Chronic diseases are a major cause of morbidity and mortality in Lebanon, straining the healthcare system. Patient empowerment is recognized as a strategy to enhance self-management and outcomes. This study aimed to develop and validate a Patient Empowerment Outcomes (PEO) scale adapted to Lebanon and to examine associated factors. A cross-sectional survey was conducted with 640 adults with chronic conditions using structured face-to-face interviews. The questionnaire included sociodemographic and behavioral items, along with four validated tools: the focused Patient Assessment of Chronic Illness Care (fPACIC), General Practice Interpersonal Care (GPIC), Health Empowerment and Self-Management (HESM), and the new PEO scale. Higher PEO scores were significantly associated with older age (B = 0.102, p = 0.002), proactive behaviors (B = 5.486, p = 0.001), and higher GPIC (B = 0.319, p < 0.0001), HESM (B = 0.681, p < 0.0001), and fPACIC (B = 0.104, p = 0.037) scores. Negative associations included greater medication burden (B =  - 0.395, p = 0.029) and health fatalism (B =  - 1.406, p = 0.008). The PEO scale is a valid, culturally adapted tool to assess empowerment in Lebanese patients with chronic diseases. Findings highlight the role of communication, self-management, and informed decision-making in guiding patient-centered interventions and policies.

Background Chemotherapy-induced peripheral neuropathy (CIPN) is a common and potentially disabling adverse effect of cancer treatment that can persist long after neurotoxic chemotherapy completion. While the physical manifestations of CIPN have been widely documented, less is known about patients' lived experiences in low- and middle-income countries. This study aimed to explore the experiences, impacts, coping strategies, and healthcare-seeking behaviors of Lebanese patients living with CIPN. Methods A qualitative descriptive study was conducted among adult cancer patients experiencing CIPN at a referral hospital in Lebanon. Semi-structured interviews were performed and audio-recorded. Interviews were transcribed verbatim and analyzed using thematic analysis. Coding was conducted independently by two researchers, and themes were identified through an iterative process. Results Nineteen patients participated in the study. Participants described a wide range of persistent sensory symptoms, including numbness, tingling, pain, burning sensations, electric shocks, and hypersensitivity, predominantly affecting the hands and feet. CIPN had substantial consequences on activities of daily living, autonomy, work life, social participation, and quality of life. Many participants reported fatigue, emotional distress, frustration, and uncertainty related to persistent symptoms and limited treatment options. Pharmacological management was perceived as largely ineffective, with gabapentinoids being the most commonly prescribed treatment despite limited evidence supporting their use. Participants frequently relied on self-directed and non-pharmacological coping strategies, including massage, exercise, and home remedies. Healthcare-seeking behaviors were characterized by a strong reliance on oncologists, limited use of multidisciplinary services, insufficient patient education regarding CIPN, and financial barriers to care. Despite these challenges, participants demonstrated considerable resilience, drawing on family support, spirituality, faith, and adaptive coping strategies to maintain their identity, independence, and hope for the future. Conclusions CIPN imposes a substantial multidimensional burden on Lebanese cancer patients, affecting physical, emotional, social, and professional functioning. Findings highlight important unmet needs regarding patient education, multidisciplinary supportive care, and equitable access to symptom management services. Strengthening supportive care pathways while considering the cultural, social, and economic realities of the Lebanese context may improve the management, lived experience and quality of life of patients with CIPN.

This study aimed to assess the comprehensiveness of existing policies, strategies, and research regarding harm reduction services for refugees and displaced populations in Lebanon, evaluating service availability, access barriers, and policy gaps to inform targeted and evidence-based interventions and improve health outcomes for this vulnerable group. A systematic review was conducted to examine substance use and harm reduction among refugees in accordance with PRISMA guidelines. The study protocol was registered in PROSPERO. PubMed, EMBASE, and Google Scholar databases were searched using free-text words and MeSH terms, including substance use, drug use, harm reduction, hepatitis C virus (HCV) screening, hepatitis B virus (HBV) screening, refugees, treatment access, and displaced population. Grey literature from the Lebanese Ministry of Public Health, World Health Organization, and other global reports was reviewed separately and included in the PRISMA flowchart, alongside peer-reviewed studies. The risk for bias in included research papers was evaluated using the Joanna Briggs Institute Critical Appraisal Tools. A total of 387 papers (369 peer-reviewed studies and 18 grey literature reports on harm reduction and substance use) were retrieved, and 29 were included in the review after screening and full-text evaluation (17peer reviewed articles and 12 grey literature reports). The results revealed a lack of structured harm reduction policies specifically targeting refugees. The identified barriers include legal restrictions, stigma, and poor integration of harm reduction services into healthcare programs. Of the 12 grey literature documents, only four mentioned harm reduction provision, and none offered a comprehensive strategy to enhance access for this vulnerable group. Many studies were general and lacked focused insights into substance use or harm reduction in refugee settings. The findings suggest that current policies require adaptation, as they inadequately address the specific vulnerabilities and barriers faced by refugee populations. Priority actions include adapting policies to refugee contexts, expanding mobile harm reduction clinics to improve accessibility, and integrating HCV screening into refugee healthcare services. Further targeted research is urgently required to characterize substance use patterns among refugees and develop evidence-informed interventions.

