title: Perspectives and experiences of patients with type 2 diabetes observing the Ramadan fast.
abstract: Diabetes is a common chronic disease among Australians. Culturally and linguistically diverse groups are observed to have higher prevalence rates of diabetes. Continuing management needs adherence to medication and diet regimens. Religious practices such as fasting can affect diabetes management and medication use. Pharmacists as medication specialists have a significant role in helping people observing religious practices such as the Ramadan fast, which involves month-long absolute abstinence from food during daylight hours, to maintain good control over their condition.
  
  
  
  This study investigated the perspective of patients with type 2 diabetes (T2D) who undertake the fast of Ramadan, to understand their experiences, health-related needs and service preferences regarding diabetes management.
  
  
  
  A qualitative, exploratory design was used in this study. Data collection comprised the conduct of semi-structured interviews with a purposive convenient sample of patients in areas of ethnic diversity in Sydney, using a standardised interview guide. Interview data were transcribed verbatim and thematically analysed.
  
  
  
  Twenty-five semi-structured interviews (68% males) among a heterogeneous sample of fasting T2D patients were conducted. Themes emerging from analysis of transcripts included issues relating to sociocultural pressure for T2D patients to fast; lack of awareness about the role of pharmacists and, most importantly, the need to train pharmacists in cultural sensitivity and clinical implications thereof.
  
  
  
  Community awareness about the role of the pharmacists in assisting medication use and adjustment during fasting periods should be enhanced. Furthermore, community pharmacists need to be trained about the unique religious and sociocultural issues of patients with diabetes opting to observe spiritual rituals such as the Ramadan fast. Clinical education in this area should up-skill pharmacists to inculcate self-management behaviours in fasting T2D patients.
authors.affiliation: a Faculty of Pharmacy , University of Sydney , Sydney , NSW , Australia.
authors.forename: Hadi A
authors.initials: HA
authors.lastname: Almansour
authors.affiliation: a Faculty of Pharmacy , University of Sydney , Sydney , NSW , Australia.
authors.forename: Betty
authors.identifier: 0000-0001-8757-9403
authors.initials: B
authors.lastname: Chaar
authors.affiliation: a Faculty of Pharmacy , University of Sydney , Sydney , NSW , Australia.
authors.forename: Bandana
authors.identifier: 0000-0002-0674-5017
authors.initials: B
authors.lastname: Saini
mesh_terms: D000328:Adult; D001294:Attitude to Health / Q000208:ethnology*; D001315:Australia / Q000453:epidemiology; D054521:Cultural Competency; D018864:Cultural Diversity; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology / Q000523:psychology; D005215:Fasting / Q000523:psychology*; D005247:Feeding Behavior / Q000208:ethnology / Q000523:psychology; D005260:Female; D006801:Humans; D007514:Islam; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D020380:Needs Assessment; D010346:Patient Care Management / Q000592:standards*; D010595:Pharmacists / Q000592:standards*; D024382:Professional Role; D036301:Qualitative Research; D012067:Religion
keywords: Ramadan; Type 2 diabetes; fasting; pharmacist; type 2 diabetes patients