Mental Health During COVID-19: An Evaluation of Academic Universities' Contribution to Existing Research.

Increases in mental health problems have been observed during COVID-19 pandemic. Therefore, this topic of research became a priority, especially at the academic level. The objectives of this review were to summarize academic contribution to mental health research during the era of COVID-19. A scoping review of studies conducted at different academic institutions and examining alterations in mental health during the pandemic during the last three years was conducted. Fifty-five studies were included. These focused on different mental health changes that occurred in the era of COVID-19 such as changes in work habits or existing psychological conditions, COVID-19-related fear depression, anxiety and stress. Most of the included studies were observational (76.7%). The majority of the publications were published in Scimago Journal Rank Q1 journals (57.1%). The average number of citations per publication was 15.3 ± 30.13 [0-125]. The number of citations was higher in papers with international collaboration of authors (p = 0.031). Publications with COVID-19 as a main objective were more cited than papers not directly related to this subject (25.9 ± 39.45 vs 4.14 ± 3.2; p = 0.044). Mental health problems are a common response to the COVID-19 pandemic. The contribution of academic universities to different mental health research studies that took place during COVID-19 outbreak have underlined this reality. However, more representative research from other institutional settings will be needed, particularly in vulnerable populations.

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.

Association of Chronic Urticaria with Psychological Distress: A Multicentre Cross-sectional Study.

Chronic urticaria is a debilitating disease that affects health-related quality of life, but few studies have evaluated its impact on psychological wellbeing. The aim of this study was to evaluate the quality of life of patients with chronic urticaria and determine its impact on their emotional and psychological wellbeing. A cross-sectional multicentre study of a cluster of 264 Lebanese patients visiting dermatology/immunology clinics was conducted between July 2018 and June 2020. The impact of chronic urticaria on quality of life was assessed using the Chronic Urticaria Quality of Life Questionnaire (CU-Q2oL) and Dermatology Life Quality Index (DLQI), as well as its consequences on mood changes using the Patient Health Questionnaire-9 (PHQ-9) and Beirut Distress Score 22 (BDS-22) scores. A multivariable analysis of covariates was performed to determine the effect of the triggering factors of urticaria on both CU-Q2oL and PHQ-9. A moderate negative correlation was found between Urticaria Control Test and quality of life scores as well as PHQ-9 and BDS-22 (p < 0.001). Patients with the lowest Urticaria Control Test score had the highest impairment in quality of life and depression scores. In conclusion, chronic urticaria compromises patients' quality of life and emotional wellbeing. This distress is more pronounced when the disease is more severe.

Navigating the crisis: A review of COVID-19 research and the importance of academic publications - The case of a private university in Lebanon.

Objectives: The threat of the Corona virus has had a profound global impact, prompting extensive discussions among academicians and medical researchers seeking to understand its implications across various fields. Consequently this review aims to explore the COVID-19 research approaches adopted at the Lebanese American University (LAU) between 2019 and 2022 and, to eventually shed light on the importance of the academic publications during this crisis period in the context of Lebanon. Design Data sources Eligibility criteria: Studies related to "Coronavirus", "SARS-CoV-2," or "COVID-19″ were extracted from the SciVal database spanning the period 2019 to 2022. The identified studies, totaling 97 publications, were indexed in Scopus and Web of Science and underwent narrative analysis along with an evaluation using a predefined scale to determine their eligibility. The majority of the studies were literature reviews, followed by observational studies, modeling studies, systematic reviews, and meta-analyses. Results: The majority of the identified studies (31 %) were focused on the medical field, primarily the impact of SARS-CoV-2 infection. Additionally, 22 % of studies discussed updates related to global finance and economic markets, while 18 % addressed the psychological burden of the pandemic. Other areas covered in the literature included the impact on performance, nutrition, tourism, politics, and telecommunication. Conclusion: This study marks a pioneering endeavor that sparks a crucial dialogue regarding peer-reviewed scientific literature during a period of immense need for accurate information. The prevalence of literature reviews can be attributed to the demand for swift dissemination of preliminary findings and the increased call for COVID-19-related research. However, despite the abundance of publications in this specific domain, it is imperative for future research to shift its focus towards the development of novel therapies, preventive measures, psychological insights, and strategies to address the socioeconomic and financial burdens stemming from the pandemic. This study has the potential to establish a standardized framework for addressing similar crises across diverse fields and at various levels. Limitations: The review readily acknowledges certain limitations. By solely relying on specific databases like Scopus and WoS, there is a possibility of inadvertently overlooking relevant studies. Although the study provides insights into the impact of COVID-19 across different fields and their respective publications, it is important to recognize that the continuous updates to databases and potential exclusions of related studies may have imposed constraints on the findings. Moreover, the urgency for expeditious peer-review during the pandemic may have heightened the chances of errors and diminished transparency. This urgency has unfortunately increased the risk of fraudulent activities and misconduct.