Conformity, the adjustment of attitudes and behaviors to align with group norms, is a key aspect of social influence, yet no validated tool exists to measure this construct in Arabic-speaking populations. This study aimed to translate, culturally adapt, and validate the Arabic version of the Mehrabian Conformity Scale (MCS) among Lebanese adults, with a secondary objective to examine its associations with relevant sociodemographic and behavioral variables. A cross-sectional online study was conducted between February and March 2025 among 460 participants recruited via snowball sampling. The 11-item MCS was translated using forward–backward translation. The Exploratory Factor Analysis (EFA) revealed a two-factor solution explaining 68.7

[This corrects the article DOI: 10.1371/journal.pone.0322554.].

BACKGROUND:The potential mediating effects of work fatigue and well-being on the relationship between personal abilities and inclusive healthcare practices among community pharmacists remain an understudied area in Lebanon. The aim is to examine the factors associated with community pharmacists' professional inclusivity and their moral/ethical attitudes. It also investigates how pharmacists' well-being and work fatigue mediate the relationship between personal abilities, specifically empathy and emotional intelligence, and the expected outcomes. METHODS:Online cross-sectional study, conducted in 2023 among 430 Lebanese community pharmacies. Inclusivity, equity, and professional integrity were evaluated using the Pharmacy Inclusivity and Accessibility Scale (PIAS-13), the Population Prioritization and Equity Index (PPEI-24), and the Professional Commitment and Integrity Scale (PCIS-15). Moral and ethical perceptions were assessed using the Ethical Pharmacy Practice Scale (EPPS-16), the Moral Exception and Blame-Avoidance Scale (MEBAS), and the short form of the Moral Expansiveness Scale (MESx). Emotional Intelligence was measured using the Wong and Law Emotional Intelligence Scale (WLEIS), empathy using the Toronto Empathy Questionnaire (TEQ), and work fatigue using the Three-Dimensional Work Fatigue Inventory (3D-WFI). Multivariable and mediation analyses were conducted to examine relationships among variables. RESULTS:Among graduate pharmacists, well-being mediated the associations between empathy, emotional intelligence, and priority assessment-a measure of inclusive practice-with β = -.02, 95% CI [-.11, -.04], P = 0.058, and β = -.03, 95% CI [-.07, .001], P = 0.013, respectively. Well-being also mediated the association between empathy and moral expansiveness (an indicator of inclusive attitudes) (β = -.02, 95% CI [.006, .079], P = 0.044). In contrast, work fatigue did not mediate any of the examined associations in this group. Among undergraduate pharmacists, work fatigue partially and negatively mediated the relationships between empathy and emotional intelligence with professional commitment and integrity, whereas well-being showed no mediating effects. CONCLUSION:This study highlights the complex interplay of factors influencing community pharmacists' professional inclusivity and moral/ethical attitudes. Both concepts were associated with emotional intelligence, empathy, and moral expansiveness. Additional research is necessary to validate these findings, investigating targeted educational interventions, in particular, to enhance inclusivity in pharmacy practice.

