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Cherfane M, Boueri M, Issa E, Abdallah R, Hamam A, Sbeity K, Saad A, Abi-Gerges A. Unveiling the unseen toll: exploring the impact of the Lebanese economic crisis on the health-seeking behaviors in a sample of patients with diabetes and hypertension. BMC Public Health 2024; 24:628. [PMID: 38413883 PMCID: PMC10900622 DOI: 10.1186/s12889-024-18116-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 02/15/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND Against the backdrop of Lebanon's escalating multifaceted crisis which resulted in medication shortages for chronic diseases and unaffordable healthcare services, the current study endeavors to shed light on a critical yet overlooked facet of the Lebanese economic crisis- its profound impact on the health-seeking behaviors of patients with hypertension and diabetes mellitus. METHODS An exploratory cross-sectional study based on an online questionnaire was conducted on 156 adult Lebanese citizens diagnosed medically with either hypertension or diabetes. We gathered sociodemographic characteristics and healthcare-related challenges faced during the economic crisis. We also assessed stress levels using the Depression Anxiety Stress Scale (DASS-21). Descriptive and bivariate analyses were done using SPSS version 26. RESULTS The mean age of the population was 49.8 ± 17.7 years old, 51.6% were females and 48.4% were males, 29.7% had diabetes, 51.3% had hypertension and 19.0% had both diseases. Among all, 84.2% reported dissatisfaction with the current healthcare system, 31.6% reported changing their physician mainly because of unaffordable consultation fees (66%) or immigration of the physician (32%). Of those with hypertension and/or diabetes, less than 20% reported finding all their prescribed medications and 47% either modified or discontinued their treatment without seeking medical advice. In case of drug shortage, patients relied on stocked reserves (26%), alternative/generic medications (10%) and external sources for medication procurement such as relatives living abroad (41.7%), outsourcing suppliers (19.9%), dispensaries (19.6%) and NGOs (20.3%). All participants reported a high stress level (5.03/7) with a mean total DASS-21 score of 38.7 ± 35.8 that were attributed to August 4th Beirut port explosion (81.0%), global pandemic (81%), unstable political conditions (90.5%), economic crisis (96.8%), medication shortage (91.8%) and inability to access healthcare (74.1%). Higher sub-scores for anxiety, depression and total stress were insignificantly noted in participants with both hypertension and diabetes (p > 0.05). CONCLUSION Our findings explore how the economic crisis has taken its toll on almost all aspects of healthcare in a sample of patients with diabetes and hypertension in Lebanon. The drug shortage as well as disruptions in affordable healthcare access imposed several barriers to adequate adherence to treatment regimens and acted as important mental health stressors.
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Affiliation(s)
- Michelle Cherfane
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, P.O. Box 36, Lebanon
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie- Liban), Beirut, Lebanon
| | - Myriam Boueri
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, P.O. Box 36, Lebanon
| | - Elio Issa
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, P.O. Box 36, Lebanon
| | - Racha Abdallah
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, P.O. Box 36, Lebanon
| | - Ali Hamam
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, P.O. Box 36, Lebanon
| | - Kassem Sbeity
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, P.O. Box 36, Lebanon
| | - Anthony Saad
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, P.O. Box 36, Lebanon
| | - Aniella Abi-Gerges
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, P.O. Box 36, Lebanon.