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.

Lebanese pharmacists' confidence and self-perceptions of computer literacy: scale validation and correlates.

BACKGROUND: Most pharmacists agree that continuing education (CE) programs positively affect their practice and increase their knowledge, with computer-based courses being their preferred type of CE (60.6%). The route to using medical e-services and e-learning is not straightforward. High setup costs and time commitments to sustain quality are issues brought up in this respect. Therefore, the objectives of this study were to validate the general confidence with computer use (GCWCU) scale and assess computer literacy and its associated factors among Lebanese pharmacists. METHODS: This cross-sectional study was conducted, using a random sample of Lebanese pharmacists from all districts of Lebanon. The general confidence with computer use (GCWCU) scale was used to assess computer literacy. RESULTS: This study enrolled 628 (83.73%) pharmacists. The GCWCU items converged over two factors (Cronbach's alpha = 0.716). A higher GCWCU was associated with the ease of access to the Order of Pharmacists of Lebanon e-library (beta = 2.58), owning a tablet (beta = 2.80), being connected for 4 h daily (beta = 2.71), the ease of access to the learning management system (beta = 2.39), holding a PhD (beta = 4.28) or a PharmD (beta = 1.16), and working in hospitals (beta = 2.60). CONCLUSION: This study showed that the GCWCU is adequate to assess computer literacy in Lebanese pharmacists and identified factors affecting and/or associated with computer literacy. It presented insights into essential computer skills and abilities of Lebanese pharmacists and identified factors associated with their general confidence with computer use in their practice. These findings would help decision-makers and CE providers design learning materials for pharmacists to improve their computer literacy for better practice and patient care.

The Arabic Urticaria Activity Score and Chronic Urticaria Quality of Life Questionnaire: validation and correlations.

BACKGROUND: The international guideline for urticaria recommends the use of the Urticaria Activity Score 7 (UAS7) and the Chronic Urticaria Quality of Life Questionnaire (CU-Q2oL) to assess patients with chronic spontaneous urticaria (CSU) for their disease activity and impact on quality of life, respectively. Over the last decade, both tools have been validated in many different languages but not in Arabic. OBJECTIVE: To validate the Arabic UAS7 and CU-Q2oL in patients with CSU in Lebanon. METHODS: After a structured translation process of both instruments into Arabic, their construct and known-groups validity as well as internal consistency reliability were tested in a longitudinal prospective study using a cluster sample of 152 Lebanese CSU patients. The study also included a repetitive administration of both instruments in 2-week intervals in 44 patients in order to assess their test-retest reliability. RESULTS: Both the Arabic UAS7 and CU-Q2oL demonstrated high internal consistency (Cronbach alpha of 0.95 and 0.82, respectively) and moderate-to-high test-retest reliability (intraclass coefficient of 0.61 and 0.91, respectively). Exploratory factor analysis of the Arabic CU-Q2oL revealed five components that explained 81.8% of the total variance. Significant correlations were found between the Arabic CU-Q2oL and the Dermatology Life Quality Index (DLQI) (r = 0.86) and mild-to-moderate correlations between the Arabic UAS7 and CU-Q2oL (r = 0.52) as well as the DLQI (r = 0.51). CONCLUSIONS: Our findings demonstrate that the Arabic versions of the UAS7 and the CU-Q2oL are valid and reliable patient-reported outcome measures in patients with CSU in Lebanon.

Pharmacists and continuing education: a cross-sectional observational study of value and motivation.

