Diabetes patient management by pharmacists during Ramadan

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.

Fasting, Diabetes, and Optimizing Health Outcomes for Ramadan Observers: A Literature Review

“…Most reported being willing to attend a workshop to learn about the adjustment of medication regimens during RamadanAmin and Chewning [20]Alexandria, EgyptCS; analyzed the responses from the above study to explore the utility of the planned behavior theory model in predicting the behavior of pharmacists towards adjusting medication regimens for patients during RamadanRandom sampling out of a list of 3309 community pharmacies in Alexandria277 pharmacists93%Sample pharmacists were more likely to change simpler aspects of patient medications (e.g., dose regimen changes, rather than recommending a different class of medications). In this sample, current practice was limited to minimal intervention delivery, which is perhaps reflective of provider confidenceWilbur et al [45]QatarCS descriptive study using a Web-based custom developed questionnaire that contains items focussed on pharmacist attitudes towards appropriate patient care and knowledge about medication adjustments for patients with diabetes who were undertaking the Ramadan fast. This was completed by participants 3 months prior to Ramadan 2012Convenience sample obtained from Qatar University College of Pharmacy—internal pharmacist database178 pharmacists31%Pharmacists reported frequent encounters with patients who have diabetes during Ramadan.…”

Knowledge of diabetes mellitus and safe practices during Ramadan fasting among Muslim patients with diabetes mellitus in Singapore

“…medication adjustment) prior to the month-long fast. (17) Structured education and interventional programmes, for both Muslim patients with DM and healthcare professionals involved in the care of these patients, (18)(19)(20)(21) are important to bridge the knowledge gap and to correct inappropriate practices so that the complication rates observed among these patients during Ramadan can be reduced.…”

“…Section 1 tested the patients' general knowledge of DM using a modified, 16-item version of the validated Michigan Diabetes Knowledge Test (MDKT). (9) All of the questions from the original MDKT were retained, except for Questions 4,15,17,18,19,21 and 23, and one option each in Questions 1 and 2 were modified to better suit the Singapore population (Appendix). The patients were required to select the best answer for each of the 16 multiple-choice questions.…”

Managing medications during Ramadan fasting

“…15 That said, research in other predominantly Muslim countries, such as Qatar and Pakistan, has shown that pharmacists and physicians with a good knowledge of Islam still have knowledge gaps about how to adjust medications safely. [16][17][18] In other words, there is plenty of opportunity to support Muslim patients during Ramadan, but we all have a lot to learn about how to do so safely.…”