1.1. The Evolution and Circumstances of Coronavirus Disease 2019 (COVID-19)

A cluster of pneumonia cases emerged in Wuhan, China, in December 2019 [1]. This led to the identification of a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which spread rapidly, prompting the World Health Organization (WHO) to declare a global pandemic on March 11, 2020 [2, 3]. The virus likely originated from zoonotic transmission linked to a seafood market in Wuhan [4]. Since then, COVID-19 has had a profound global impact, with preventive measures such as mask-wearing and social distancing being implemented worldwide [2, 3, 5, 6].

The pandemic severely disrupted economies, leading to lockdowns, business closures, and border shutdowns [7]. Essential supplies, including ventilators and personal protective equipment, were in short supply during the crisis [8, 9]. The Middle East and South Africa experienced rapid virus spread due to their economic ties with China, resulting in millions of cases and deaths [10–12]. Kuwait implemented strict measures, such as curfews and quarantines, following its first COVID-19 cases in February 2020 [13, 14]. The curfews led to significant disruptions in daily life, affecting public health behaviors [15–17].

The pandemic’s economic burden has been particularly significant in less developed nations [18]. A study in Kuwait found the cost per COVID-19 patient to be KD 2216 (USD 7344), with intensive care unit (ICU) expenses comprising a large portion. The total annual cost for COVID-19 care in Kuwait was estimated at 5.5% of the 2021 healthcare budget [19]. Prioritizing prevention and optimizing healthcare systems are critical to reducing such financial strains.

1.2. Using the Knowledge, Attitudes, and Practices (KAPs) Model to Study the KAPs Regarding the Health-Related Studies

The KAPs model helps researchers understand how individual knowledge, attitudes, and behaviors affect health responses during outbreaks. KAP surveys use standardized questions to gather both qualitative and quantitative data, identifying misconceptions that may hinder behavior change. These surveys capture opinions, revealing potential gaps between what people say and do [20]. The KAP model, first applied in the 19th century, suggests that knowledge and attitudes shape behaviors, particularly in relation to infectious disease prevention efforts, which are influenced by fear and emotions [21]. In healthcare, a study found that knowledge of pain management was a significant predictor of practice among healthcare providers [22]. Another study in Malaysia revealed higher knowledge scores among female university students regarding osteoporosis [23]. Additionally, a KAP-based study in China on intervertebral disc herniation patients demonstrated improved understanding, attitudes, and behaviors after health education [24]. Thus, the KAP model aids public health efforts by shaping more effective epidemic management strategies.

1.3. Using the KAP Model to Study the KAPs of the Populations Regionally

The KAP model has been widely applied to understand COVID-19-related behaviors across various regions. A global study of 71,890 participants from 22 countries revealed that 92% had moderate to high compliance with lockdown measures [25]. In Asia, 98% of 6910 Chinese participants wore masks, with higher COVID-19 knowledge linked to better prevention practices [26]. In South Korea, knowledge directly influenced attitudes and practices [27]. Similarly, in Nepal, 93.1% avoided crowded places, and mask-wearing was linked to gender and education [28].

In Africa, educated participants in Nigeria and Tanzania demonstrated better practices [29–32]. In the Arab world, Egypt and Syria found variations in KAPs by gender and location, with females generally showing higher compliance [33, 34]. Palestinian women and West Bank residents also demonstrated greater adherence to preventive measures [35].

A Middle Eastern study involving Kuwait, Saudi Arabia, and Jordan highlighted moderate knowledge and optimism about controlling COVID-19 [36]. Specifically in Kuwait, diabetic patients showed moderate knowledge but good prevention practices, highlighting knowledge gaps that need addressing through public education [37].