OBJECTIVE: To validate the scales of motivation and value towards CE and determine the factors affecting the motivation and value for CE among the Lebanese pharmacists. METHODS: A cross-sectional observational study was conducted between February and May 2018, using a random sample of Lebanese pharmacists. Data collection was performed by a team of pharmacists independent of the study. The self-administered questionnaire was available in both English and French, and comprised sections on factors related to the value and motivation of pharmacists to enrol in the CE programme. RESULTS: Of the 750 questionnaires distributed, 628 (83.37%) were completed and collected back. The value and motivation scales' items converged over a solution of one and two factors, respectively, explaining a total of 67.62% and 60.86% of the variance, respectively. Cronbach's alpha values were as follows: value of CE (0.686) and motivation for CE (0.800). Higher scores of value of CE were significantly associated with pharmacists who find the access to e-library (platform of online courses) easy (Beta = 1.154), want long-term courses with certification (Beta = 1.088) and those employed in a community pharmacy (Beta = 1.344). Higher scores of motivation for CE were significantly associated with pharmacists being aware of their CE credits (Beta = 2.14), working during weekdays and evening shifts (Beta = 1.659) and those who preferred long-term courses (Beta = 1.869). CONCLUSION: This study validated the scales of motivation and value towards CE among Lebanese pharmacists and showed that pharmacists' motivation and value towards CE were highly correlated. These findings could help design more convenient and personalized programmes, thereby increasing the motivation of pharmacists towards new CE activities.

Mandatory continuing education for pharmacists in a developing country: assessment of a three-year cycle.

BACKGROUND: In Lebanon, mandatory continuing education (CE) for pharmacists was implemented in January 2014. OBJECTIVE: The objectives of this study are to assess 1) the overall adherence to the mandatory CE program, 2) pharmacists' preferences related to CE, and 3) barriers to adherence to CE. METHODS: By the end of October 2017, an evaluation of pharmacists' participation in the mandatory CE program was conducted using electronic reports available in the Learning Management System (LMS). Descriptive results were presented as frequencies and percentages. In addition, a cross-sectional survey was conducted among pharmacists to better understand their preferences and barriers to their participation to the CE program. Finally, a focus group was organized with pharmacists who did not start their CE. RESULTS: Out of all registered pharmacists in Lebanon, 68.30% started their CE and 25.6% already achieved their required credits. Among pharmacists enrolled in the CE system, the majority (69%) used the online courses at least once. Moreover, CE enrolment was similar among old and young pharmacists except for those newly registered. The majority of pharmacists preferred clinical and pharmacological topics, followed by preventive medicine and transferable skills. Barriers to engaging in CE were mainly work and family obligations, lack of interest, lack of time, and difficulties in commuting and technology use. CONCLUSION: Although results of the present study are similar to those in developing countries, the resistance to change is higher. The Lebanese Pharmacists Association [Ordre des Pharmaciens du Liban] should develop strategies to motivate and enroll more pharmacists in the CE system, based on the barriers and preferences cited in the results, while continuing to offer high quality and cost-favorable CE programs to Lebanese pharmacists.

Mandatory continuing education for pharmacists in a developing country: assessment of a three-year cycle

Background: In Lebanon, mandatory continuing education (CE) for pharmacists was implemented in January 2014. Objective: The objectives of this study are to assess 1) the overall adherence to the mandatory CE program, 2) pharmacists' preferences related to CE, and 3) barriers to adherence to CE. Methods: By the end of October 2017, an evaluation of pharmacists' participation in the mandatory CE program was conducted using electronic reports available in the Learning Management System (LMS). Descriptive results were presented as frequencies and percentages. In addition, a cross-sectional survey was conducted among pharmacists to better understand their preferences and barriers to their participation to the CE program. Finally, a focus group was organized with pharmacists who did not start their CE. Results: Out of all registered pharmacists in Lebanon, 68.30% started their CE and 25.6% already achieved their required credits. Among pharmacists enrolled in the CE system, the majority (69%) used the online courses at least once. Moreover, CE enrolment was similar among old and young pharmacists except for those newly registered. The majority of pharmacists preferred clinical and pharmacological topics, followed by preventive medicine and transferable skills. Barriers to engaging in CE were mainly work and family obligations, lack of interest, lack of time, and difficulties in commuting and technology use. Conclusion: Although results of the present study are similar to those in developing countries, the resistance to change is higher. The Lebanese Pharmacists Association [Ordre des Pharmaciens du Liban] should develop strategies to motivate and enroll more pharmacists in the CE system, based on the barriers and preferences cited in the results, while continuing to offer high quality and cost-favorable CE programs to Lebanese pharmacists

No disponible

Attitudes of Lebanese pharmacists towards online and live continuing education sessions.

