title: Predicting pharmacists' adjustment of medication regimens in Ramadan using the Theory of Planned Behavior.
abstract: BACKGROUND
  During Ramadan, many Muslim patients may choose to abstain from food, drink and oral medications from dawn to sunset.
  
  
  OBJECTIVE
  This study explored the utility of the Theory of Planned Behavior (TPB) model in predicting community pharmacists' Medication Regimen Adjustment (MRA) behavior for patients during Ramadan.
  
  
  METHODS
  A sample of pharmacists was drawn from a recent list of community pharmacies in the Alexandria governorate. A cross-sectional, self-administered survey was completed by community pharmacists to determine their attitudes and behaviors regarding adjustment of medication regimens around Ramadan. Multiple linear regression was used to predict MRA as a function of the TPB constructs and four other factors - "pharmacist initiation of the conversation on MRA," "number of hours worked," "age," and "religion" of pharmacist.
  
  
  RESULTS
  Two hundred seventy-seven (92.9%) of the 298 approached pharmacists participated. While 94.2% reported performing one or more kinds of MRA around Ramadan for at least one patient, the majority of these were for a small percentage of patients. The most common MRA was changing the frequency of taking the medication followed by the dose of the medication, the dosage form of the medication and the medication itself. Statistically significant predictors of MRA in the final model included patient social pressure (PSP) (β = 0.274, P < 0.001), pharmacist perceived behavioral capability (PBC) (β = 0.217, P < 0.001), pharmacist perceived patient benefit (PPB) (β = 0.207, P = 0.001), initiating communication (β = 0.167, P = 0.001) and the number of working hours (β = 0.145, P = 0.005).
  
  
  CONCLUSIONS
  The TPB appears to have utility in predicting pharmacists' MRA behavior. Pharmacists may be open to a larger MRA role than they are currently performing. There is a need to prepare pharmacists who are frequently requested to adjust patients' medication regimens to make sure they provide a safe transition for fasting patients into and out of Ramadan.
authors.affiliation: School of Pharmacy, University of Wisconsin-Madison, Madison, WI 53705-2222, USA; Sonderegger Research Center, School of Pharmacy, University of Wisconsin-Madison, Madison, WI 53705-2222, USA. Electronic address: mohamedezzat21@gmail.com.
authors.forename: Mohamed E K
authors.initials: ME
authors.lastname: Amin
authors.affiliation: School of Pharmacy, University of Wisconsin-Madison, Madison, WI 53705-2222, USA; Sonderegger Research Center, School of Pharmacy, University of Wisconsin-Madison, Madison, WI 53705-2222, USA.
authors.forename: Betty
authors.initials: B
authors.lastname: Chewning
mesh_terms: D003157:Community Pharmacy Services; D004334:Drug Administration Schedule; D005215:Fasting; D005247:Feeding Behavior; D006801:Humans; D007514:Islam; D010595:Pharmacists
keywords: Egypt; Medication; Pharmacist; Ramadan; Theory of Planned Behavior