Adherence to treatment and harmful effects of medication shortages in the context of severe crises: scale validation and correlates.

BACKGROUND: Medication shortage is a public health problem, affecting patients' outcomes mainly through the difficulty in maintaining adherence, particularly in the context of a severe economic crisis. There is a need for a new scale that assesses the effect of medication shortage on adherence. AIM: To develop and validate a scale to evaluate the harmful impact of medication shortage among the general Lebanese population and assess its correlates and association with medication adherence. METHODS: A questionnaire was used to assess medication shortage harmful effects and patients' adherence, allowing to generate the Harmful Impact of Medication Shortage scale (HIMS). The factor analysis, convergent validity and reliability of the generated scale were assessed, followed by multivariable regressions to evaluate its correlates. RESULTS: The developed HIMS scale is a 9-item tool, used to assess how difficult it was for people to deal with medication shortages and their harmful effects on treatment. It was significantly and inversely linked to treatment adherence and affected by the patients' socioeconomic status and the type of chronic disease. CONCLUSION: The Harmful Impact of Medication Shortage scale could be an efficient tool to measure the detrimental effects of medication shortages among the Lebanese adult population with chronic diseases, particularly affecting treatment adherence. Future studies and evidence are still needed to confirm our findings and help build global mitigation policies addressing medication shortages.

Opioid use disorder in two samples of the Lebanese population: scale validation and correlation with sleep and mood disorders.

BACKGROUND: The revised Opioid Risk Tool (ORT-OUD) is a brief, self-report scale designed to provide clinicians with a simple, validated method to screen for the risk of developing an Opioid Use Disorder (OUD) in patients without a prior history of substance abuse. This study aimed to translate and validate the Arabic version of ORT-OUD in the Lebanese population and assess its clinical validity in a sample of patients with OUD. METHODS: This cross-sectional study in the Lebanese population used several validated scales to assess the risk of OUD, including the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST). Other tools evaluated chronotype and sleep and mood disturbances. Principal component analysis with Varimax rotation was applied to assess ORT-OUD construct validity. Convergent validity with the Arabic version of ASSIST was evaluated. The ORT-OUD criterion validity was then assessed in a clinical sample of patients with OUD. RESULTS: This study included 581 participants. The prevalence of the OUD risk in the Lebanese population using the ORT-OUD scale and the ASSIST-opioids scale was estimated at 14.5% and 6.54%, respectively. No items of the ORT-OUD were removed; all items converged over a solution of four factors with an eigenvalue > 1, explaining a total of 68.2% of the variance (Cronbach's alpha = 0.648). The correlation coefficients between the ORT-OUD total score and ASSIST subscales were as follows: ASSIST-opioids (r = 0.174; p = < 0.001), ASSIST-sedatives (r = 0.249; p < 0.001), and ASSIST-alcohol (r = 0.161; p = < 0.001). ORT-OUD clinical validation showed a correlation with ASSIST-opioids (r = 0.251; p = 0.093) and ASSIST-sedatives (r = 0.598; p < 0.001). Higher ORT-OUD scores were associated with a family and personal history of alcohol and substance consumption and higher insomnia and anxiety scores. CONCLUSIONS: This study is the first to validate the Arabic version of ORT-OUD in the Lebanese population, an essential step towards improving the detection and management of OUD in this population.

Academic pharmacist competencies in ordinary and emergency situations: content validation and pilot description in Lebanese academia.

BACKGROUND: In the absence of a similar study in the Lebanese context, this study aimed to validate the content of the specialized competencies frameworks of academic pharmacists (educators, researchers, and clinical preceptors) and pilot their use for practice assessment in the context of multiple severe crises. METHODS: A web-based cross-sectional study was conducted between March and September 2022 among academic pharmacists enrolled by snowball sampling using a questionnaire created on Google Forms. RESULTS: The suggested frameworks had appropriate content to assess the competencies of academic pharmacists. Educators and clinical preceptors were confident in all their competencies except for emergency preparedness. Researchers had varying levels of confidence, ranging from moderate to high confidence for many competencies, but gaps were reported in fundamental research, conducting clinical trials, and pharmacy practice research (mean < 80). Educators and researchers relied primarily on experience and postgraduate studies, while clinical preceptors emphasized undergraduate studies to acquire their respective competencies. Continuing education sessions/programs were the least cited as a competency-acquiring venue across all roles. CONCLUSION: This study could develop and validate the content of frameworks for specialized competencies of academic pharmacists, including educators, researchers, and clinical preceptors, in a challenging setting. The frameworks were also piloted for practice assessment, which could contribute to supporting effective performance and sustained development of practitioners and help link the skills and competencies pharmacists learn during their studies with those required for a career in academia.

