Knowledge, Attitudes, and Practices of Healthcare Providers Towards Advance Directive for COPD Patients in Riyadh, Saudi Arabia

Background: Chronic obstructive pulmonary disease (COPD) is a significant burden in Saudi Arabia. Improving the attitudes, awareness, and knowledge of healthcare providers toward advance directives and/or advanced care planning (ACP) can increase the use of advance directives. This study aims to investigate healthcare providers' knowledge, attitudes, and practices concerning advance directives for COPD patients in Riyadh, Saudi Arabia. Methods: This cross-sectional study was employed to assess the knowledge, attitudes, and practices of healthcare providers towards ACP for COPD patients in Riyadh between June and December 2024. The questionnaire was adapted from previous research. Multiple logistic regression was performed to assess the factors associated with good knowledge and positive attitude. Results: A total of 268 participants were included in the analysis. The total mean of knowledge score was 6.96 +/- 2.22 out of 12. A total of 161 participants (60.1%) had a poor knowledge score, and 107 participants (39.9%) had a good knowledge score. The total mean of attitude score was 16.23 +/- 23.21 out of 26. A total of 148 participants (55.2%) had a poor attitude score and 120 participants (44.8%) had positive attitude. Participants with over 15 years of experience exhibited significantly higher odds of good knowledge (OR = 6.76, 95% CI = 1.03-44.21, p = 0.04). Participants who lived in the Western region had significantly lower odds of good knowledge (OR = 0.32, 95% CI = 0.14-0.71, p = 0.005). Nurses and respiratory therapists had significantly lower odds of having positive attitude (OR = 0.19, 95% CI = 0.09-0.42, p = 0.0001 and OR = 0.34, 95% CI = 0.16-0.75, p = 0.007, respectively). Participants who lived in the Western region had significantly lower odds of having positive attitude (OR = 0.42, 95% CI = 0.19-0.95, p = 0.005). Conclusions: Healthcare providers in Saudi Arabia demonstrated a moderate level of knowledge of ACP for COPD patients. This was accompanied by a moderately positive attitude towards this practice. Future studies should examine effective educational and professional interventions to enhance ACP practices.