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      Primary health care policy and vision for community pharmacy and pharmacists in Lebanon

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          Abstract

          Within a crippling economic context and a rapidly evolving healthcare system, pharmacists in Lebanon are striving to promote their role in primary care. Community pharmacists, although held in high esteem by the population, are not recognised as primary health care providers by concerned authorities. They are perceived as medication sellers. The role of the pharmacist in primary health care networks, established by the Ministry of Public Health (MOPH) to serve most vulnerable populations, is limited to medication delivery. The practice of the pharmacy profession in Lebanon has been regulated in 1950 by the Lebanese Pharmacists Association [Order of Pharmacists of Lebanon] (OPL). In 2016, the OPL published its mission, vision, and objectives, aiming to protect the pharmacists’ rights by enforcing rules and procedures, raise the profession’s level through continuous education, and ensure patients’ appropriate access to medications and pharmacist’s counseling for safe medication use. Since then, based on the identified challenges, the OPL has suggested several programs, inspired by the World Health Organization and the International Pharmaceutical Federation guidelines, as part of a strategic plan to develop the pharmacy profession and support patient safety. These programs included the application of principles of good governance, the provision of paid services, developing pharmacists’ core and advanced competencies, generation of accreditation standards for both community pharmacy and pharmacy education, suggesting new laws and decrees, continuing education consolidation and professional development. There was an emphasis on all decisions to be evidence assessment-based. However, OPL faces a major internal political challenge: its governing body, which is reelected every three years, holds absolute powers in changing strategies for the three-year mandate, without program continuation beyond each mandate. Within this context, we recommend the implementation of a strategic plan to integrate pharmacy in primary health centers, promoting the public health aspect of the profession and taking into account of critical health issues and the changing demographics and epidemiological transition of the Lebanese population. Unless the proposed blueprint in this paper is adopted, the profession is unfortunately condemned to disappear in the current political, economic and health-related Lebanese context.

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          Most cited references34

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          Low productivity, rising R&D costs, dissipating proprietary products and dwindling pipelines are driving the pharmaceutical industry to unprecedented challenges and scrutiny. In this article I reflect on the current status of the pharmaceutical industry and reasons for continued low productivity. An emerging 'symbiotic model of innovation', that addresses underlying issues in drug failure and attempts to narrow gaps in current drug discovery processes, is discussed to boost productivity. The model emphasizes partnerships in innovation to deliver quality products in a cost-effective system. I also discuss diverse options to build a balanced research portfolio with higher potential for persistent delivery of drug molecules. Copyright © 2012 Elsevier Ltd. All rights reserved.
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            Expansion of scope of practice and diminishing revenues from dispensing are requiring pharmacists to increasingly adopt clinical care services into their practices. Pharmacists must be able to receive payment in order for provision of clinical care to be sustainable. The objective of this study is to update a previous systematic review by identifying remunerated pharmacist clinical care programs worldwide and reporting on uptake and patient care outcomes observed as a result.
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              The changing face of pharmacy practice and the need for a new model of pharmacy education.

              Pharmacy profession has evolved from its conventional and traditional drug focused basis to an advanced patient focused basis over the years. In the past century the pharmacists were more involved in compounding and manufacturing of medicines, but this role has significantly reduced over time. This advancement in the role of pharmacist calls for them to be the part of the broader health care team working for providing better health care for the patients, thus contributing in achieving the global millennium development goals. To match up, the role of today's pharmacists needs to be expanded to include pharmaceutical care concepts, making the pharmacist a health care professional rather than a drug seller in a commercial enterprise. Therefore, pharmacy schools should prepare a program that has competence with the changing role of the pharmacist. The education should provide ability for critical thinking, improve problem-solving skills and decision making during pharmacotherapy. The student should be trained to create, transmit, and apply new knowledge based on cutting-edge research in the pharmaceutical, social, and clinical sciences; collaborate with other health professionals and learn to enhance the quality of life through improved health for the people of local society and as well as the global community.
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                Author and article information

                Contributors
                Journal
                Pharm Pract (Granada)
                Pharm Pract (Granada)
                Pharmacy Practice
                Centro de Investigaciones y Publicaciones Farmaceuticas
                1885-642X
                1886-3655
                Apr-Jun 2020
                03 June 2020
                : 18
                : 2
                : 2003
                Affiliations
                Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK) . Jounieh (Lebanon). souheilhallit@ 123456hotmail.com
                Science PRO, Medical and Marketing Solutions . Jal el Dib (Lebanon). carla.abouselwan@ 123456sciencepro.me
                National Institute of Public Health, Clinical Epidemiology & Toxicology (INSPECT-LB) . Beirut (Lebanon). pascalesalameh1@ 123456hotmail.com
                Author information
                https://orcid.org/0000-0001-6918-5689
                https://orcid.org/0000-0002-8140-8694
                https://orcid.org/0000-0002-4780-0772
                Article
                pharmpract-18-2003
                10.18549/PharmPract.2020.2.2003
                7290176
                32566052
                d0e60ec3-908f-4b6a-a186-ebe07dc6292d
                Copyright: © Pharmacy Practice and the Authors

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY-NC-ND 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Categories
                International Series: Integration of community pharmacy in primary health care

                pharmacies,primary health care,delivery of health care,integrated,ambulatory care,community health services,pharmacists,community pharmacy services,professional practice,lebanon

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