Background:Problematic Use of Licit Substances is an increasing public health concern in Lebanon, where political and economic instability, alongside cultural and religious diversity, may intensify risk behaviors, while social desirability and conformity can influence their reporting. This study aims to assess the profiles of participants related to social desirability and conformity pressures and their association with licit substance use and problematic use. Methods:A cross-sectional online survey was conducted among 460 adults in Lebanon (February-March 2025). Data on cigarette, waterpipe, and alcohol use were collected alongside validated measures of social desirability and conformity. A two-step cluster analysis was first conducted to determine the optimal number of clusters, followed by K-means clustering to classify participants based on their social desirability and conformity scores, with subsequent regression analyses examining sociodemographic and cluster membership correlation with substance use behaviors. Results:Three clusters emerged: Norm Internalizing Perfectionists (N = 127 (29.2%)); Detached Autonomists (N = 143 (32.9%)); and Strategic Conformists (N = 165 (37.9%)). The risk of problematic substance use was higher in the detached/autonomous phenotype and increased with age and among male gender participants, while religious prohibition appeared strongly protective. Differential results were found for waterpipe and alcohol, in comparison with problematic cigarette use. Conclusion:Considering social desirability and conformity allows for more precise identification of problematic substance use clusters, guiding targeted prevention and intervention. This complex interplay of personality traits, cultural values, age, gender, and education highlights the need for culturally sensitive, gender-specific, and cluster-tailored public health and psychosocial interventions rather than universal approaches.

Background and Aims:While pharmacists undoubtedly exert considerable influence over medication adherence and the patient experience with healthcare, a complex interplay of factors should also be considered, encompassing the sociodemographic characteristics of patients, the pharmacist-related factors, patient satisfaction, and the nature of the community pharmacy experience. This study aimed to assess the dynamics of these factors and examine their association with the adherence of patients to medications. Methods:An online cross-sectional study was undertaken from April 11 to April 27, 2023, to assess the association between community pharmacy-related experiences and patient medication adherence in a sample of 865 Lebanese adults using the Lebanese Medication Adherence Scale (LMAS-14). Results:Of all participants, 38.5% were regular visitors to the community pharmacy, and 57.7% visited the community pharmacy to obtain nonprescription medications. Almost half of the participants stated that the counseling time by the pharmacist is between 5 and 10 min (47.6%). The majority of the participants perceive the pharmacist as a medication expert (94.2%), a health counselor (81.0%), a health promoter (66.2%), and a practitioner who is patient-centered (73.3%). Older patient age (Beta = 0.08), always visiting the community pharmacy to obtain nonprescription medications (Beta = 3.63), having public health coverage (Beta = 2.37), and spending more than 10 min on counseling about a medication and/or medical condition (Beta = 3.10) were significantly associated with better medication adherence. Visiting a pharmacy to obtain chronic and nonprescription medications (Beta = -2.98) and having irregular health coverage (Beta = -2.60) were significantly associated with lower medication adherence. However, overall satisfaction with pharmacy experience was not associated with medication adherence (p > 0.05). Conclusion:Pharmacists are seen as experts in medication and holistic healthcare providers. Sociodemographic attributes and specific community pharmacy experience items influence medication adherence. While recognizing that the effects of age and health coverage can guide interventions, emphasizing the role of pharmacists, including extended counseling, could enhance medication adherence and, thus, health outcomes.

Tobacco use is a significant global public health issue, increasingly affecting low- and middle-income countries. In culturally sensitive contexts like Lebanon, self-reported smoking may be unreliable, particularly among socially restricted groups such as women and youth. This study aims to evaluate the discrepancy between perceived and actual dependence on cigarettes and waterpipes in the Lebanese population and its association with social desirability, while also examining gender differences and patterns among self-identified non-smokers and younger individuals. A cross-sectional study was conducted between February and March 2025, enrolling a total of 377 participants. Data were collected through an online self-administered survey distributed via Google® Forms, using previously validated scales for smoking dependence and social desirability assessment. The present study showed a substantial gap between self-perception and actual nicotine dependence among Lebanese youth and young adults: despite scoring high on the Lebanese Cigarette Dependence and Waterpipe Dependence scales, 10.6

