Drug therapy for chronic diseases during the holy month of Ramadan: a literature review

Objectives: In this study, we aimed to review the drug therapy for chronic diseases during the holy month of Ramadan. Methods: In this study, we conducted an extensive search of 50 databases through the Saudi Digital Library search engine. We included meta-analysis, randomized controlled studies and observational studies published in English language in May 2017. The search terms included Ramadan, fasting, medication, therapy, type of disease, and medication based on therapeutic class. Medication list related to the gastrointestinal tract diseases, asthma and rheumatoid arthritis and the switch from regular days to Ramadan days revealed comparative safety, efficacy studies, cost of type of medication for each disease studies and national or international evidence based guidelines of switching short half-life to long half-life. All parenteral dosage form of medication were excluded from the analysis. All medications should be listed in the MOH drug formulary. Results: A total of 710 studies were obtained after an extensive search with specific terms. Of those, 104 studies were duplicate studies and 606 studies were included for further evaluation. The evaluation revealed that 27 studies investigated medications related to the gastrointestinal diseases and Ramadan and 15 studies were about medicines for asthma and rheumatoid arthritis and Ramadan. Of those 42 studies of Ramadan and chronic diseases, only 5 studies were found to be appropriate for further evaluation. The suggested draft of list of medications of chronic diseases from regular days to the Ramadan days is explored in the review. Conclusion: The guidelines medications of chronic disease (Asthma, RA, GIT disease) intake during the holy month of Ramadan is not found. The studies of drug schedules in Ramadan does not exist. The investigations about medications therapy of chronic disease are highly recommended in Muslim countries.