Abstract
BackgroundMany Muslim diabetes patients choose to participate in Ramadan despite medical advice to the contrary. This study aims to describe Qatar pharmacists’ practice, knowledge, and attitudes towards guiding diabetes medication management during Ramadan.MethodsA cross-sectional descriptive study was performed among a convenience sample of 580 Qatar pharmacists. A web-based questionnaire was systematically developed following comprehensive literature review and structured according to 4 main domains: subject demographics; diabetes patient care experiences; knowledge of appropriate patient care during Ramadan fasting; and attitudes towards potential pharmacist responsibilities in this regard.ResultsIn the 3 months prior to Ramadan (July 2012), 178 (31%) pharmacists responded to the survey. Ambulatory (103, 58%) and inpatient practices (72, 41%) were similarly represented. One-third of pharmacists reported at least weekly interaction with diabetes patients during Ramadan. The most popular resources for management advice were the internet (94, 53%) and practice guidelines (80, 45%); however only 20% were aware of and had read the American Diabetes Association Ramadan consensus document. Pharmacist knowledge scores of appropriate care was overall fair (99, 57%). Pharmacists identified several barriers to participating in diabetes management including workload and lack of private counseling areas, but expressed attitudes consistent with a desire to assume greater roles in advising fasting diabetes patients.ConclusionQatar pharmacists face several practical barriers to guiding diabetes patient self-management during Ramadan, but are motivated to assume a greater role in such care. Educational programs are necessary to improve pharmacist knowledge in the provision of accurate patient advice.
Highlights
Many Muslim diabetes patients choose to participate in Ramadan despite medical advice to the contrary
Consensus statements, reviews or reports outlining diabetes patient management during Ramadan, and any research pertaining to health professional fasting diabetes patient care experience were evaluated and adapted for development of our questionnaire
Survey questions were structured according to 4 main domains: subject demographics; diabetes patient care experiences; knowledge of appropriate patient care during Ramadan fasting; and attitudes towards potential pharmacist responsibilities in this regard
Summary
Many Muslim diabetes patients choose to participate in Ramadan despite medical advice to the contrary. Fasting is not recommended for type 1 diabetes patients, those who are non-adherent to therapy or who have poor glycemic control [1]. These individuals in particular are at increased risk of hypo- and hyperglycemic episodes as well as metabolic complications associated with dehydration [2]. Many diabetes patients choose to participate despite the medical and religious advice excusing them from the Ramadan fast [3,4,5]. Recommendations for diabetes medication dosing adjustments tailored for both type 1 and type 2 diabetes patients are outlined. Despite availability of such resources, studies have identified gaps in prescribed diabetes patient care, notably inappropriate health professional discouragement towards fasting and lack of counseling regarding medications or instructions for breaking the fast [10,11,12]
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