise and practices of Lebanese pharmacists in providing immunization services. Objective: This study aimed to determine predictors that are associated with vaccine administration by pharmacists in Lebanon, and to assess experiences and practices in providing immunization. Methods: This is a cross-sectional study that included pharmacists from all over Lebanon. A web-based self-administered validated questionnaire was adapted with permission. A snowball sampling technique was used to collect data through an electronic self-administered questionnaire between March and June 2021. The web-link to the survey was also shared by the Order of Pharmacists of Lebanon with all registered pharmacists to gather a sample from different districts all over Lebanon. Results: A total of 315 pharmacists were included. A significant positive association was found between completion of an immunization training program (ORa = 2.085, [95%CI 1.006:4.322], P = 0.048), full-time pharmacists (ORa = 2.504, [95%CI 1.156:5.426], P = 0.02), 1 to 4 years of practice experience (ORa = 3.855, [95%CI 1.849:8.039], P < 0.0001), geographic area of practice (ORa = 3.201, [95%CI 1.242:8.249], P = 0.016;ORa = 5.373, [95%CI 1.859:15.530], P = 0.002 for Beirut and Mount Lebanon respectively), educating the public about immunization (ORa = 3.012, [95%CI 1.281:7.083], P = 0.011);and vaccine administration. Conclusion: The study highlights the need for additional immunization training programs to pharmacists to expand their ability and role as immunizers. It also provides intuition for policy makers to upgrade legislation relating to pharmacy continuing education and immunization training in order to enable pharmacists to have a greater role in direct vaccination.