This study examines the impact of program accreditation on education quality and career outcomes among students and graduates of health-related disciplines in Lebanon. In the absence of a national accrediting body, many universities seek international accreditation. Additionally, the study validates four scales measuring factors influencing university choice and perceptions of accreditation. A cross-sectional study was conducted between September and December 2023, enrolling 642 participants, including students and graduates from Lebanese health-related programs. Four validated scales included: Reasons for Choosing University Program (RCUP, 14 items), Perception of University Program Accreditation (PUPA, 12 items), Perceived Impact on Education Quality (PI-AQE, 27 items), and Perceived Impact on Career Outcomes (PI-ACO, 9 items). Principal component analysis with Promax rotation assessed construct validity. Bivariate analyses (t-tests and ANOVA) examined relationships between scales and participant characteristics. Multivariate analysis of covariance (MANCOVA) adjusted for sociodemographic and university-related factors, while multiple regression explored predictors of time to employment for graduates. Students from three universities reported significantly lower RCUP scores, indicating weaker motivations for their program choice. Clear communication of accreditation status correlated positively with RCUP (β = 1.097, p = 0.004). Pharmacy students scored higher on RCUP (β = 2.412, p = 0.002). Higher income levels (β = 1.829, p = 0.020) and awareness of accreditation (β = 2.348, p = 0.004) were linked to more favorable PUPA scores. Females (β = 4.981, p = 0.002) and high-income individuals (β = 3.777, p = 0.040) anticipated a stronger impact on PI-AQE. Graduates, particularly those with a PhD (β = 4.755, p = 0.042) or a Bachelor’s degree (β = 2.557, p = 0.003), expressed more positive PI-ACO perceptions. Conversely, uncertainty about accreditation was associated with lower PI-ACO scores (β = -3.019, p = 0.004). Notably, university accreditation status (β = -0.355, p = 0.011) and longer professional experience (β = -0.274, p = 0.010) were significantly linked to a shorter time to employment. This study validates tools for assessing accreditation’s impact on Lebanese health education. Findings emphasize that accreditation status, program choice, and demographics significantly shape perceptions of education quality and career prospects. Effective communication about accreditation may enhance career readiness and suggest potential benefits for employment prospects. These findings emphasize the importance of accreditation as a strategic tool for advancing health education quality and optimizing career prospects in the healthcare sector.

Inclusiveness in healthcare encompasses inclusivity, diversity, and equity, and is hypothesized to be affected by healthcare professionals' ethical attitudes and moral behaviors, emotional intelligence, and well-being. This study aimed to validate a battery of tests and develop a composite scale to assess inclusiveness components in pharmaceutical care among a sample of community pharmacists. A self-administered questionnaire was distributed to community pharmacists and students training in community pharmacies. The questionnaire collected participants' sociodemographic characteristics and used validated scales to assess their inclusivity, prioritization of patients, ethical attitudes, moral behaviors, emotional intelligence, well-being, and work fatigue. After confirming scale validity, clustering analysis was conducted, a composite scale was derived (VIP-Care Scale), and correlates of inclusiveness scores were identified. The validated battery comprised three components: (1) Healthcare Equity, Inclusivity, and Professional Integrity; (2) Moral and Ethical Perceptions; and (3) Psychological Wellness and Interpersonal Skills. Overall, participants demonstrated moderate levels of inclusiveness. Female gender, working in high-volume pharmacies (> 100 patients/day), and extensive experience (> 12 years) were significantly associated with higher inclusiveness scores. Conversely, lower inclusiveness was linked to working 1-16 h per week and the absence of a designated place in the pharmacy for discussing confidential information. This study could validate a battery of tests and an associated composite scale (the VIP-Care Scale) to measure inclusiveness in pharmaceutical care and identify its correlates. The scales demonstrated robust construct and structural validity in exploratory and confirmatory factor analyses, with excellent internal consistency, establishing the battery's validity and reliability. Future validation should assess test-retest reliability, cross-cultural applicability, and convergent validity.

Background:In crisis-affected settings like Lebanon, community pharmacists face mounting challenges in securing quality medications and supporting patient care. This study aims to explore the association between pharmacy services, pharmacist-patient relationships, and patient quality of life during Lebanon's ongoing socioeconomic collapse. Methods:A cross-sectional study was conducted in April 2023, using an online convenience sampling. Validated tools, including the 5-Level EuroQol (EQ-5D-5L) and EQ visual analog scale (EQ-VAS), were used to assess quality of life among a sample of 865 Lebanese adults recruited via social media platforms. Due to the absence of a national census, random sampling was not feasible, limiting generalizability. Results:Higher EQ-VAS scores were significantly associated with better financial well-being (Beta = 0.18, p < 0.001), high monthly income (Beta = 7.04, p < 0.001), regular pharmacy visits (Beta = 3.06, p = 0.035), and perceiving pharmacists as medication counselors (Beta = 5.43; p = 0.003). Lower scores were associated with a higher number of chronic diseases (Beta = -2.66; p < 0.001), obtaining chronic medications from the pharmacy (Beta = -6.20), frequent pharmacy visits for medical care or counseling (Beta = -7.00; p = 0.003), spending more than 10 min with the pharmacist for counseling about a medication and/or medical condition (Beta = -6.31). Conclusion:This study uniquely quantifies the association between pharmacist-patient interactions and quality of life in a context of systemic disruption. While previous literature has acknowledged pharmacists' roles, our findings demonstrate that their perceived counseling function and continuity of care are independently associated with improved well-being, even after adjusting for socioeconomic and health-related factors.

