Hospital Pharmacy - April 2020 - 114

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Hospital Pharmacy 55(2)

Table 1. Characteristics of Hospitals Where Pharmacists Were
Recruited.

Variables

Nonteaching
hospitals

Teaching
hospitals

(n = 85)

(n = 22)

Districts
Beirut
9 (10.6%)
Mount Lebanon
41 (48.2%)
North
3 (3.5%)
South
14 (16.5%)
Beqaa
15 (17.6%)
Nabatieh
3 (3.5%)
Types
Public
71 (83.5%)
Private
14 (16.5%)
Number of beds
1 to 99 beds
45 (52.9%)
100 to 199 beds
40 (47.1%)
200 to 299 beds
-
>300 beds
-
Number of intensive care unit beds
1 to 5 beds
19 (22.4%)
6 to 10 beds
26 (30.6%)
11 to 20 beds
47 (25.8%)
>20 beds
-
Specialized units
Oncology unit
34 (43.6%)
Transplantation unit
1 (1.3%)
Burn unit
1 (1.2%)
Psychiatry unit
1 (1.3%)
Geriatric unit
6 (7.7%)

11 (50%)
7 (31.8%)
-
2 (9.1%)
2 (9.1%)
-
1 (4.5%)
21 (95.5%)
-
15 (68.2%)
6 (27.3%)
1 (4.5%)
-
12 (54.5%)
8 (36.4%)
2 (9.1%)
20 (90.9%)
6 (27.3%)
2 (9.1%)
3 (13.6%)
2 (0.1%)

than 43% of the nonteaching hospitals and in 90.9% of teaching hospitals.

Hospital Pharmacy Working Schedule
A significantly higher percentage of teaching hospitals had
"on-call" assistants and clinical pharmacists compared with
nonteaching hospitals (P < .05; Table 2).

Pharmacists' Degrees and Hospitals' Affiliations
A significantly higher percentage of teaching hospitals had a
chief pharmacist with MBA degree (33.3% vs 4.7%), oncology pharmacists with MPH degree (19% vs 1.2%), assistant
pharmacists with PharmD degree (42.9% vs 14.1%), and
clinical pharmacists with PharmD degree (33.3% vs 3.5%),
MPH degree (9.5% vs 0%), or MBA degree (23.8% vs 1.2%).
In addition, a significantly higher percentage of teaching
hospitals had an affiliation with a school of pharmacy (86.4%
vs 32.5%), a school of medicine (86.4% vs 43.4%), or a
school of nursing (86.4% vs 57.8%) compared with nonteaching hospitals (Table 3).

Pharmacy Services
A significantly higher percentage of teaching hospitals
reported to have pharmacists responsible for providing
drug information for medication use (93.8% vs 63.9%),
monitoring formulary compliance (100% vs 70.5%), and
supervising the patient counseling service (72.2% vs
47.6%). Finally, a significantly higher percentage of teaching hospitals had both pharmacy undergraduate and
PharmD students' training programs as compared with
nonteaching hospitals (Table 4).

Discussion
In this study, we found that teaching hospitals had significantly more personnel with additional qualifications, particularly in the fields of clinical pharmacy and pharmacy
management (chief pharmacists mainly) than nonteaching
hospitals. Furthermore, pharmacy services in teaching hospitals seemed to be more progressive and affiliated with
health care schools. However, due to the limited number of
hospital beds in nonteaching hospitals, the number of pharmacists may be justified especially in the absence of
Pharmacy laws that set the minimum number of pharmacist to patient ratio.
Despite the availability of national hospital accreditation
standards that apply for all kinds of hospitals, there is no
existing data published on the compliance with these standards or the current scope of hospital pharmacy in Lebanon.
Furthermore, there are no local guidelines in Lebanon issued
by the Republic of Lebanon Ministry of Public Health or by
the OPL10 for hospital pharmacy practice. According to
expert opinion, hospital pharmacy practice in Lebanon is primarily centered on the operational management of medication acquisition and distribution.11 Guidance on the minimum
requirements for hospital pharmacy is only provided by
international bodies including the ASHP and FIP Basel statements.12 The overarching goals of hospital pharmacy by both
the ASHP and the FIP advocate for optimizing patient outcomes via pharmacy services through the appropriate use of
medications. Although the application of these guidelines in
Lebanon is not mandatory, they seem to be applied better in
teaching hospitals than in nonteaching ones.
Moreover, transcending geographical locations and the
defined scope of hospital pharmacy within individual countries, common goals include engaging pharmacists in preventing medication errors in prescribing, dispensing, and in
administration to improve patient safety.13 As evidenced in
the results of the survey, teaching hospitals were more likely
to have pharmacists providing information on safe medication use, and although not statistically significant, there was
a higher trend toward having a designated champion for
medication safety. On the contrary, data showed nonsignificant differences between teaching and nonteaching hospitals
in the processes of drug procurement, preparation, and delivery, in addition to drug administration.
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