Muslims’ patients’ medication use behavior and perceptions regarding collaboration with pharmacists during Ramadan

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dc.contributor.advisorBarner, Jamie C.
dc.contributor.committeeMemberBrown, Carolyn
dc.contributor.committeeMemberFord, Kentya
dc.contributor.committeeMemberRascati, Karen
dc.contributor.committeeMemberAtif, Said
dc.creatorAlshehri, Ahmed Mohammed
dc.creator.orcid0000-0002-6150-2341
dc.date.accessioned2018-10-09T17:49:10Z
dc.date.available2018-10-09T17:49:10Z
dc.date.created2018-05
dc.date.issued2018-05
dc.date.submittedMay 2018
dc.date.updated2018-10-09T17:49:10Z
dc.description.abstractThe purpose of this study was to identify factors influencing Muslim diabetic patients’ medication usage changes during Ramadan without a health care provider’s approval and to describe their perceptions of proposed pharmacists’ services during Ramadan. An anonymous survey was distributed in two languages (English and Arabic) to a convenience sample of adult diabetic Muslims at two mosques in San Antonio, TX. Andersen’s behavioral model of health services for vulnerable populations was used as the study model. Bivariate and multivariate logistic regression analysis was used to identify the impact of participants’ predisposing, enabling, need, and satisfaction with care factors on whether they changed their medication usage during Ramadan without a health care provider’s approval (no change or changing only the medication time vs. changing aspects other than the medication time). In addition, a scale of 17 items divided into four subdomains (encouragement and support regarding fasting, understanding Islamic religion/culture, creating a Muslim-friendly and welcoming environment, and modifying medications for fasting) was used to address the second objective. Descriptive statistics were performed for all the study variables and Cronbach’s alphas were performed to assess scale reliability. A total of 76 participants with diabetes completed the survey. The scales showed good to excellent internal consistency reliability (i.e., Cronbach’s alphas between 0.67 and 0.91). The independent-samples t-test showed that participants who changed their medications without health care providers’ approval had: more health care barriers (2.7 ± 0.5 vs. 2.2 ± 0.4), more diabetic complications (2.8 ± 2.2 vs 1.5 ± 0.7), and lower satisfaction with care (3.3 ± 0.9 vs 3.8 ± 0.6 ) when compared to those who did not change or changed only the time of their medications. The multivariate logistic regression showed that only health care barriers had a significant relationship with participants’ changing medication usage during Ramadan without a health care provider’s approval (Wald chi-square = 5.70, p = 0.017). As the score for health barriers increased by one unit, the odds of changing medication usage without a health care provider’s approval increased by 7.20 times (OR = 7.20, 95% CI = 1.43 – 36.4, p = 0.017). A post-hoc multivariate logistic regression analysis exploring specific barriers showed that only the health care cost barriers had a statistically significant relationship with participants’ changing medication usage during Ramadan without a health care provider’s approval (Wald chi-square = 4.37, p = 0.037). As health care cost barriers increased by one unit, the odds of changing medication usage without a health care provider’s approval increased by 2.23 times (OR = 2.23, 95% CI = 1.05 – 4.72, p = 0.037). Regarding the proposed pharmacists’ services during Ramadan, participants had positive perceptions (3.9 ± 0.7; out of 5). Participants were in favor of pharmacists better understanding their religion and culture so as to help them manage their medication while fasting during Ramadan. In conclusion, barriers related to health care, especially those related to cost, constituted the only predictor of participants’ changing medication usage during Ramadan without a health care provider’s approval. Health care providers should be aware of health care cost barriers and identify strategies that may help to mitigate them. Pharmacists and other health care providers need to know the importance of Ramadan so that they are able to advise Muslim patients who choose to fast.
dc.description.departmentPharmaceutical Sciences
dc.format.mimetypeapplication/pdf
dc.identifierdoi:10.15781/T26T0HF83
dc.identifier.urihttp://hdl.handle.net/2152/68745
dc.language.isoen
dc.subjectMuslims
dc.subjectRamadan
dc.subjectDiabetes
dc.subjectMedication adherence
dc.subjectMinorities health
dc.subjectPharmacist satisfactions
dc.subjectMedication usage behavior
dc.titleMuslims’ patients’ medication use behavior and perceptions regarding collaboration with pharmacists during Ramadan
dc.typeThesis
dc.type.materialtext
thesis.degree.departmentPharmacy
thesis.degree.disciplinePharmaceutical Sciences
thesis.degree.grantorThe University of Texas at Austin
thesis.degree.levelDoctoral
thesis.degree.nameDoctor of Philosophy

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