Knowledge, Attitude, and Practice Toward Diabetic Retinopathy Among People With Diabetes: A Systematic Review and Meta‐Analysis

ABSTRACT Purpose This systematic review and meta‐analysis aimed to evaluate the levels of Knowledge, Attitude, and Practice (KAP) regarding Diabetic Retinopathy (DR) among people with diabetes and to explore demographic and contextual factors influencing these components. Methods Following the PRISMA guidelines, we conducted a comprehensive search of PubMed, ScienceDirect, Cochrane Library, and Google Scholar, with no time restriction (updated to 2025). We included 29 questionnaire‐based cross‐sectional studies comprising 14,830 participants. Study quality was assessed using the AXIS tool. Data were analyzed using Comprehensive Meta‐Analysis (CMA) and OpenMeta [Analyst] software with a random‐effects model. Results The pooled prevalence of good knowledge, positive attitude, and good practice toward DR was 43.1%, 49.6%, and 40.0%, respectively. Subgroup analysis revealed higher KAP levels in high‐income countries compared to low‐ and middle‐income countries. Meta‐regression showed a statistically significant but minimal effect of positive attitude on good practice ( p < 0.001), while knowledge was not significantly associated with attitude ( p = 0.737) or practice ( p = 0.190). Conclusion KAP levels regarding DR remain suboptimal globally. Tailored, context‐specific interventions are essential to improve awareness and preventive behaviors, especially in resource‐limited settings.