Assessing and validating the specialized competency framework for pharmacists in sales and marketing (SCF-PSM): a cross-sectional analysis in Lebanon.

OBJECTIVES: Competencies refer to the knowledge, skills, attitudes, and behaviors individuals develop through education, training, and experience. These competencies can be formulated into a framework to support practitioner development for effective and sustained performance. In the absence of a national framework for pharmacy education and practice in Lebanon, the Order of Pharmacists of Lebanon (OPL, the official association of pharmacists in Lebanon) pioneered the development of a pharmacy competency framework in 2017. This study aimed to validate and assess the specialized competency framework for pharmacists in sales and marketing (SCF-PSM) after updating the framework previously published by the OPL. The secondary objective was to assess, in a pilot survey, the personal characteristics associated with these competencies. METHODS: After validating the content of the specialized competency framework, a survey involving Lebanese pharmacists was performed through a 15-min online questionnaire distributed over social media platforms, groups of pharmacists, and individual pharmacists' contact numbers. KEY FINDINGS: Pharmaceutical knowledge, communication, emergency response, and operation management during emergencies were satisfactory (more than 80/100). Other activities during emergencies, such as patient care and population health interventions and evaluation, research, and dissemination of research outcomes, received a moderate score (75-78/100), similar to legal practice (78/100), teamwork (76/100), and management skills (75/100). The lowest reported confidence was related to professional communication skills (other than communication per se), mainly negotiation, data processing skills, information technology, self-management, and ethical practice (< 75/100). This study reported deficiencies between what is acquired during undergraduate, postgraduate, and continuing education on the one hand and the competency framework suggested by the OPL on the other hand, showing a mismatch between the competencies of working pharmacists acquired during education and the market needs. CONCLUSIONS: This study validated a competency framework for pharmacists in sales and marketing and explored the current gaps in self-reported competencies. It also identified areas necessitating reinforcement to optimize professional practice and underscored the need for improvement in undergraduate, postgraduate, and continuing professional education.

Development and validation of the Socioeconomic Status Composite Scale (SES-C).

BACKGROUND: Socioeconomic status (SES) is a critical multifactorial determinant of health and plays a significant role in shaping an individual's health outcomes. While a composite scale has been proposed to measure SES in children, to our knowledge, limited composite scales were developed for adults in different contexts, highlighting the need for a comprehensive and valid SES measure to elucidate the relationship between SES and health in this population. OBJECTIVE: This study aimed to develop and validate a composite scale that measures the socioeconomic status in Lebanon and assess its correlates in a socioeconomic crisis context. METHODS: An online study was carried out between October and November 2022 across all Lebanese regions. Snowball sampling was used to enroll 448 adults living in Lebanon through a questionnaire created on Google Forms and shared by WhatsApp to a first sample from all geographic areas. RESULTS: The developed composite scale (SES-C) was found to be reliable and valid. It was based on several aspects of socioeconomic status, i.e., participant education level, family head education level, perceived social class, not being in debt, not receiving financial help, crowding index, participant work status, family head work status, monthly household income, and financial well-being. Furthermore, high SES was significantly associated with married status, older age, alcohol consumption, the absence of chronic disease, easy access to healthcare, private insurance coverage, and the number of rooms in the house in the bivariate analysis. In the multivariable analysis, high SES was significantly associated with age (ORa-1.13; p = 0.011) and easy access to healthcare (ORa = 7.81; p = 0.001) and inversely associated with chronic disease (ORa = 0.17; p = 0.002). Similar results with lower magnitude were found for moderate SES. CONCLUSION: The study successfully developed and validated a composite scale (SES-C) for measuring the socioeconomic status in Lebanon, taking into account the complexities of the Lebanese context. The scale was found to be reliable and valid, and its results showed significant correlations with various factors such as older age, lower risk of chronic disease, and easy access to healthcare.

