PHS90 How Do Pharmacists Advise Diabetes Patient Self-Management During the Holy Month of Ramadan?

Abstract

Many diabetes patients choose to participate in the Ramadan fast despite medical and religious advice to the contrary. Pharmacists are accessible health care resources whose guidance can help ensure safe fasting in these individuals. The aim of this study is to describe Qatar pharmacists' current practice, knowledge, and attitudes towards diabetes medication management during Ramadan. A cross-sectional survey was administered to a convenience sample of 500 pharmacists practicing in Qatar. The 30-item questionnaire was systematically developed following comprehensive literature review. The volume and nature of pharmacist interactions with diabetes patients were explored, as were attitudes regarding pharmacist roles in diabetes care during Ramadan. Awareness and access of relevant resources was assessed and knowledge of specific therapeutic and dosing recommendations was evaluated according to the proposed diabetes medication management and patient risk-assessment strategies endorsed by international medical and religious bodies. The survey was completed by 166 (33%) pharmacists during May and June 2012. Eighty-eight (53%) were based in ambulatory care and reported somewhat more interaction (at least weekly) with diabetes patients during Ramadan than hospital pharmacists (70.4%, vs. 55.8%, p=0.08). Three-quarter of respondents had never read recommended diabetes Ramadan guidelines with 62% using internet resources as their primary reference to answer fasting-related diabetes questions. Two-thirds of respondents correctly identified how to modify oral diabetes therapy dosing during Ramadan, but just 20 (12%) did so for insulin. Despite stated barriers of workload, insufficient access to patient medical records and private counseling areas, pharmacists overwhelmingly expressed willingness to assume greater roles in diabetes patient education during Ramadan. Qatar pharmacists frequently interact with diabetes patients, but application of recommended medical guidelines for care and medication dosing for fasting patients is not optimal. Despite barriers limiting enhanced participation in diabetes patient management during Ramadan, pharmacists are interested in developing these services.