Introduction Self-efficacy in research and personal characteristics of pharmacists are necessary to lead and implement pharmaceutical research strategies. This study primarily aimed to confirm the validity of the Research Self-Efficacy Scale (RSES) among early-career pharmacists; a secondary objective was to assess participants' perspectives on research self-efficacy while considering personal characteristics, such as strategic thinking and leadership. Methods Using an exploratory factor analysis and internal consistency measure, the RSES scale validity and reliability were assessed among Lebanese early-career pharmacists. Its association with personal attributes, such as global self-efficacy, leadership, and strategic thinking, was also assessed through correlation with validated measures. Results The RSES scale was found to be valid and reliable. Pharmacists from foreign universities scored higher on the RSES compared to their counterparts from Lebanese institutions. Additionally, a positive correlation was found between self-efficacy, generalized self-efficacy, and strategic thinking scores, while differences between universities and year of study did not reach statistical significance. Conclusion This study demonstrated that the RSES is a valid and reliable tool for assessing research self-efficacy among early-career pharmacists in Lebanon. Several strategies could be implemented at the institutional and national levels to strengthen self-efficacy and cultivate a sustainable research environment. These include enhancing educational frameworks, integrating research opportunities, and fostering international collaborations. Future research using this validated scale will be instrumental in evaluating the effectiveness of such interventions.

In Lebanon, widespread antibiotic prescribing has led to antimicrobial resistance (AMR), a notable public health concern driven by inappropriate use. As future prescribers, medical students play a critical role in combating AMR. This study aimed to evaluate their AMR awareness and antibiotic prescribing practices, identify knowledge gaps, and suggest interventions to promote appropriate antibiotic use and limit local AMR emergence. A cross-sectional study was conducted among Lebanese medical students from July 1, 2021, to September 30, 2022. Data were collected via a structured online questionnaire using snowball sampling. The questionnaire was informed by published articles and the authors’ expertise. It included sociodemographic data and novel, context-specific scales assessing antibiotic prescribing attitudes, knowledge of AMR drivers, and prudent prescribing practices, addressing gaps in existing tools. The sample included 164 medical students, with a mean age of 22.78 ± 3.94 years. Furthermore, 89.6

Our study aims to describe the extent of caregiver burden and its associated factors among family caregivers of community-dwelling older adults in Lebanon in the context of multiple crises. During May-June 2024, a quantitative cross-sectional study was carried out in Lebanon involving 544 caregivers of older adults. Participants were recruited online via various social media platforms. Measures of the caregiving burden and related concepts were executed using validated scales and reports related to the care recipient's situation. Bivariate and multivariable analyses were conducted to investigate factors associated with caregiver burden. The findings showed that most caregivers were females with lower education levels and facing financial difficulties. Among the participants, 28% reported a severe caregiving burden, 19% a moderate burden, and 24% a mild burden. The burden of caregiving was higher when the care recipient was financially dependent on the caregiver, had dementia or chronic musculoskeletal (reduced mobility) conditions, and was not able to socially integrate. The burden was also higher when the caregiver was older, lived in a remote region, was a part-time worker, had financial distress, provided care for a longer period, used maladaptive coping strategies, had no assistance, and received lower social support. This study showed that the financial difficulties of both the caregiver and the care recipient added to the usual burden of caregiving in the Lebanese context. These findings highlight the need for targeted interventions and support systems to alleviate the burden on family caregivers in Lebanon, especially given the country's rapidly aging population, the difficult multifaceted crisis, and the limited availability of formal care services.