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Younes S, Hallit S, Mohammed I, El Khatib S, Brytek-Matera A, Eze SC, Egwu K, Jabeen R, Pavlović N, Salameh P, Cherfane M, Akel M, Haddad C, Choueiry R, Fekih-Romdhane F, Iskandar K. Moderating effect of work fatigue on the association between resilience and posttraumatic stress symptoms: a cross-sectional multi-country study among pharmacists during the COVID-19 pandemic. Biopsychosoc Med 2024; 18:4. [PMID: 38374107 PMCID: PMC10875825 DOI: 10.1186/s13030-024-00300-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 01/01/2024] [Indexed: 02/21/2024] Open
Abstract
INTRODUCTION In the context of the COVID-19 pandemic, pharmacists, despite their vital contributions, have faced significant challenges that have impacted their mental well-being, potentially leading to the development of Post-Traumatic Stress symptoms (PTSS). The aim of this study was to investigate the role of work-related fatigue as a potential moderator in the relationship between pharmacists' resilience and their likelihood of experiencing PTSS during the COVID-19 pandemic. METHODS A cross-sectional survey was conducted online in eight countries from January to December 2021, including Brazil, Lebanon, Nigeria, Pakistan, Poland, Serbia, and Tunisia. The mediation analysis was conducted using PROCESS MACRO (an SPSS add-on) v3.4 model 1, taking work fatigue as a moderator in the association between resilience and PTSS. RESULTS A total of 442 pharmacists were enrolled in this study (mean age = 33.91 ± 10.36 years) with 59.5% of them being females. The results were adjusted over country, gender, working in contact with COVID-19, working patients, working mandatory hours, working voluntary hours, age, household crowding index and number of months engaged in COVID-19. The interactions resilience by physical (Beta = 0.02; p = .029), mental (Beta = 0.02; p = .040) and emotional (Beta = 0.03; p = .008) work fatigue were significantly associated with PTSS; for pharmacists with low to moderate levels of physical (Beta = - 0.33; p < .001 and Beta = - 0.21; p = .001), mental (Beta = - 0.29; p < .001 and Beta = - 0.18; p = .006) and emotional (Beta = - 0.31; p < .001 and Beta = - 0.17; p = .008) work fatigue, higher resilience was significantly related to lower PTSS levels. However, for pharmacists with high levels of physical/mental/emotional work fatigue, the association between resilience and PTSS became non-significant. CONCLUSION This study highlights the complex relationship between work-related fatigue, resilience, and PTSS in pharmacists. It emphasizes the need to address work-related fatigue for pharmacists' psychological well-being during crises, offering insights for tailored support and interventions.
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Affiliation(s)
- Samar Younes
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Lebanese International University, Beirut, Lebanon
- Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban (INSPECT- LB), Beirut, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
- Applied Science Research Center, Applied Science Private University, Amman, Jordan
| | - Irfan Mohammed
- Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Sarah El Khatib
- Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban (INSPECT- LB), Beirut, Lebanon
- Department of Health Sciences, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - Anna Brytek-Matera
- Eating Behavior Laboratory (EAT Younes et al. BioPsychoSocial Medicine, Institute of Psychology, University of Wroclaw, Wroclaw, Poland
| | | | - Kenneth Egwu
- Faculty of Pharmaceutical Sciences, University of Nigeria, Nsukka, Nigeria
| | - Rawshan Jabeen
- Department of Research & Development, Children's Hospital Karachi, Karachi, Pakistan
| | - Nebojša Pavlović
- Department of Pharmacy, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, Novi Sad, 21000, Serbia
| | - Pascale Salameh
- Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban (INSPECT- LB), Beirut, Lebanon
- Gilbert and Rose Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
- Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
| | - Michelle Cherfane
- Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban (INSPECT- LB), Beirut, Lebanon
- Gilbert and Rose Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
| | - Marwan Akel
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Lebanese International University, Beirut, Lebanon
- Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban (INSPECT- LB), Beirut, Lebanon
| | - Chadia Haddad
- Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban (INSPECT- LB), Beirut, Lebanon
- Gilbert and Rose Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
- School of Health Sciences, Modern University for Business and Science, Beirut, Lebanon
| | - Randa Choueiry
- Department of Medicinal Sciences, Faculty of Medicine, Lebanese University, Beirut, Lebanon
| | - Feten Fekih-Romdhane
- Department of Psychiatry "Ibn Omrane", Razi Hospital, Manouba, 2010, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Katia Iskandar
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Lebanese International University, Beirut, Lebanon.
- Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban (INSPECT- LB), Beirut, Lebanon.
- Institut supérieur de santé publique de l'université Saint-Joseph de Beyrouth, campus des sciences médicales, rue de Damas, BP 11-5076, Riad El Solh, Beyrouth, 1107 2180, Lebanon.
