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Beliefs, practices and knowledge of community pharmacists regarding complementary and alternative medicine: national cross-sectional study in Lebanon
  1. Mohamad Ali Hijazi1,
  2. Hibeh Shatila2,
  3. Abdalla El-Lakany1,
  4. Maha Aboul Ela1,
  5. Samer Kharroubi2,
  6. Mohamad Alameddine3,4,
  7. Farah Naja2
  1. 1 Department of Pharmaceutical Sciences, Beirut Arab University, Beirut, Lebanon
  2. 2 Department of Nutrition and Food Sciences, American University of Beirut, Beirut, Lebanon
  3. 3 Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
  4. 4 Strategy & Institutional Excellence, Mohammed Bin Rashid University of Medicine and Health Sciences College of Medicine, Dubai, Dubai, United Arab Emirates
  1. Correspondence to Dr Mohamad Alameddine; ma164{at} and Professor Farah Naja; fn14{at}


Introduction Pharmacists are uniquely positioned to provide patients with evidence-based information in order to ensure effective and safe use of Complementary and alternative medicine (CAM) products.

Objective Assess beliefs, practices and knowledge related to CAM products among community pharmacists in Lebanon.

Design, methods and setting Using stratified random sampling, a nationally representative survey was conducted among community pharmacists in Lebanon. Through face-to-face interviews, pharmacists completed a multicomponent questionnaire consisting of four sections: (1) sociodemographic characteristics; (2) beliefs related to regulation of CAM products, role of media in promoting their safe use, availability of resources and continuing education; (3) practices including selling CAM products, providing advice for patients and reporting adverse effects and (4) knowledge about specific CAM products, their uses, side effects and interactions.

Results A total of 341 pharmacists agreed to participate (response rate: 86%). Only pharmacists with complete data were included in this study (n=310). Pharmacists agreed that CAM products are effective (63.8%) and that they should be exclusively sold in pharmacies (80.3%), but disagreed that commercially marketed CAM products are well regulated (63.5%) and that media plays a positive role in educating users about these products (55.8%). As for practices, 64.5% of pharmacists were always or often advising patients on safe use; however, 74.2% of participants rarely or never reported adverse effects. Regarding knowledge, although the majority of pharmacists were aware of the uses of CAM products, fewer knew about their side effects and their interactions with drugs. After adjustment for covariates, receiving education/training on CAM products during university was the sole predictor of higher knowledge score (ß=0.68, 95% CI 0.29 to 1.07).

Conclusions This study revealed positive beliefs of pharmacists in Lebanon towards CAM products and indicated important gaps in their practice and knowledge. Deliberate efforts to enhance the education of pharmacists are warranted to ensure the safe integration and use of CAM products in Lebanon.

  • complementary medicine
  • pharmacist
  • national cross sectional study
  • community
  • health policy
  • lebanon

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  • MA and FN contributed equally.

  • Contributors FN and MAH: designed the data collection form and the methodology. MAH: managed data collection. SK and HS: analysed the data. FN, MAH, MA and HS: wrote the first draft of the manuscript. AE and MAE: contributed to drafting the paper. All authors reviewed and approved the final version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Ethics approval This study protocol was approved by the Institutional Review Board (IRB) at the Beirut Arab University under the protocol number 2018H-0052-P-R-0249.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement A de-identified dataset related to this study could be made available with the approval of the IRB committee if necessary.

  • Patient consent for publication Not required.

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