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Background Saudi Vision 2030 is transforming the country's healthcare system, with efficacy, accessibility, and patient satisfaction with healthcare services serving as key indicators for assessing patient care quality. As blindness and impaired vision continue to be a rising health issue in most Eastern Mediterranean Region (EMR) nations, including Saudi Arabia, this study focused on measuring patient satisfaction with healthcare services in ophthalmology clinics. Objectives This study aimed to assess the level of patient satisfaction with healthcare services in ophthalmology clinics and its related factors in the Makkah region of Saudi Arabia in 2022-2023. Methods A cross-sectional study was conducted on a convenience sample of 553 Saudi and non-Saudi patients, aged 18 years and older, who attended private and government ophthalmology clinics in the Makkah region of Saudi Arabia during the period between November 2022 and February 2023. A self-administered questionnaire was distributed on several electronic platforms like WhatsApp, X (formerly known as Twitter), Telegram, and Snapchat to collect the data. Finally, all the data were entered and analyzed through the IBM SPSS software version 26. Results A total of 553 responses were obtained. The majority were aged between 18 and 35 years old (76.5%, n=423), with the female gender being dominant (79.7%, n=441). More than half of them (52.3%, n=289) preferred to receive ophthalmological healthcare services from governmental hospitals. The most commonly diagnosed eye disease was refractive error (43.2%, n=239). Patient satisfaction with healthcare services provided in ophthalmology clinics represented 75% (n=415). The odds of being satisfied with ophthalmology clinics are expected to decrease by at least 44% among individuals over the age of 35 (odds ratio (OR) =0.437; 95% CI=0.257-0.743; p=0.002). Moreover, those who had been married were predicted to decrease the chance of being satisfied by at least 50% compared to patients who had never been married (OR=0.538; 95% CI=0.352-0.823; p=0.004). Compared to students, patients who were currently employed were predicted to decrease the chance of being satisfied by at least 48% (OR = 0.481; 95% CI=0.270-0.856; p=0.013). Additionally, those with a higher monthly income had decreased odds of being satisfied by at least 58% (OR=0.583; 95% CI=0.381-0.893; p=0.013). In contrast, compared to patients with associated comorbidity, patients who have no comorbidity were predicted to have an increased chance of being satisfied by at least two-fold than those who had comorbidities (OR=2.023; 95% CI=1.199-3.413; p=0.008). Conclusions The study concludes that 75% of the patients attending ophthalmology clinics in the Makkah region of Saudi Arabia were satisfied with the healthcare services provided in these clinics. Most patients acknowledged the time of care, doctors' professionalism, continuity of care, comprehensive examination, and their education about their disease and management, in addition to doctors listening to them during their visits to ophthalmology clinics. Factors affecting patient satisfaction with medical services in ophthalmology clinics are patient age, occupation, marital status, monthly income, and associated comorbidities. Further studies are recommended to deeply understand patients' needs and obtain more suggestions to be fully satisfied with healthcare services in ophthalmology clinics and other different healthcare facilities.
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PURPOSE: The traditional standard of care for Graves' ophthalmopathy (GO) is glucocorticoid therapy, which is associated with many long-term side effects. The aim of this systematic review and meta-analysis was to compare the traditional therapy to novel monoclonal antibodies (e.g. rituximab [RTX], teprotumumab, and tocilizumab [TCZ]). METHODS: We searched the Medline, Embase, and Cochrane Central Register of Controlled Trials databases. We included randomized controlled trials (RCTs) that compared different monoclonal antibodies (e.g. RTX, teprotumumab, and TCZ) with glucocorticoids or placebo in patients with GO. We evaluated the clinical activity score (CAS), proptosis, subjective diplopia using the Gorman score, quality of life (QoT), adverse events, change in lid fissure, NOSPECS score, and TSH receptor antibody (TRAb) levels. The odds ratio (OR) was used to represent dichotomous outcomes. The continuous outcomes were represented as standardized mean difference (SMD). Data were pooled using the inverse variance weighting method. Risk of bias was assessed using the revised Cochrane risk-of-bias tool for randomized trials. RESULTS: Six (n = 571) RCTs were deemed eligible. The different monoclonal antibodies were significantly more efficacious than glucocorticoid/placebo in terms of reduction in CAS (SMD = -1.44, 95% confidence interval (CI): -1.91--0.97, P < 0.00001, I2 = 74%), change in proptosis (SMD = -4.96, 95% CI: -8.02--1.89, P = 0.002, I2 = 99%), QoL (SMD = 2.64, 95% CI: 0.50-4.79, P = 0.02, I2 = 97%), and Gorman score for diplopia (OR = 3.42, 95% CI: 1.62-7.22, P = 0.001, I2 = 8%). However, monoclonal antibodies have shown higher rates of adverse events (OR = 2.91, 95% CI: 1.12-7.56, P = 0.03, I2 = 62%). No significant difference was found with respect to lid fissure, NOSPECS, and TRAb levels. CONCLUSION: This meta-analysis demonstrated that monoclonal antibodies were associated with more favorable clinical outcomes than standard steroid therapy or placebo, especially with regard to CAS, change in proptosis, diplopia, and QoL, with teprotumumab being superior. In addition, only minor safety concerns were identified with monoclonal antibodies though less worrisome than using traditional steroids.