- Faculty of Public Health-Section 2 (CERIPH), Lebanese University, Fanar, 90656, Lebanon.
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Cherfane M, Vallée A, Kab S, Salameh P, Goldberg M, Zins M, Blacher J. Risk factors for uncontrolled blood pressure among individuals with hypertension on treatment: the CONSTANCES population-based study. Int J Epidemiol 2024; 53:dyae027. [PMID: 38412540 DOI: 10.1093/ije/dyae027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 02/06/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND We aimed to assess factors associated with uncontrolled blood pressure (BP) among individuals with hypertension on treatment, by sex. METHODS We conducted a nested cross-sectional analysis using data from the population-based cohort study CONSTANCES, designed as a randomly selected sample of French adults aged 18-69 years at study inception. We included 11 760 participants previously diagnosed with hypertension and taking antihypertensive medications. Uncontrolled BP was defined as mean systolic BP ≥140 mmHg and/or mean diastolic BP ≥90 mmHg. Sex-specific age-adjusted multivariable analyses were performed using logistic regression models stratified by stages of uncontrolled hypertension. RESULTS The mean age of participants was 59.4 years. The prevalence of uncontrolled BP was 51.4%, and it was higher in men than in women [adjusted odds ratio (aOR), 1.80; 95% CI, 1.67-1.94]. In both sexes, the lower the age, the lower the prevalence of uncontrolled hypertension. Low level of education and history of cardiovascular events had, respectively, higher and lower odds of uncontrolled BP. In men, additional risk factors included overweight and obesity (aOR, 1.15; 95% CI, 1.00-1.32; and aOR, 1.45; 95% CI, 1.23-1.70, respectively), lack of physical activity (aOR, 1.20; 95% CI, 1.04-1.40), low adherence to a Dietary Approach to Stop Hypertension diet (aOR, 1.21; 95% CI, 1.05-1.40) and heavy alcohol consumption (aOR, 1.33; 95% CI, 1.08-1.63), with the last two factors persisting across different stages of uncontrolled BP. CONCLUSIONS From a population-based perspective, socio-economic and behavioural characteristics were risk factors for uncontrolled hypertension, but they differed by sex and by stage of uncontrolled hypertension. Modifiable risk factors, such as weight, diet, physical activity and alcohol consumption, have an important role in the control of hypertension.
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Affiliation(s)
- Michelle Cherfane
- Population Health Division, Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
- Nutritional Epidemiology Research Unit (EREN), Inserm U1153, Paris 13 University Sorbonne Paris Cité, Bobigny, France
- INSPECT-LB, Institut National de Santé Publique d'Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut, Lebanon
| | - Alexandre Vallée
- Faculty of Medicine, Université Paris Cité, Paris, France
- Diagnosis and Therapeutic Center, Hypertension and Cardiovascular Prevention Unit, Hôtel-Dieu Hospital, AP-HP, Paris, France
| | - Sofiane Kab
- Population-Based Epidemiological Cohorts Unit, Inserm, UMS011, Villejuif, France
| | - Pascale Salameh
- Population Health Division, Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
- INSPECT-LB, Institut National de Santé Publique d'Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut, Lebanon
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
- Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
| | - Marcel Goldberg
- Faculty of Medicine, Université Paris Cité, Paris, France
- Population-Based Epidemiological Cohorts Unit, Inserm, UMS011, Villejuif, France
| | - Marie Zins
- Faculty of Medicine, Université Paris Cité, Paris, France
- Population-Based Epidemiological Cohorts Unit, Inserm, UMS011, Villejuif, France
| | - Jacques Blacher
- Nutritional Epidemiology Research Unit (EREN), Inserm U1153, Paris 13 University Sorbonne Paris Cité, Bobigny, France
- Faculty of Medicine, Université Paris Cité, Paris, France
- Diagnosis and Therapeutic Center, Hypertension and Cardiovascular Prevention Unit, Hôtel-Dieu Hospital, AP-HP, Paris, France
