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Chamoun et al
The current survey also showed a considerable influence
of hospital pharmacists on physician prescribing practices, as
reflected by pharmacists being members of the Pharmacy
and Therapeutics (P&T) committee, responsible for formulary compliance, management, and updates. Furthermore,
reflected within the scope of services was also the involvement in antimicrobial stewardship, pharmacotherapy, and
pharmacokinetic consults. According to the Basel statements, the presence of a formulary, P&T committee, involvement in policy development, and the involvement of
pharmacists on patient care rounds and receipt of pharmacotherapy consults all reflect pharmacy services' influence on
prescribing.4
However, despite the fact that increasing the number of
pharmacists in direct patient care improves patient outcomes,19 the availability of clinical pharmacy services in
hospitals across Lebanon is still limited. Pharmacists participating in patient care rounds were reported to be less
than 50% of hospitals, even though clinical pharmacists
were available. This is comparable with some international
reports, where 91% of hospitals reported having clinical
pharmacy services, but only 28% of the hospitals reported
that their pharmacists regularly attended patient care
rounds.20 Our results are also comparable with data from
Saudi Arabia, where only 26% of 46 governmental and private hospitals reported that hospital pharmacists attended
patient care rounds.21
Based on the survey results, some reported services
were indicative of partial clinical pharmacy practice such
as the pharmacotherapy consults and medication counseling. In addition, as shown in the results, hospital pharmacists in Lebanon are involved in quality management and
interprofessional committees such as antimicrobial stewardship. The role of the hospital pharmacist in quality
improvement programs and the evaluation of the effectiveness of the medication use system is supported by both the
FIP and the ASHP. Engaging in quality improvement activities and organizational committees pertaining to the medication use, selection, prescription, procurement, storage,
preparation, dispensing, distribution, administration, and
monitoring, in collaboration with other health care professionals is recommended to ensure safe medication use processes.12,22 Further research initiatives regarding hospital
pharmacy, utilizing the FIP Basel statements, and other
international standards are needed to benchmark to published international studies.

Conclusion
In conclusion, the study showed high compatibility of hospital pharmacy practice in Lebanon with international hospital pharmacy practice statements. Both teaching and
nonteaching hospitals had similar practices at the level of
drug procurement, preparation, and administration; however, teaching hospitals had significantly better influences

on medication prescription and monitoring and had a more
established clinical pharmacy practice in terms of number
and qualifications of clinical pharmacists and approach in
securing patient safety. The Ministry of Public Health in
Lebanon, in collaboration with the OPL, should set standardized requirements for hospital pharmacy practice
including the minimum qualifications for educational
training and years of experience, role of the hospital pharmacist in the medication use process, and number of pharmacists needed in each setting to secure medication safety
and improve patients' outcomes. The law in addition to
hospital accreditation will standardize and optimize hospital pharmacy services across the country.
Acknowledgments
The authors would like to thank the members of the Hospital
Pharmacy Scientific Committee at the Order of Pharmacists of
Lebanon.

Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect
to the research, authorship, and/or publication of this article.

Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.

Supplemental Material
Supplemental material for this article is available online.

ORCID iDs
Lamis R. Karaoui

https://orcid.org/0000-0002-7857-7374

Youssef Akiki

https://orcid.org/0000-0003-2062-4737

Katia Iskandar

https://orcid.org/0000-0001-5544-6681

References
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2. Syndicat des Hopitaux au Liban, Hospitals. Last updated 2014.
http://www.syndicateofhospitals.org.lb/Hospitals/Index/50.
Accessed March 14, 2018.
3. Simpson SH. The roles we have as hospital pharmacists. Can J
Hosp Pharm. 2017;70(1):3-4.
4. International Pharmaceutical Federation, Hospital Pharmacy
Section. Revised FIP Basel statements on the future of hospital pharmacy. The Hague, the Netherlands: International
Pharmaceutical Federation. www.fip.org/files/fip/FIP_BASEL
_STATEMENTS_ON_THE_FUTURE_OF_HOSPITAL
_PHARMACY_2015.pdf. Accessed October 26.
5. American Society of Health-System Pharmacists. ASHP statement on the roles and responsibilities of the pharmacy executive. Am J Health Syst Pharm. 2016;73(5):329-332.

https://www.orcid.org/0000-0002-7857-7374 https://www.orcid.org/0000-0003-2062-4737 https://www.orcid.org/0000-0001-5544-6681 https://data.worldbank.org/indicator/SH.XPD.TOTL.ZS?view=chart https://data.worldbank.org/indicator/SH.XPD.TOTL.ZS?view=chart http://www.syndicateofhospitals.org.lb/Hospitals/Index/50 http://www.fip.org/files/fip/FIP_BASEL_STATEMENTS_ON_THE_FUTURE_OF_HOSPITAL_PHARMACY_2015.pdf http://www.fip.org/files/fip/FIP_BASEL_STATEMENTS_ON_THE_FUTURE_OF_HOSPITAL_PHARMACY_2015.pdf http://www.fip.org/files/fip/FIP_BASEL_STATEMENTS_ON_THE_FUTURE_OF_HOSPITAL_PHARMACY_2015.pdf

Hospital Pharmacy - April 2020

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