1.4. Using the KAP Model to Study the KAPs of Healthcare Workers and Pharmacists

Several studies explored pharmacists’ KAPs toward COVID-19. In Pakistan, community pharmacists had sufficient knowledge but lacked appropriate attitudes and behaviors, suggesting a need for educational programs [38]. In Kisangani, pharmacy students exhibited good KAP [39]. A study in Nepal highlighted the importance of certified pharmacists and regular training, linking educational attainment with better KAP [40]. Vietnamese pharmacists showed strong COVID-19 knowledge but had regional disparities [41]. In the UAE, pharmacists demonstrated moderate knowledge and appropriate practices [42].

By employing the KAP model, the article aims to delve into the depth of pharmacists’ knowledge regarding COVID-19, their attitudes and practices toward it, and how these factors translate into their actual practices or behaviors.

2.1. Study Design

A cross-sectional survey was conducted from August 15 to August 30, 2022. Sample quantity and selection: since respondents to the questionnaire were chosen at random, a convenience sample was acquired. The minimum acceptable sample size using statistical software indicated that a sample size of 385 is representative of the infinite population [43]. A total of 400 completed surveys were considered valid for analysis.

2.2. Data Collection

Online survey forms were used to gather data from people in Kuwait because disease transmission is contagious. By sending out invitations to complete the survey, participants were chosen at random. The questionnaire was created by carefully examining pertinent research and including validated questions from earlier studies that used the KAPs model for COVID-19 assessment. To generate a link and a KAP questionnaire for data collection, the Google Forms application was utilized.

The survey consisted of 22 KAP questions, including nine questions about knowledge, four questions about attitudes, and nine questions about COVID-19 prevention and control practices.

There were two sections in the questionnaire. Demographic information, including age, gender, marital status, and educational attainment, was gathered in the first section. The 22 KAP questions, which covered subjects, including clinical presentations, COVID-19 transmission channels, and control strategies, made up the second half. In order to answer these questions, participants could select an option such as Agree/Disagree, Not Sure, or Yes/No.

Pharmacists who properly answered more than half of the questions were deemed to possess sufficient knowledge, a positive attitude, and positive practices. The categorical scale was utilized to assess the responses. A greater comprehension of COVID-19 was indicated by a higher score. Each question was limited to one response per participant.

2.3. Data Analysis

Data were entered and analyzed using SPSS v 23.0. Descriptive statistics were initially used to summarize the sociodemographic characteristics of the participants. This included calculating frequencies and percentages for categorical variables such as gender, age group, marital status, and educational level, providing an overview of the study population’s distribution.

To explore associations between sociodemographic factors and outcomes related to COVID-19 KAP, chi-square tests (χ² tests) were utilized. These tests determined whether significant relationships existed between categorical variables such as gender, age group, marital status, and educational level with adequate knowledge, positive attitude, and appropriate practice. The reported p-values indicated the statistical significance of these associations, highlighting notable disparities among different demographic groups.

Logistic regression analysis was conducted to identify significant sociodemographic determinants of KAP scores. This method provided odds ratios (ORs) with 95% confidence intervals (CIs) and p-values, which helped quantify the likelihood of having adequate knowledge, a positive attitude, or appropriate practice based on various factors such as gender, age, marital status, and educational level. These analyses revealed specific trends and significant predictors within the study population.

Correlation analysis, specifically Pearson correlation coefficients, was used to examine the relationships between continuous variables such as knowledge score, attitude score, and practice score. This analysis assessed the strength and direction of the associations between these variables, revealing that while there was a positive association between knowledge and attitude scores, attitude alone did not strongly predict actual preventive practices.

Finally, analysis of variance (ANOVA) or the Kruskal–Wallis test was likely used to compare mean scores of KAP across different age groups, marital statuses, and educational levels. These tests helped determine if there were statistically significant differences among the groups, providing further insight into how sociodemographic factors influenced COVID-19-related behaviors and perceptions.