The specialized competency framework for industry pharmacists (SCF-IP): validation and pilot assessment.

OBJECTIVES: This study aimed to validate a specialized competency framework for industry pharmacists and assess correlates related to the competency domains in a pilot sample. METHODS: A team of experts assessed the old framework and improved its content validity after a thorough literature review, using the Delphi technique. Domains and their respective competencies and behaviors were re-defined in the framework. Afterward, a web-based cross-sectional study was carried out between March and October 2022, enrolling a convenient sample of ten industry pharmacists who worked in Lebanese pharmaceutical plants. Participants were contacted through the Syndicate of the Pharmaceutical Industries in Lebanon. RESULTS: The specialized competency framework for Lebanese industry pharmacists comprised seven domains. Behavioral items had appropriate loading on their respective factors, which could involve one, two or three competencies. Cronbach alpha values for all domains were close to one, showing appropriate reliability. Each domain was correlated with at least another one, except for domains related to pharmaceutical and industrial development and emergency preparedness, which were not correlated with other domains. The lowest confidence was found in the research and development domain, particularly among participants with only a PharmD. CONCLUSIONS: This study validated the specialized competency framework for Lebanese industry pharmacists. Some domains, specifically those related to industrial development and emergency preparedness, were found to diverge from others. Therefore, it would be recommended to include additional education in the emergency preparedness, research and development fields and to integrate industry-specific skills, courses, and training programs into academic curricula. Furthermore, specialized postgraduate degrees may be necessary to produce practice-ready pharmacists to operate effectively in this vital setting.

Validation of the specialized competency framework for pharmacists in hospital settings (SCF-PHS): a cross-sectional study.

OBJECTIVES: This study aimed to validate the content of the specialized competency frameworks for pharmacists working in hospital settings (hospital and clinical pharmacists) and pilot the frameworks for practice assessment. METHODS: This online cross-sectional study was carried out between March and October 2022 among a sample of 96 Lebanese pharmacists working in hospital settings. The frameworks were distributed to full-time hospital and clinical pharmacists, who filled them out according to their role in the hospital. RESULTS: Overall, the competencies were distributed over five domains for hospital pharmacists (fundamental skills, safe and rational use of medicines, patient-centered care, professional skills, and preparedness for emergencies), while for clinical pharmacists, competencies were distributed over seven domains (quality improvement, clinical knowledge and skills, soft skills, ability to conduct clinical research, ability to provide effective education, use information technology to make decisions and reduce errors, and emergency preparedness). Moreover, Cronbach alpha values were appropriate, indicating sufficient to high internal consistency. Pharmacists were highly confident in most competencies, with some exceptions related to research in emergency settings (data evaluation, research, and reporting). CONCLUSIONS: This study could validate competency frameworks for clinical and hospital pharmacists, with the competencies and their respective behaviors showing an adequate construct analysis. It also identified the domains that require further development, i.e., soft skills and research in emergency settings. Both these domains are timely and needed to overcome the current practice challenges in Lebanon.

The specialized competency framework for community pharmacists (SCF-CP) in Lebanon: validation and evaluation of the revised version.

BACKGROUND: In the absence of similar studies in Lebanon, this study aimed at upgrading and validating the Lebanese specialized competencies framework for community pharmacists (SCF-CP) as a tool to transform community practice and support the professional development and career progression of community pharmacists. METHODS: Content validity was assessed and improved through a team of experts. After a thorough literature review and utilizing the Delphi technique, six domains were defined in the framework, with their respective competencies and behaviors. A cross-sectional study was then carried out from March to October 2022 using an online questionnaire created on Google Forms. The snowball technique was applied to reach community pharmacists across all the Lebanese governorates. RESULTS: The final sample included 512 community pharmacists. The construct validity of the framework was confirmed by factor analysis. The Kaiser-Meyer-Olkin measures of sampling adequacy were satisfactory for all models ranging from 0.500 to 0.956 with a significant Bartlett's test of sphericity (P < 0.001). The internal consistency of all competency domains was confirmed by Cronbach's alpha, with values ranging from 0.803 to 0.953. All competencies were significantly correlated with their respective domains (P < 0.001), and all domains were significantly correlated with each other and with the framework (P < 0.001). The participants declared being competent in all domains relating to fundamental skills, safe and rational use of medicines, pharmacy management, professional skills, public health fundamentals, and emergency preparedness and response, with some exceptions, such as compounding, management, and emergency preparedness. A higher declared competency level was associated with having more experience and receiving more than 50 patients per day. CONCLUSION: Our findings could demonstrate that the Lebanese specialized competency framework is a valid and reliable tool. This framework could help assess the minimum competencies that community pharmacists should possess or acquire and direct initial and continuing education for better practice. Hence, it could be adopted by the authorities and implemented in the Lebanese community pharmacy setting.