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Sakr F, Safwan J, Cherfane M, Salameh P, Sacre H, Haddad C, El Khatib S, Rahal M, Dia M, Harb A, Hosseini H, Iskandar K. Knowledge and Awareness of Stroke among the Elderly Population: Analysis of Data from a Sample of Older Adults in a Developing Country. Medicina (Kaunas) 2023; 59:2172. [PMID: 38138275 PMCID: PMC10744528 DOI: 10.3390/medicina59122172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 12/03/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023]
Abstract
Background and Objectives: Stroke prevention has traditionally concentrated on research to improve knowledge and awareness of the disease in the general population. Since stroke incidents increase with age, there is a need to focus on the elderly, a high-risk group for developing the disease. This study aimed to examine the level of stroke awareness and knowledge, their predictors, and their source of information. Materials and Methods: A prospective cross-sectional study targeted Lebanese senior citizens aged 65 years and above. A total of 513 participants enrolled in the study through a self-administered survey distributed using a snowball sampling technique. Results: Most participants had appropriate baseline knowledge (more than 75% correct answers) of stroke, including risk factors, alarming signs, and preventive measures. Better knowledge of disease risks was significantly associated with having a university degree (ORa = 1.609; p = 0.029). Participants who had previous ischemic attacks showed significantly lower knowledge of the alarming signs (ORa = 0.467; p = 0.036) and prevention measures (ORa = 0.427; p = 0.029). Those suffering from depression had better knowledge of stroke alarming signs (ORa = 2.060.; p = 0.050). Seeking information from pharmacists, physicians, or the internet was not significantly associated with better knowledge of stroke risks, alarming signs, and preventive measures. Conclusions: The present study showed that seniors had fair knowledge of stroke, despite gaps in stroke prevention measures. Healthcare providers could play a leading role in improving public health by educating seniors to enhance awareness about prevention measures, detecting alarming signs, and acting fast to save a life.
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Affiliation(s)
- Fouad Sakr
- School of Pharmacy, Lebanese International University, Beirut 1105, Lebanon; (J.S.); (M.R.); (M.D.); (A.H.); (K.I.)
- UMR U955 INSERM, Institut Mondor de Recherche Biomédicale, Université Paris-Est Créteil, 94010 Créteil, France;
- École Doctorale Sciences de la Vie et de la Santé, Université Paris-Est Créteil, 94010 Créteil, France
- Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut 1103, Lebanon; (M.C.); (P.S.); (H.S.); (C.H.); (S.E.K.)
| | - Jihan Safwan
- School of Pharmacy, Lebanese International University, Beirut 1105, Lebanon; (J.S.); (M.R.); (M.D.); (A.H.); (K.I.)
- Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut 1103, Lebanon; (M.C.); (P.S.); (H.S.); (C.H.); (S.E.K.)
| | - Michelle Cherfane
- Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut 1103, Lebanon; (M.C.); (P.S.); (H.S.); (C.H.); (S.E.K.)
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos 4504, Lebanon
- College of Health Sciences, Abu Dhabi University, Abu Dhabi 25586, United Arab Emirates
| | - Pascale Salameh
- Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut 1103, Lebanon; (M.C.); (P.S.); (H.S.); (C.H.); (S.E.K.)
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos 4504, Lebanon
- Faculty of Pharmacy, Lebanese University, Beirut 1103, Lebanon
- Department of Primary Care and Population Health, University of Nicosia Medical School, 2417 Nicosia, Cyprus
| | - Hala Sacre
- Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut 1103, Lebanon; (M.C.); (P.S.); (H.S.); (C.H.); (S.E.K.)
| | - Chadia Haddad
- Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut 1103, Lebanon; (M.C.); (P.S.); (H.S.); (C.H.); (S.E.K.)
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib 1525, Lebanon
- School of Health Sciences, Modern University for Business and Science, Beirut 7501, Lebanon
| | - Sarah El Khatib
- Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut 1103, Lebanon; (M.C.); (P.S.); (H.S.); (C.H.); (S.E.K.)
