M42 Ramadan fasting for patients with chronic respiratory diseases: a systematic review and consensus recommendations for healthcare professionals
Notice bibliographique
Résumé
<h3>Background</h3> Ramadan, observed by nearly two billion Muslims worldwide, involves fasting from dawn to sunset, presenting challenges for individuals with chronic respiratory diseases due to potential risks from altered medication regimens and oral intake restrictions. This study aimed to synthesise the current evidence to develop consensus recommendations for managing patients with asthma, chronic obstructive pulmonary disease (COPD), interstitial lung disease (ILD), and bronchiectasis during Ramadan. <h3>Methods</h3> A comprehensive search of electronic databases was conducted including MEDLINE, EMBASE and Google Scholar, according to a pre-specified protocol (PROSPERO CRD42024532759) to identify studies on the outcomes of Ramadan fasting in individuals with chronic respiratory diseases. The findings informed consensus recommendations stratified by the risk of adverse outcomes using the IDF-DAR risk assessment criteria. An international expert group including both medical and religious experts, was convened to refine these guidelines, achieving consensus approval from all authors. <h3>Results</h3> 11 studies met the inclusion criteria, primarily addressing asthma and COPD, with no relevant studies found on ILD or bronchiectasis. The studies revealed that fasting did not significantly impact hospitalisation rates or lung function tests in individuals with stable asthma and COPD. However, the studies were limited by small sample sizes and methodological limitations, limiting the generalisability of findings. To develop the consensus recommendations, a multinational panel of 12 reviewers was assembled, comprising both muslim and non-muslim experts. The panel included respiratory physicians, general practitioners, and religious scholars, ensuring recommendations were both religiously sensitive and medically robust. 19 recommendations were developed to support patients considering fasting, emphasising pre-Ramadan consultations, individualised risk assessments, and adjustments to medication regimens to accommodate fasting hours. <h3>Conclusion</h3> This systematic review highlights the need for larger, well-designed, studies to better understand the implications of Ramadan fasting across chronic respiratory diseases, particularly ILD and bronchiectasis. The developed recommendations offer a structured approach to assess the risks associated with fasting, ensuring healthcare providers can offer informed and safe guidance during Ramadan. These recommendations should be applied with consideration of individual clinical judgement and patient preferences. Future research should aim to fill the gaps identified, supporting evidence-based guidelines that reconcile medical and religious considerations.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,005 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».