Specialized competency framework for pharmacists in managerial positions in sales and marketing (SCF-PMSM): development, validation, and correlates.

BACKGROUND: Pharmacists in sales and marketing roles need specific skills for managerial positions, and a framework for evaluating and developing these competencies is necessary. Currently, no such framework is known to exist. OBJECTIVE: This study aimed to develop and validate a specialized competency framework for pharmacists in sales and marketing managerial positions and assess correlates related to the competency domains. METHODS: This web-based study carried out between March and October 2022 enrolled a convenient sample of 60 pharmacists with managerial positions in sales and marketing, contacted by phone, working in the field of sales and marketing from the five governorates of Lebanon (Beirut, Beqaa, Mount Lebanon, South, and North). RESULTS: The framework demonstrated good construct and structural validity in all domains except for emergency preparedness, which had a low correlation with other domains. Competencies were well correlated with respective domains, and behaviors had excellent loadings on corresponding competencies. As for the correlates of the competency domains, males were more confident than females (p < .05), and participants with more experience (or heavier workload) reported higher competency levels (p < .05), particularly for upper management skills, communication skills, and professional practice. Further, education level was not significantly correlated with declared competency, with experience being the most cited source of competence (68.25%), followed by postgraduate degrees (42.48%) and continuing education sessions (33.93%), while undergraduate education was the least reported (29.5%). CONCLUSION: This study could develop and validate the Specialized Competency Framework for Pharmacists in Managerial Positions in Sales and Marketing (SCF-PMSM) among a sample of Lebanese pharmacists. This framework demonstrated good reliability, content, construct, and structural validity in all the domains, with the competencies being well correlated with their respective domains and behaviors having excellent loadings on related competencies, except for emergency preparedness and response. It also revealed a mismatch between what is taught at undergraduate and postgraduate levels and the needs in practice.

Knowledge, Attitude, and Practices of the General Population toward the Old-New Outbreak of Cholera in a Developing Country.

Background: In October 2022, the first case of cholera since 1993 was recorded in Lebanon. This study aimed to develop and validate a tool to explore the knowledge, attitudes, and practices (KAP) toward cholera infection and its prevention among the general population in Lebanon and identify the associated factors related to the KAP assessment to guide prevention and awareness strategies. The nation's already precarious healthcare system might become overwhelmed by the response to the cholera outbreak. Therefore, evaluating the level of cholera-related KAP among the Lebanese population is crucial since it directly affects the disease's treatment, control, and prevention. Methods: This online cross-sectional study was carried out between October and November 2022 during the cholera outbreak in Lebanon. Snowball sampling was used to recruit 448 adults living in Lebanon. Results: The suggested KAP scales had adequate structural and convergent validity and were internally consistent. The disease knowledge was inversely associated with the reluctance to receive educational information (ß = -1.58) and cigarette smoking (ß = -1.31) but positively associated with the female gender (ß = 1.74) and awareness of vaccine availability and efficacy (ß = 1.34). For attitude, healthcare professionals were less frightened than others (ß = 2.69). Better practices were related to better knowledge (ß = 0.43), while inadequate practices were associated with getting information from social media (ß = -2.47). Conclusions: This study could identify notable gaps in the knowledge, attitudes, and practices, which varied according to participant characteristics. Cholera incidence can be reduced by improved community education and training, increased access to safe water, sanitation, and hygiene amenities, and changes in behavior. These findings warrant additional actions by public health stakeholders and governmental authorities to promote better practices and curb disease transmission.

Mechanisms of Neurorespiratory Toxicity Induced by Fentanyl Analogs-Lessons from Animal Studies.