- Faculty of Public Health, Lebanese University, Tripoli 1300, Lebanon
| | - Mohamad Rahal
- School of Pharmacy, Lebanese International University, Beirut 1105, Lebanon; (J.S.); (M.R.); (M.D.); (A.H.); (K.I.)
| | - Mohammad Dia
- School of Pharmacy, Lebanese International University, Beirut 1105, Lebanon; (J.S.); (M.R.); (M.D.); (A.H.); (K.I.)
| | - Ahmad Harb
- School of Pharmacy, Lebanese International University, Beirut 1105, Lebanon; (J.S.); (M.R.); (M.D.); (A.H.); (K.I.)
| | - Hassan Hosseini
- UMR U955 INSERM, Institut Mondor de Recherche Biomédicale, Université Paris-Est Créteil, 94010 Créteil, France;
- École Doctorale Sciences de la Vie et de la Santé, Université Paris-Est Créteil, 94010 Créteil, France
- Service de Neurologie, Hôpital Henri Mondor, AP-HP, 94010 Créteil, France
| | - Katia Iskandar
- School of Pharmacy, Lebanese International University, Beirut 1105, Lebanon; (J.S.); (M.R.); (M.D.); (A.H.); (K.I.)
- Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut 1103, Lebanon; (M.C.); (P.S.); (H.S.); (C.H.); (S.E.K.)
- Faculty of Pharmacy, Lebanese University, Beirut 1103, Lebanon
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Safwan J, Halat DH, Akel M, Younes S, Rahal M, Mourad N, Akiki Z, Cherfane M, Saade F, Bouraad E, Dabbous M, Sakr F. The impact of COVID-19 on the mental health of Lebanese pharmacists: A national cross-sectional study. Front Public Health 2023; 11:1156840. [PMID: 37124813 PMCID: PMC10134900 DOI: 10.3389/fpubh.2023.1156840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 03/20/2023] [Indexed: 05/02/2023] Open
Abstract
Introduction The COVID-19 pandemic has induced a global mental health crisis with variable consequences. This study aimed to assess the psychological impact of COVID-19 regarding anxiety, insomnia, depression, and response to trauma on pharmacists in Lebanon during COVID-19, and to identify factors contributing to psychological distress. Methods This was a cross-sectional study among pharmacists that involved the use of the 7-item Generalized Anxiety Disorder (GAD-7), 7-item Insomnia Severity Index (ISI), Patient Health Questionnaire 9-item depression module (PHQ-9), and Impact of Event Scale revised (IES-R) subscales. Descriptive statistical analyses were performed to determine the study distribution. The associations between the scores and the participants' characteristics were assessed using the Chi-square test. Four binary logistic regression models were used to evaluate the association between the scores and the potential confounders, followed by four multivariable logistic regressions. An alpha of 0.05 was used to determine statistical significance. Results Participants comprised 311 pharmacists from all Lebanese districts, of whom 251 (80.7%) were females and 181 (58.2%) aged between 26 and 35 years. The majority of the participants were community pharmacists (n = 178, 57.2%). A considerable proportion of participants had symptoms of anxiety (n = 128, 41.2%), insomnia (n = 64, 20.6%), depression (n = 157, 50.5%), and subjective stress (n = 227, 78.8%). Higher anxiety (aOR: 1.73, 95% CI: 1.08; 2.78, p-value: 0.02), higher depression (aOR: 3.06, 95% CI: 1.73; 5.39, p-value: 0.001), and higher stress (aOR: 1.86, 95 percent CI: 1.11; 3.14, p-value: 0.02) scores were significantly associated with pharmacists who reported that their work involves contact with infected/suspected COVID-19 patients. Interestingly, pharmacists who expressed concern about contracting COVID-19 infection had significantly higher anxiety (aOR: 2.35, 95% CI: 1.40; 3.94, p-value: 0.001) and higher depression scores (aOR: 2.64, 95% CI: 1.49; 4.67, p-value: 0.001) respectively. Conclusion The preliminary results from pharmacists in Lebanon reflect increase in stress, burden, and frustration felt by pharmacists, creating a negative impact on their mental health and well-being during the global pandemic. As frontline healthcare workers, the role of pharmacists in the community should not be overlooked, and their mental health should be well investigated.