BACKGROUND: Continuing education (CE) is an internationally recommended approach as a lifelong learning model for pharmacists, enabling them to maintain the necessary knowledge, skills and ethical attitudes so as to remain current and competent in their practice. OBJECTIVES: The objective of this study is to 1) describe factors associated with taking different types of CE courses among pharmacists in Lebanon, and 2) assess the correlation between types of CE activity and the attitude of Lebanese pharmacists (motivation and value) and their computer literacy. METHODS: This is a cross-sectional observational study conducted between February and May 2017, using a random sample of Lebanese pharmacists from all districts of Lebanon. All pharmacists were eligible to participate; the sample consisted of those who agreed to complete the questionnaire. The questionnaire includes questions about computer literacy, motivation and value about CE, in addition to sociodemographic characteristics of pharmacists. RESULTS: Out of the 750 questionnaires distributed, 628 (83.73%) were filled out and returned to be analyzed. The mean age of the participants was 39.04 (SD 10.57) years, 66.9% of them were females, and 41.1% of them had a bachelor degree in pharmacy and worked in Mount Lebanon. Among the 628 respondents, 567 (90.3%) have earned at least one CE credit. Of those, 5.4% took mainly online courses, 15.4% took mainly live courses and the remaining took both types of CE. Higher motivation (aOR=1.05; CI 0.994-1.109) and higher value (aOR=1.076; CI 0.968-1.197) were associated with higher odds of taking live CE courses. Higher motivation (aOR=1.07; 95%CI 0.994-1.152) was associated with higher odds of taking online CE courses. Higher motivation (aOR=1.059; 95%CI 1.006-1.114) and higher general confidence with computer use (aOR=1.058; 95%CI 1.012-1.106) were significantly associated with higher odds of taking both types of CE courses. CONCLUSIONS: A high percentage of Lebanese pharmacists enrolled in the CE system, mainly driven by motivation and value of CE, in addition to a higher general confidence in computer use. Further efforts should be exerted by the Lebanese Order of Pharmacists to motivate pharmacists and help them improve their computer literacy, which is expected to improve not only enrollment in CE activities, but also the completion of their CE requirements.

Attitudes of Lebanese pharmacists towards online and live continuing education sessions

Background: Continuing education (CE) is an internationally recommended approach as a lifelong learning model for pharmacists, enabling them to maintain the necessary knowledge, skills and ethical attitudes so as to remain current and competent in their practice. Objectives: The objective of this study is to 1) describe factors associated with taking different types of CE courses among pharmacists in Lebanon, and 2) assess the correlation between types of CE activity and the attitude of Lebanese pharmacists (motivation and value) and their computer literacy. Methods: This is a cross-sectional observational study conducted between February and May 2017, using a random sample of Lebanese pharmacists from all districts of Lebanon. All pharmacists were eligible to participate; the sample consisted of those who agreed to complete the questionnaire. The questionnaire includes questions about computer literacy, motivation and value about CE, in addition to sociodemographic characteristics of pharmacists. Results: Out of the 750 questionnaires distributed, 628 (83.73%) were filled out and returned to be analyzed. The mean age of the participants was 39.04 (SD 10.57) years, 66.9% of them were females, and 41.1% of them had a bachelor degree in pharmacy and worked in Mount Lebanon. Among the 628 respondents, 567 (90.3%) have earned at least one CE credit. Of those, 5.4% took mainly online courses, 15.4% took mainly live courses and the remaining took both types of CE. Higher motivation (aOR=1.05; CI 0.994-1.109) and higher value (aOR=1.076; CI 0.968-1.197) were associated with higher odds of taking live CE courses. Higher motivation (aOR=1.07; 95%CI 0.994-1.152) was associated with higher odds of taking online CE courses. Higher motivation (aOR=1.059; 95%CI 1.006-1.114) and higher general confidence with computer use (aOR=1.058; 95%CI 1.012-1.106) were significantly associated with higher odds of taking both types of CE courses. Conclusions: A high percentage of Lebanese pharmacists enrolled in the CE system, mainly driven by motivation and value of CE, in addition to a higher general confidence in computer use. Further efforts should be exerted by the Lebanese Order of Pharmacists to motivate pharmacists and help them improve their computer literacy, which is expected to improve not only enrollment in CE activities, but also the completion of their CE requirements

No disponible

Enoxaparin 20 mg for thromboprophylaxis in severe renal impairment.