In 2020, fentanyl and its analogs contributed to ~65% of drug-attributed fatalities in the USA, with a threatening increasing trend during the last ten years. These synthetic opioids used as potent analgesics in human and veterinary medicine have been diverted to recreational aims, illegally produced and sold. Like all opioids, central nervous system depression resulting from overdose or misuse of fentanyl analogs is characterized clinically by the onset of consciousness impairment, pinpoint miosis and bradypnea. However, contrasting with what observed with most opioids, thoracic rigidity may occur rapidly with fentanyl analogs, contributing to increasing the risk of death in the absence of immediate life support. Various mechanisms have been proposed to explain this particularity associated with fentanyl analogs, including the activation of noradrenergic and glutamatergic coerulospinal neurons and dopaminergic basal ganglia neurons. Due to the high affinities to the mu-opioid receptor, the need for more elevated naloxone doses than usually required in morphine overdose to reverse the neurorespiratory depression induced by fentanyl analogs has been questioned. This review on the neurorespiratory toxicity of fentanyl and analogs highlights the need for specific research focused on these agents to better understand the involved mechanisms of toxicity and develop dedicated strategies to limit the resulting fatalities.

The association of management and leadership competencies with work satisfaction among pharmacists in Lebanon.

BACKGROUND: Pharmacists are at the core of the healthcare system and are the most accessible healthcare professionals. Their new roles involve leadership skills, among others. Work satisfaction of pharmacists might affect the quality of the services they provide. Hence, the primary objective of this study was to evaluate the management/leadership skills and work satisfaction of pharmacists and working pharmacy students. The secondary objective was to establish the relationship between management/leadership competencies and work satisfaction. METHODS: This cross-sectional study enrolled 415 Lebanese pharmacists and fifth-year pharmacy students (undergraduates) working in different pharmacy sectors across Lebanon from August 2021 through October 2021 using the snowball sampling technique and validated tools to assess management/leadership competencies and work satisfaction. RESULTS: Management/leadership competencies were significantly correlated with work satisfaction (B = 0.288) and inversely associated with being engaged/married (B = - 2.825) and living outside Beirut or Mount Lebanon (B = - 1.873). Pharmacy students did not significantly differ in their leadership/management level from graduate pharmacists. Work satisfaction was significantly associated with management/leadership competencies (B = 0.062) and inversely related to education level (B = - 0.644). CONCLUSIONS: Pharmacists' work satisfaction and management/leadership competencies are interrelated, although the level of satisfaction seemed lower than the declared level of competencies. These concepts are differentially affected by personal and work-related characteristics. More efforts should be exerted to improve both the satisfaction and management/leadership competencies of pharmacists in Lebanon.

The effect of research on the perceived quality of teaching: a cross-sectional study among university students in Lebanon.

INTRODUCTION: The complementarity between research and teaching is still debated, although several higher education institutions require instructors to do research. In the absence of a consensus on this matter and given the lack of related studies in Lebanon, this study aimed to describe students' perception of research integration into teaching, and to link research and professional skills to quality teaching, using validated scales related to these concepts. METHODS: A standardized questionnaire was diffused to university students; it included validated scales: the Student Perception of Research Integration Questionnaire (SPRIQ), the Adapted-Teachers' quality assessment questionnaire (A-TQAQ), the Student Evaluation of Teaching short form (SET37-QS), and Knowledge and Attitudes Towards Health Research Questionnaire. RESULTS: Research integration was well perceived, and teaching was well evaluated by 445 participants from various disciplines, particularly those of a higher socioeconomic level, majoring in health, and females, as indicated by their mean scores. Research-active instructors had a significantly better-perceived teaching quality (17%; p < 0.001) than their non-active counterparts. This finding was particularly true among postgraduate and higher GPA students. The multivariable analysis showed that the knowledge and attitude towards research were related to students' better perception of research integration and higher evaluation of teaching. CONCLUSION: This study showed an overall good perception of research and teaching evaluation among participants from various disciplines, with research-active instructors having a better-perceived teaching quality. These findings could guide decisions on research integration into curricula using multidisciplinary methodologies to strengthen research integration and involve students in research activities.

Pharmacy education and workforce: strategic recommendations based on expert consensus in Lebanon.