Background Instrumental activities of daily living (IADL) refer to activities necessary for independent living, emphasizing community-related tasks. The literature has limited measurement tools that address autonomous living in contemporary communities. Consequently, our study aimed to develop, cross-culturally adapt, and evaluate the psychometric properties of a recently updated IADL scale called the Autonomy in Daily Functioning-Contemporary Scale (ADF-CS). Additionally, it sought to examine the level of agreement between informant reports and self-reports on the ADF-CS. Method Following translation and cross-cultural adaptation, a first cross-sectional study was carried out among 544 family caregivers of community-dwelling older adults to assess the psychometric properties of the ADF-CS. The internal consistency of the scale was evaluated via Cronbach’s alpha. Content and convergent validity, factorial analysis—including confirmatory factor analysis (CFA) and exploratory factor analysis (EFA)—and known group validity were also assessed. A second cross-sectional study involving 44 paired caregivers and care recipients was conducted to examine the level of agreement in responses to the ADF-CS scale between caregivers and older adults. Response agreement was evaluated through intraclass and Cohen’s kappa correlation coefficients. Results The internal consistency of the ADF-CS and its factors was high (Cronbach’s alpha between 0.83 and 0.90). The robust positive correlation between the total ADF-CS score and the ADL score supported the convergent validity of the ADF-CS Arabic version. Moreover, the statistically significant variations in ADF-CS mean scores among various age groups and some chronic disease groups supported the scale’s known group validity. The EFA of the ADF-CS yielded a two-factor solution with an eigenvalue exceeding 1, explaining 63.13% of the variance. The CFA demonstrated that all the items in each component fit well with their intended constructs. Additionally, the intraclass and kappa correlation coefficient results were excellent, indicating robust agreement in the responses of caregivers and their respective older adults. Conclusion The Arabic version of the ADF-CS is a reliable and valid informant-reported measure for assessing IADL in older adults living in a contemporary community.

Background: Antimicrobials have revolutionized medicine globally, but emerging antimicrobial resistance due to antimicrobial misuse might revert the world to the “pre-antibiotic era”. Research on the topic contributes to fighting antimicrobial resistance and developing related strategies. Hence, this bibliometric analysis aimed to assess antimicrobial research productivity in Lebanon. Methods: Relevant publications were retrieved from PubMed, and data were assessed using the VOS viewer. The most research-active institutions, collaboration patterns, and various antimicrobial research areas were reported and discussed. Results: Research productivity has exhibited an increasing trend over the past 20 years. Private institutions were the most active (90%), while international collaborations were moderate (40%), mainly with institutions in the United States and France. The only visible public-private partnership involved collaboration between the Lebanese University and other institutions. While immunology and molecular biology-related keywords were frequently used before 2012, more clinical (treatment outcome, antimicrobial stewardship, antimicrobial resistance) and environmental cluster-related keywords appeared later, with a low occurrence of resistance and the One Health concept. Conclusion: This study assessed research productivity related to antimicrobials from Lebanese institutions; it showed the need for greater public sector involvement, expanded national and international research collaborations, and increased focus on critical concepts such as antimicrobial resistance and the One Health approach. Future studies should evaluate research quality and expand the search to additional research platforms other than PubMed for a more comprehensive understanding of the Lebanese research productivity in this field and further optimize strategic measures to combat antimicrobial resistance, optimize research agenda, and improve patient health outcomes.

Background The perception of pharmacy policymaking among early-career pharmacists is crucial for developing and advancing the profession. This study aimed to construct and validate a new tool, the Pharmaceutical Policymaking Perception Scale (PPPS), and assess pharmacy students’ and graduates’ perceptions of pharmaceutical policymaking in Lebanon.Methods A standardized questionnaire was disseminated through electronic platforms. It included sociodemographic characteristics, education-related variables, and scales measuring leadership, general self-efficacy, strategic thinking, and public service motivation. The validity of the newly developed PPPS was confirmed, and concepts were linked through multivariate analyses.Results The PPPS tool exhibited excellent psychometric properties, with its items loading on two factors representing the positive and negative perceptions of pharmaceutical policymaking. The scale demonstrated excellent reliability as well as robust content, construct, structural, and concurrent validity. Only 4% of participants scored above 70, indicating relatively low perceptions of pharmaceutical policymaking in Lebanon. Higher PPPS scores were associated with higher self-efficacy and strategic thinking, while lower scores were linked to reduced public service motivation. No association was found between PPPS and leadership.Conclusion The novel PPPS scale offers valuable insights into pharmacists’ views, enabling a more comprehensive assessment of policymaking perceptions. The potential disconnection between the studied concepts raises concerns. Further research is recommended to confirm these findings, and urgent action by educators and policymakers is essential to effectively engage with early-career pharmacists and enhance their motivation to serve the profession in challenging circumstances.