OBJECTIVE: This study was performed to evaluate the efficacy of daily subcutaneous enoxaparin 20 mg in patients with renal failure. METHODS: This retrospective cohort study included nonsurgical patients aged ≥18 years with a creatinine clearance rate of <30 mL/minute who were prescribed enoxaparin 20 mg subcutaneously (SC) daily for ≥3 days. The main outcome measures were the occurrence of a venous thromboembolic event (VTE) and bleeding events. RESULTS: One hundred sixty patients were identified. VTE occurred in 9 patients (5.6%), and bleeding events occurred in 37 (23.1%). Multivariable analysis showed that an age of >75 years was significantly associated with an increased risk of bleeding, while a creatinine clearance rate of 15 to 29 mL/minute was significantly associated with a lower risk of bleeding. CONCLUSION: In patients with renal failure, enoxaparin 20 mg SC daily resulted in a 5.6% incidence of VTE, which is similar to the previously published acceptable incidence of VTE in patients with normal renal function receiving enoxaparin 40 mg SC daily. The incidence of major bleeding events was 10%, which is lower than that previously published in the literature.

Pain management in hospitals: patients' satisfaction and related barriers.

BACKGROUND: Suboptimal pain control has been frequently reported in healthcare settings and documented to negatively impact patients' health. Patients' perception regarding pain management may influence their satisfaction regarding treatment. OBJECTIVES: This study focuses on the assessment of patients' satisfaction regarding pain therapy and defining patient-related barriers for its implication. METHODS: A cross-sectional study was conducted in two tertiary care hospitals from April till July 2017. A face-to face interview questionnaire was filled regarding pain scores and patients' attitudes regarding pain management. Both medical and post-surgical adult patients with all types of pain were eligible to participate. A descriptive analysis of patient satisfaction and perceptions regarding pain management was done. RESULTS: Results from 183 participants with a mean age of 49 (SD=17.33) revealed that pain was their main reason for hospitalization (71.6% of the cases). Numeric pain scores were recorded only in 14.2% of the patient medical files. Pain intensity documentation by healthcare professionals was found in 41.5% of the cases, and 7.7% of the patients had to wait for more than 30 minutes before getting the pain medication. Around 85% of the patients were satisfied with their pain management. Patients' barriers to effective pain therapy were mainly fear of adverse effects, addiction, and additional costs (p<0.05). CONCLUSIONS: Pain remains a prevalent problem that requires more efforts for improvement. Our study can effectively serve as a start for larger studies where barriers to pain management can be assessed as an independent variable affecting pain management practice.

Pain management in hospitals: patients' satisfaction and related barriers

Background: Suboptimal pain control has been frequently reported in healthcare settings and documented to negatively impact patients' health. Patients' perception regarding pain management may influence their satisfaction regarding treatment. Objectives: This study focuses on the assessment of patients' satisfaction regarding pain therapy and defining patient-related barriers for its implication. Methods: A cross-sectional study was conducted in two tertiary care hospitals from April till July 2017. A face-to face interview questionnaire was filled regarding pain scores and patients' attitudes regarding pain management. Both medical and post-surgical adult patients with all types of pain were eligible to participate. A descriptive analysis of patient satisfaction and perceptions regarding pain management was done. Results: Results from 183 participants with a mean age of 49 (SD=17.33) revealed that pain was their main reason for hospitalization (71.6% of the cases). Numeric pain scores were recorded only in 14.2% of the patient medical files. Pain intensity documentation by healthcare professionals was found in 41.5% of the cases, and 7.7% of the patients had to wait for more than 30 minutes before getting the pain medication. Around 85% of the patients were satisfied with their pain management. Patients' barriers to effective pain therapy were mainly fear of adverse effects, addiction, and additional costs (p<0.05). Conclusions: Pain remains a prevalent problem that requires more efforts for improvement. Our study can effectively serve as a start for larger studies where barriers to pain management can be assessed as an independent variable affecting pain management practice

No disponible