Pharmacy in Lebanon has been taught for years, and the profession has known the golden ages in previous years. However, with the recent graduation of hundreds of pharmacists, without prior workforce planning, the oversupply of non-specialized pharmacists caused a mismatch with the needs of the market. The context of severe socioeconomic and sanitary crises has further exacerbated the situation, with hundreds of pharmacists leaving the country. A group of pharmacy experts joined to suggest strategic solutions to face such challenges, suggesting a clear strategy for education and the workforce, overarched by educational and professional values and based on six main pillars: (1) implement a national competency framework (including the core and specialized competency frameworks) to be used as a basis for licensure (colloquium); (2) implement a national pharmacy program accreditation, encompassing standards related to competencies adoption and assessment, curricula, teaching methods, research and innovation, instructors' and preceptors' skills, and experiential training; (3) organize training for students and early-career pharmacists; (4) optimize continuing education and implement continuous professional development, fostering innovation and specialization among working pharmacists; (5) develop and implement a pharmacy workforce strategy based on pharmacy intelligence, job market, and academic capacities; (6) develop and implement a legal framework for the above-mentioned pillars in collaboration with ministries and parliamentary commissions. Under the auspices of the relevant authorities, mainly the Order of Pharmacists of Lebanon and the Ministry of Education and Higher Education, the suggested strategy should be discussed and implemented for a better future for the pharmacy profession.

Assessing self-reported core competencies of public health practitioners in Lebanon using the WHO-ASPHER validated scale: a pilot study.

BACKGROUND: The World Health Organization and the Association of Schools of Public Health in the European Region recommend the self-assessment of public health core competencies to strengthen the proficiency of the public health workforce and prepare them for future challenges. A framework for these competencies is lacking and highly needed in Lebanon. This study aims to validate the WHO-ASPHER self-declared scale and evaluate the perceived competency level of the different categories of Lebanese public health practitioners. METHODS: This population-based cross-sectional study conducted online between July and September 2021 involved 66 public health practitioners who graduated from different universities in Lebanon. Data were collected using the snowball technique via a self-report questionnaire that assessed public health proficiency, categorized into 1) content and context, 2) relationship and interactions, and 3) performance and achievements. The rotated component matrix technique was used to test the construct validity of the scales. Bivariate and multivariate analyses were performed after ensuring the adequacy of the models. Significance was set at a p-value < 0.05. RESULTS: The factor analysis for scale domains showed that the Barlett test sphericity was significant (p < 0.001), high loadings of items on factors, and Cronbach's alpha values of more than 0.9 in all three categories, showing an appropriate scale validity and reliability. The perceived level of competencies was significantly different between public health professionals and other health professionals with public health activities. All respondents scored low in most public health categories, mainly science and practice. CONCLUSION: Data findings showed variability of self-declared gaps in knowledge and proficiency, suggesting the need to review the national public health education programs. Our study offers a valuable tool for academia and public health professionals to self-assess the level of public health proficiency and guide continuous education needs for professional development.

Assessment of knowledge, attitude, and practice regarding the disposal of expired and unused medications among the Lebanese population.

BACKGROUND: Medication waste is a public health problem affecting developed and developing countries. In Lebanon, a developing country in the Middle East, efforts are being deployed in hospitals but not in the community. OBJECTIVE: This study aimed to validate a questionnaire to explore the knowledge, attitude, and practice (KAP) towards the disposal of unused and expired medicines among the Lebanese population and then identify the factors associated with these variables comparatively between the general population and healthcare professionals. METHODS: A cross-sectional study was conducted among the general Lebanese population in May-June 2022 using a standardized questionnaire. The validity and reliability of the KAP scales were assessed, then a thorough statistical analysis was done to explore the factors associated with these scales. RESULTS: The KAP scales generated by this study were valid and reliable. Using these scales, 24.5%, 22.6%, and 21% of participants demonstrated proper knowledge, attitude, and practice, respectively. Higher knowledge scores were significantly associated with female gender (Beta = 0.97), a high monthly income (Beta = 1.68), a secondary (Beta = 6.11) or university (Beta = 6.80) education level, and postgraduate education (Beta = 7.13). However, older age (Beta = - 0.06) and a low monthly income (Beta = - 3.06) were significantly associated with lower knowledge scores. A higher knowledge score (Beta = 0.06) was significantly associated with a more positive attitude regarding unused or expired medication disposal. Being a healthcare professional (Beta = 0.72) was significantly associated with a higher practice score, while being a female (Beta = - 0.32) and living in a rural area (Beta = - 0.37) were significantly associated with lower practice scores. CONCLUSION: This study validated KAP scales regarding medication waste in Lebanon and showed low KAP scores in the majority of respondents. Factors associated with higher KAP scores in various aspects of medication disposal, including gender, age, education level, and profession (healthcare professionals), suggest the need to consider those when implementing targeted corrective measures. Although further studies are required to confirm our findings, this study could be the ground for a medication waste management national strategy in Lebanon.

