Knowledge, Attitude, and Practice Regarding Diabetic Retinopathy Screening and Eye Management Among Diabetics in Saudi Arabia

Abstract

Background Globally, one of the leading causes of blindness is diabetic retinopathy (DR). However, many patients do not participate in DR screening because of a lack of awareness. This study aims to assess the knowledge, attitude, and practice (KAP) level regarding DR screening and eye management among diabetic patients in Saudi Arabia. Methodology This cross-sectional study was conducted among diabetic patients aged 18 years or older in Saudi Arabia between October 2022 and February 2023. A validated online KAP-36 questionnaire collected information on sociodemographic data, diabetes profile, diabetes-related complications, and KAP regarding DR screening and management. Results Of the 1,391 diabetic patients, 736 (52.9%) had good knowledge about DR screening and care, while 655 (47.1%) had poor knowledge. A positive attitude toward eye examination for the early detection of DR was noticed among 1,124 (80.8%) participants. Regarding the participants’ practice of regular fundus examination, 1,000 (71.9%) participants had good practice. Significant relationships were found between education level (p = 0.017), diabetes mellitus (DM) type and duration (p= 0.01, 0.02), type of treatment (p = 0.001), and a high degree of knowledge. Significant determinants of patients’ favorable attitudes included their type of diabetes (p = 0.003), region of residence (p = 0.038), and work or education outside the medical field (p = 0.001). Age (p = 0.001), location of residence (p = 0.015), educational attainment (p= 0.041), and type of diabetes (p = 0.045) were the factors that determined good practice. Conclusions Many diabetic patients supported DR screening and engaged in it regularly. Unfortunately, only around half of the participants had a good understanding of DR. Type 2 diabetes mellitus (T2DM), a longer history of DM, and being highly educated were factors associated with a diabetic patient’s higher level of knowledge. Positive attitudes were significantly higher among those living in the central Saudi region, employed outside of the medical field, and those with T2DM. Finally, regarding the practice of eye screening and management among diabetic patients, elderly patients living in the southern Saudi region and those with T2DM were adherent to their regular eye examinations. Consequently, the key to ensuring adequate adherence to DR screening may be intervention techniques and focused education to increase patients’ knowledge of DR.