‘Fasting and prayer don't concern the doctors … they don't even know what it is': communication, decision-making and perceived social relations of Pakistani Muslim patients with long-term illnesses

Shared understanding about the context in which patients manage long-term conditions is a precursor to effective lay-professional partnerships. Religious identity influences the health beliefs and practices of many British Pakistani Muslim patients. Failure to acknowledge and discuss this influence on long-term illness management leads to a vacuum in professional knowledge, inadequate support for patients' decision-making and poor responses to their requests for assistance. Findings indicate a need for practitioners to initiate more open discussion and raise questions about the pathways leading to higher rates of complications and the relationship between social status and health inequalities in this population.