A pilot assessment of the career and job satisfaction of the pharmaceutical workforce in Lebanon.

BACKGROUND: Lebanon has been recognized as a center for high-quality healthcare services in the Middle East because of its prestigious facilities certified by international bodies, competent health workers, and credible pharmaceutical sector. This study assessed the professional situation of the Lebanese pharmaceutical workforce upon graduation and entry to the job market. It also evaluated the satisfaction of pharmacists with the financial, physical, and psychological aspects of their job and the effect of the current socioeconomic crisis on their profession. METHODS: A cross-sectional study was performed between January and May 2021 among 114 Lebanese pharmacists from all pharmaceutical sectors across Lebanon. A self-administered questionnaire was elaborated to assess the pharmaceutical workforce in Lebanon. The online questionnaire was built using Google Forms and disseminated via emails and social platforms. RESULTS: Fresh graduates seemed more oriented toward community pharmacies, and 78.1% of the participants worked at least once in their lifetime in a community pharmacy. Pharmacists from the public university worked predominantly in the community pharmacy sector, while those who graduated from private universities worked mainly as medical representatives. Hospital pharmacy comprised significantly more PharmD graduates than other sectors; medical representatives had mainly a BS pharmacy, while those working as industrial pharmacists had a Master's degree. A low percentage (31.6%) of participants found it easy to get hold of a job across different pharmaceutical sectors while 64.0% considered the internships experience insufficient to get employed. Nearly half (48.2%) of the respondents were poorly satisfied with their job, and 54.0% of community pharmacists reported not working in their preferred field compared to 39.1% of pharmacists from other sectors. Also, 65.79% felt that the economic crisis and the consequent medication shortages affected their credibility and how society perceived them. About half (45.61%) of the participants reported that their employment status was not affected by the crisis; the rest got a second job to cover their expenses (15.79%) or changed jobs (14.91%). CONCLUSION: Our study findings revealed that most Lebanese fresh graduates worked as community pharmacists, which does not correspond to their preference, the available job market, and the modern pharmacy wingspan. Most pharmacists were also financially, physically, and emotionally dissatisfied due to the Lebanese economic crisis that added heavy workloads and responsibilities without any financial raise.

Developing a national pharmaceutical research strategy in Lebanon: opportunities to bridge the gaps and reach the goals.

Pharmaceutical research can be structured into clear national strategies that optimize patient health and foster innovation. The objectives of this document are to assess the need for a national pharmaceutical research strategy based on the current situation in Lebanon, to identify the strengths and weaknesses of pharmaceutical research in Lebanon, and to suggest a pharmaceutical research strategy for Lebanon, including goals and objectives. In Lebanon, in the absence of a national health research policy, pharmaceutical research is conducted in academia or hospitals, although projects are the result of personal or team initiatives that should be organized to better serve the needs of the country. Many strengths of pharmaceutical research were identified, such as the pharmaceutical workforce and academics who are willing to contribute to research, while the implementation of the national pharmaceutical strategy represents an important opportunity to promote research. Among the weaknesses is the lack of research culture in some institutions and interinstitutional/interprofessional collaborations. Thus, the suggested strategy aims to structure pharmaceutical research in Lebanon, including the priorities towards which research is directed, the process by which research is conducted, and the workforce conducting research. It will mainly rely on the World Health Organization's interrelated goals (organization, priorities, capacity, standards, and translation). The implementation of the suggested pharmaceutical research strategy will only be achieved through the leadership of the pharmaceutical authorities and the collaboration of stakeholders.