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Affiliation(s)
- Jihan Safwan
- Biomedical Sciences Department, School of Pharmacy, Lebanese International, University, Beirut, Lebanon
- INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
- *Correspondence: Jihan Safwan,
| | - Dalal Hammoudi Halat
- Academic Quality Department, QU Health, Qatar University, Doha, Qatar
- Pharmaceutical Sciences Department, School of Pharmacy, Lebanese International, University, Beirut, Lebanon
| | - Marwan Akel
- INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
- Pharmacy Practice Department, School of Pharmacy, Lebanese International, University, Beirut, Lebanon
- School of Education, Lebanese International University, Beirut, Lebanon
| | - Samar Younes
- Biomedical Sciences Department, School of Pharmacy, Lebanese International, University, Beirut, Lebanon
- INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
| | - Mohamad Rahal
- Pharmaceutical Sciences Department, School of Pharmacy, Lebanese International, University, Beirut, Lebanon
| | - Nisreen Mourad
- INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
- Pharmaceutical Sciences Department, School of Pharmacy, Lebanese International, University, Beirut, Lebanon
| | - Zeina Akiki
- INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
| | - Michelle Cherfane
- INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
- Population Health Division, Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
| | - Faraj Saade
- Biomedical Sciences Department, School of Pharmacy, Lebanese International, University, Beirut, Lebanon
- Alice Ramez Chagoury School of Nursing, Lebanese American University, Byblos, Lebanon
- Lebanese Order of Pharmacists, Beirut, Lebanon
| | - Etwal Bouraad
- Biomedical Sciences Department, School of Pharmacy, Lebanese International, University, Beirut, Lebanon
- Department of Epidemiology and Population Health, American University of Beirut, Beirut, Lebanon
| | - Mariam Dabbous
- Pharmacy Practice Department, School of Pharmacy, Lebanese International, University, Beirut, Lebanon
| | - Fouad Sakr
- Biomedical Sciences Department, School of Pharmacy, Lebanese International, University, Beirut, Lebanon
- INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
- UMR U955 INSERM, Institut Mondor de Recherche Biomédicale, Université Paris-Est, Créteil, France
- École Doctorale Sciences de la Vie et de la Santé, Université Paris-Est, Créteil, France
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Chahine B, Cherfane M, Sakr F, Safwan J, Dabbous M, Akel M, Rahal M. Community pharmacists' perceptions and role in the management of common dermatological problems in Lebanon: a cross-sectional study. Int J Pharm Pract 2021; 29:573-579. [PMID: 34454404 DOI: 10.1093/ijpp/riab056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 08/01/2021] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To explore the types and frequency of dermatologic disorders routinely encountered by community pharmacists in Lebanon, identify their educational preparedness and confidence, reasons for referrals to dermatologists and their attitude toward the potential pharmacist role in the treatment of dermatologic disorders. METHODS A cross-sectional descriptive study was conducted between June and October 2017. It involved the use of a self-administered questionnaire, distributed to a randomly selected sample of 500 community pharmacists from all Lebanese districts. KEY FINDINGS A total of 456 pharmacists completed the questionnaire. Sixty-four per cent of participants had received a dermatology course at university and 38.7% had undertaken some form of postgraduate education in dermatology. Pharmacists believed that the most commonly encountered disorders were sunburn (22.6%) and acne (15.6%) during spring/summer and skin dryness (18.8%) followed by head lice (13.1%) during autumn/winter. Additionally, more than half of respondents reported that skin-related advice requests were 6-15% of the total advice offered to patients. Sixty-four per cent were confident or extremely confident in advising patients with dermatological complaints. Pharmacists ranked 'unsure of diagnosis' as the most common reason for patient referral to dermatologists. Pharmacists who received postgraduate dermatology training had higher self-reported confidence in tackling skin diseases and their treatments (P < 0.05). CONCLUSIONS Our study revealed that community pharmacists in Lebanon commonly encounter a limited number of dermatologic disorders and the majority believed that they can confidently advise and manage patients. Nonetheless, they admitted a gap in their dermatology education at both undergraduate and postgraduate levels.