3.1. KAP Scores Related to COVID-19

Table 2 presents the distribution of adequate knowledge, positive attitude, and appropriate practice concerning sociodemographic characteristics. Overall, 83.5% of respondents exhibited adequate knowledge, 94% demonstrated a positive attitude, and 52.5% showcased appropriate practice. Notable disparities were observed across genders, with 76.3% of males and 85.8% of females possessing adequate knowledge (p = 0.04), 91.8% of males and 94.7% of females displaying a positive attitude (p = 0.201), and 62.9% of males and 49.2% of females engaging in appropriate practice (p = 0.012). Among age groups, individuals aged 31–40 exhibited the highest rates of adequate attitude (97%) and appropriate practice (55.5%), while those over 60 showed perfect scores across all categories. The educational level also significantly influenced outcomes, with 89.6% of respondents with a master’s degree demonstrating adequate knowledge (p = 0.003), while those with a PhD showed lower rates of both adequate knowledge (71.7%) and appropriate practice (54.3%).

3.2. Knowledge Scores Related to COVID-19

Table 3 examines sociodemographic determinants of knowledge scores regarding clinical presentation, transmission, and treatment. Significant results include gender, where males exhibited lower knowledge on clinical presentation (OR = 0.94, p = 0.036) but higher knowledge on transmission (OR = 0.77, p = 0.003). Among age groups, those aged 51–60 demonstrated increased knowledge on transmission (OR = 2.08, p = 0.049), while those over 60 showed a trend toward higher knowledge on transmission (OR = 2.04, p = 0.067). Marital status revealed that being married was associated with higher knowledge on clinical presentation (OR = 1.79, p = 0.021) and treatment (OR = 1.930, p = 0.049). Additionally, having a master’s degree showed a trend toward increased knowledge on clinical presentation (OR = 1.85, p = 0.097), and a similar trend was observed for PhD holders (OR = 1.84, p = 0.097).

3.3. Attitude Scores Related to COVID-19

Table 4 investigates sociodemographic determinants of attitude scores concerning fear of COVID-19, hygiene practices, and disease control. Notable findings include gender differences, with males showing a significantly lower attitude toward hygiene (OR = 0.703, p = 0.030). Among age groups, individuals over 60 exhibited a notably higher attitude toward disease control compared to other age groups (OR = 2.017, p = 0.012). Additionally, educational level played a role, with respondents holding a master’s degree showing a lower attitude toward fear of COVID (OR = 0.728, p = 0.051) but a higher attitude toward hygiene (OR = 1.990, p = 0.015). Conversely, those with a PhD demonstrated a significantly higher attitude toward fear of COVID (OR = 1.058, p = 0.020) but not toward hygiene or disease control.

3.4. Practice Scores Related to COVID-19

Table 5 analyzes sociodemographic determinants of practice scores concerning hygiene, distancing, and vaccination behaviors. Key findings include age-related disparities, with individuals aged 31–40 showing significantly higher practice scores for hygiene (OR = 1.951, p = 0.033) compared to other age groups. Moreover, being married was associated with significantly higher practice scores for hygiene (OR = 2.079, p = 0.013). However, there were no significant associations found between gender or educational level and practice scores in any of the assessed domains. Overall, age and marital status emerged as significant determinants of practice behaviors, highlighting potential targets for tailored public health interventions aimed at promoting preventive practices during the COVID-19 pandemic.

3.5. Relationship Between KAP

Table 6 examines the relationship between KAP scores regarding COVID-19. Significant correlations were found between knowledge and attitude scores (r = 0.313, p ≤ 0.001), indicating a positive association. However, attitude scores were not significantly correlated with practice scores (r = 0.013, p = 0.801), suggesting a weak relationship between attitude and actual behavior. Similarly, knowledge scores also showed a weak correlation with practice scores (r = 0.063, p = 0.211), although not statistically significant. These results imply that while there is a positive association between knowledge and attitude, attitude alone does not strongly predict actual preventive practices, indicating the need for interventions targeting behavior change beyond knowledge and attitude enhancement.