Hallit Souheil, Selwan Carla Abou, Salameh Pascale
Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK). Jounieh (Lebanon).
Science PRO, Medical and Marketing Solutions. Jal el Dib (Lebanon).
Pharm Pract (Granada). 2020 Apr-Jun;18(2):2003. doi: 10.18549/PharmPract.2020.2.2003. Epub 2020 Jun 3.
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.
在经济形势严峻且医疗体系迅速演变的背景下，黎巴嫩的药剂师们正努力提升自身在初级医疗保健中的作用。社区药剂师虽备受民众敬重，但相关部门并未将其视为初级医疗保健提供者，而是仅仅看作药品销售者。由公共卫生部设立以服务最脆弱人群的初级医疗保健网络中，药剂师的角色仅限于药品配送。黎巴嫩的药学专业实践于1950年由黎巴嫩药剂师协会[黎巴嫩药剂师公会]进行规范。2016年，黎巴嫩药剂师公会公布了其使命、愿景和目标，旨在通过执行规则和程序来保护药剂师的权利，通过持续教育提升该行业水平，并确保患者能适当获取药品以及获得药剂师关于安全用药的咨询服务。自那时起，基于所发现的挑战，黎巴嫩药剂师公会借鉴世界卫生组织和国际药学联合会的指导方针，提出了若干项目，作为发展药学专业和支持患者安全的战略计划的一部分。这些项目包括应用善治原则、提供付费服务、培养药剂师的核心和高级能力、制定社区药房和药学教育的认证标准、提出新的法律法规、巩固继续教育和促进专业发展。所有决策都强调要基于证据评估。然而，黎巴嫩药剂师公会面临一项重大的内部政治挑战：其管理机构每三年选举一次，在为期三年的任期内拥有改变战略的绝对权力，且每个任期之后都不会延续项目。在此背景下，我们建议实施一项战略计划，将药房整合到初级卫生中心，提升该行业的公共卫生层面，并考虑到关键的健康问题以及黎巴嫩人口不断变化的人口结构和流行病学转变。除非采纳本文提出的蓝图，否则在黎巴嫩当前的政治、经济和与健康相关的背景下，该行业将不幸走向消亡。
