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Pharmacists’ views and reported practices in relation to a new generic drug substitution policy in Lebanon: a mixed methods study

Overview of attention for article published in Implementation Science, February 2017
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  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (88th percentile)
  • Above-average Attention Score compared to outputs of the same age and source (57th percentile)

Mentioned by

1 policy source
23 tweeters


14 Dimensions

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110 Mendeley
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Pharmacists’ views and reported practices in relation to a new generic drug substitution policy in Lebanon: a mixed methods study
Published in
Implementation Science, February 2017
DOI 10.1186/s13012-017-0556-1
Pubmed ID

Fadi El-Jardali, Racha Fadlallah, Rami Z. Morsi, Nour Hemadi, Mounir Al-Gibbawi, Magda Haj, Suzan Khalil, Youssef Saklawi, Diana Jamal, Elie A. Akl


Governments in both developed and developing countries have adopted generic drug substitution policies to decrease pharmaceutical expenditures and improve access to medicine. In August 2015, the Ministry of Public Health (MOPH) in Lebanon introduced generic drug substitution and a unified medical prescription form as policy instruments to promote generic drug use. The objective of this exploratory study was to examine the attitudes of community pharmacists and the reported practices in relation to the implementation of the new generic drug substitution policy. We used a cross-sectional mixed methods approach composed of self-administered questionnaires and semi-structured interviews. The study population consisted of community pharmacists in Lebanon. We randomly approached one pharmacy personnel from each selected community pharmacy. We conducted descriptive analyses to assess responses to questionnaire and regression analyses to understand associations between responses and respondent demographics. We analyzed qualitative data thematically. Out of 204 invited community pharmacies, 153 pharmacies participated (75% response rate). The majority of respondents (64%) were in favor of generic drug substitution; however, less than half (40%) indicated they have substituted brand drugs for generic equivalents. Moreover, 57% indicated that the existing pricing system discourages them from performing generic drug substitution. Most respondents indicated that physicians are overusing the "non-substitutable" option (84%) and that there are technical problems with processing the new prescription form (78%). Less than half (47%) reported that the MOPH is performing regular audits on the forms collected by the pharmacy. While 45% of the respondents indicated that consumers have accepted most of the generic substitutions, 21% perceived the increase in generic drug dispensing to be significant. Findings suggested a potentially significant association between being informed about generic drugs and respondents' support of the policy. Suggested strategies to address implementation challenges included strengthening stewardship function of MOPH, securing full commitment of health care providers, conducting educational and awareness campaigns about generic drugs and generic drug substitution, and aligning incentive systems of the key stakeholders. The majority of community pharmacists were supportive of generic drug substitution in general but not of the current implementation of the policy in Lebanon. Findings revealed implementation challenges at the provider, patient, and system level which are hindering attainment of the policy objectives. The key lessons derived from this study can be used for continuous improvement of the policy and its implementation.

Twitter Demographics

The data shown below were collected from the profiles of 23 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 110 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 110 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 24 22%
Student > Ph. D. Student 13 12%
Researcher 10 9%
Other 4 4%
Student > Postgraduate 4 4%
Other 15 14%
Unknown 40 36%
Readers by discipline Count As %
Pharmacology, Toxicology and Pharmaceutical Science 16 15%
Medicine and Dentistry 12 11%
Social Sciences 10 9%
Nursing and Health Professions 8 7%
Business, Management and Accounting 7 6%
Other 17 15%
Unknown 40 36%

Attention Score in Context

This research output has an Altmetric Attention Score of 18. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 01 December 2020.
All research outputs
of 21,752,314 outputs
Outputs from Implementation Science
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Outputs of similar age
of 277,489 outputs
Outputs of similar age from Implementation Science
of 7 outputs
Altmetric has tracked 21,752,314 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 92nd percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,689 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 14.6. This one has done well, scoring higher than 78% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 277,489 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 88% of its contemporaries.
We're also able to compare this research output to 7 others from the same source and published within six weeks on either side of this one. This one has scored higher than 3 of them.