Hospital pharmacy practice in Lebanon is primarily centered on the operational management of medication acquisition and distribution. Despite standards pertaining to the documentation of pharmacy patient care activities set by the Ministry of Public Health for the accreditation of Lebanese hospitals, few clinical pharmacists are currently employed by Lebanese hospitals.¹ The limited number of clinical pharmacy positions deprives pharmacy students of the opportunity to experience the role of a clinical pharmacist during their experiential rotations.

The school of pharmacy (SOP) at the Lebanese American University follows the U.S. pharmacy education standards for its Pharm.D. program, which is accredited by the Accreditation Council for Pharmacy Education. As such, the school has taken the lead in developing a faculty-based clinical pharmacy practice model at its university medical center in Beirut. Launching such a practice model by the SOP required strategic planning (Figure 1).^2-4 Securing faculty readiness to pilot the implementation of clinical services was essential, given that all faculty, including the clinical coordinator, were recruited in the tenure track. Opportunities and challenges were openly deliberated, and workload adjustments were instituted to account for clinical services, which included providing direct patient care at the medical center, serving on committees, developing clinical practice guidelines and protocols, and precepting pharmacy students on their advanced pharmacy practice experiences (APPEs). Clinical pharmacy services were then implemented in January 2013, with two faculty covering infectious diseases while the clinical coordinator covered cardiology services. The number of faculty and services continued to steadily expand, reaching, in 2016, eight services, with a team of six faculty members from the SOP, 1.5 full-time equivalent (FTE) hospital-based clinical pharmacists, and two pharmacy students per faculty (Figure 2).

Services were continuously assessed by stakeholders from both academia and practice. For justification of services, interventions by pharmacy faculty and students were documented and reported to concerned administrators at the medical center. As the services expanded, the number of interventions as well as interdisciplinary collaboration on clinical initiatives increased. Between January 2013 and December 2013, the expanded services increased the number of clinical interventions from 378 to 1234, of which 77% were accepted by health care professionals.

With the successful implementation of clinical pharmacy services, the medical center’s administration has opened new lines for recruiting two FTE hospital-based clinical pharmacists. The new recruits will collaborate with the SOP to provide consistent clinical pharmacy services at the medical center. Furthermore, the SOP has recruited one additional faculty in the nontenure track, with more flexibility to render clinical services and precept APPE rotations than faculty in the tenure-track positions, with a competing commitment to scholarship. The projection for September 2016 is to have a team of seven members from the SOP and two members from the hospital rendering clinical pharmacy services.

To our knowledge, such a model of clinical pharmacy services is one of the first in Lebanon. Our experience serves as a pioneer example for practice-academia collaboration in the region.

Figure 1. Timeline and steps for clinical pharmacy service implementation.

Figure 2. Clinical pharmacy services offered between September 2012 and May 2016.

1. Pilot trial of two clinical services.
2. Medication counseling services expanded from patient discharge counseling on the use of inhalers to include counseling on parenteral and oral anticoagulants.
3. Internal medicine services coverage expanded from two floors to four floors.

1. Republic of Lebanon Ministry of Public Health. Hospital Accreditation. Available at www.moph.gov.lb/en/DynamicPages/index/3#/en/DynamicPages/view/2514/short-term-hospitals-accreditation. Accessed July 6, 2016.
2. The consensus of the Pharmacy Practice Model Summit. Am J Health Syst Pharm 2011;68:1148-52.
3. Jenkins M, Mark SM, Saenz R, et al. Director’s Forum. Developing patient-centered services, part 2: building a hybrid pharmacy practice model. Hosp Pharm 2011;46:139-45.
4. Hertig JB, Jenkins M, Mark SM, et al. Developing patient-centered services, part 1: a primer on pharmacy practice models. Hosp Pharm 2011;46:61-5.

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