Abstract
Background and Aims:
Wet cupping, which is known as Hijamah, is one of the most commonly practiced therapeu¬tic procedures in Saudi Arabia. Hijamah centers have been really popularized, reaching up to 119 licensed centers in the country. Despite its prevalence in the region, there is still insufficient research on such procedure. The aim of this study is to assess patients’ knowledge, beliefs, attitudes toward Hijamah, and to determine its impact on health-related quality of life.

Methods:
This is an observational, cross-sectional study. A total of 551 Saudi participants, both genders, above the age of 18 years, who were practicing Hijamah were included in this study. The data were collected through an online validated self-administered questionnaire from July 2020 to March 2021. The questionnaire requested information about age, gender, educational level, as well as the participants’ knowledge, attitude, and perceptions of cupping therapy. (SPSS Inc., Chicago, IL, USA) was used for statistical computations. Chi-square test was used to assess the associations. P-value of less than 0.05 was considered significant.

Results:
Out of 551 participants, 43.4% believe that Hijamah is an effective alternative therapy, most of them being older in age. 42.8% of diabetic participants noticed an improvement in their condition. The majority stated that Hijamah was used therapeutically, mainly for fatigue and headache. Almost all study participants (92.4%) would recommend Hijamah to others. Majority of participants (65.9%) reported they would inform their physicians before undergoing Hijamah. Lastly, (71.69 %) of participants believe their physicians did not trust in Hijamah therapy.

Conclusions:
This study shows that Hijamah is highly accepted in our society. Hijamah might have a positive impact on health-related quality of life, and might be used to treat or prevent chronic illnesses. Further future research is needed to understand the biological effects of Hijamah and to formulate an evidence-based knowledge.

Key words: Hijamah, cupping therapy, quality of life, Saudi Arabia