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Affiliation(s)
- Bahia Chahine
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Michelle Cherfane
- School of Pharmacy, Lebanese International University, Beirut, Lebanon.,Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie (INSPECT-LB), Beirut, Lebanon.,College of Health Sciences, Abu Dhabi University, Abu Dhabi, United Arab Emirates
| | - Fouad Sakr
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Jihan Safwan
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Mariam Dabbous
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Marwan Akel
- School of Pharmacy, Lebanese International University, Beirut, Lebanon.,Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie (INSPECT-LB), Beirut, Lebanon
| | - Mohamad Rahal
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
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Akiki Z, Hallit S, Layoun N, Cherfane M, Sacre H, Waked M, Salameh P. Validation of the St George's respiratory questionnaire and risks factors affecting the quality of life of Lebanese COPD and asthma patients. J Asthma 2018; 56:1212-1221. [PMID: 30359153 DOI: 10.1080/02770903.2018.1531996] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Objective: We aimed to validate the Arabic version of the St George's Respiratory Questionnaire (SGRQ) for use in Lebanese Chronic obstructive pulmonary disease (COPD) and asthma patients and to identify risk factors that might affect the quality of life in these patients. Methods: COPD (n = 90) and asthma patients (n = 124) were recruited from the outpatient clinics of the Pulmonology department of a university hospital and a medical center in Beirut. They filled out a standardized questionnaire. The total SGRQ score and the component scores (symptoms, activity and impacts) were calculated. To confirm the SGRQ validity in the Lebanese population, factor analyses were applied for the whole sample, only asthma and only COPD patients, respectively. The associations between the total SGRQ score and FEV1% predicted, CCQ score and MRC scale were assessed. Multiple linear regression models were used to evaluate the association between the total SGRQ scores and the socio-demographics and the diseases risk factors. Results: COPD patients had a higher SGRQ total and subscales scores compared to asthma patients. A high Cronbach's alpha was found for the whole sample (0.802), only COPD patients (0.833) and only asthma patients (0.734). A significant negative correlation was found between FEV1% predicted and the total SGRQ scores. Occupational exposure, BMI and previous waterpipe smoking were among the factors that significantly and positively influenced a higher SGRQ score. Conclusions: The Lebanese version of the SGRQ emerges as a good health-related quality of life evaluative instrument that is reasonable to be used in COPD and asthma patients in Lebanon.
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Affiliation(s)
- Zeina Akiki
- Epidemiologie Clinique et Toxicologie, INSPECT-LB: Institut National de Sante Publique , Epidemiologie Clinique et Toxicologie, Beirut , Lebanon.,Faculty of Nursing and Health Sciences, Notre Dame Louaize University , Barsa , Lebanon.,Faculty of Public Health, Sainte Famille University , Batroun , Lebanon
| | - Souheil Hallit
- Epidemiologie Clinique et Toxicologie, INSPECT-LB: Institut National de Sante Publique , Epidemiologie Clinique et Toxicologie, Beirut , Lebanon.,Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK) , Jounieh , Lebanon
| | - Nelly Layoun
- School of Pharmacy, Lebanese International University , Beirut , Lebanon
| | - Michelle Cherfane
- Drug Information Center, Order of Pharmacists in Lebanon , Beirut , Lebanon
| | - Hala Sacre
- Epidemiologie Clinique et Toxicologie, INSPECT-LB: Institut National de Sante Publique , Epidemiologie Clinique et Toxicologie, Beirut , Lebanon.,Faculty of Medicine, Balamand University, Balamand , Lebanon
| | - Mirna Waked
- Faculty of Pharmacy, Lebanese University , Beirut , Lebanon
| | - Pascale Salameh
- Epidemiologie Clinique et Toxicologie, INSPECT-LB: Institut National de Sante Publique , Epidemiologie Clinique et Toxicologie, Beirut , Lebanon.,School of Pharmacy, Lebanese International University , Beirut , Lebanon.,Faculty of Medicine, Lebanese University , Beirut , Lebanon
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