Knowledge, attitude, and practice of patient referral among patent and proprietary medicine vendors in Obio-Akpor, Rivers state

Abstract

 Background: With the limited number of trained healthcare providers in Nigeria, PPMVs are inevitable, especially in
rural areas for the supply of drugs, and integration through appropriate referral practices is quintessential. This study
assessed the knowledge, attitude, and practice of patient referral among PPMVs in a setting with limited hospital
infrastructure.
Methodology: This cross-sectional descriptive survey was conducted in Obio-Akpor, Rivers State using a structured
questionnaire that measured the participants’ socio-demographic characteristics as well as knowledge, attitude, and
practice of patient referral. Descriptive and inferential analyses were conducted with SPSS version 25 and a p-value
≤0.05 was considered significant.
Results: Most of the respondents reported moderate knowledge, attitude, and practice (62.4%, 73.4%, and 58%
respectively) of patient referral. Multivariate analysis showed statistically significant inverse relationships between years
of experience and odds of their knowledge, attitude, and practice of referral. PPMVs with 3 years of experience reported
significantly higher odds of adequate knowledge (AOR = 178.96; 95%CI: 60.15 – 532.49; p-value <0.005), attitude
(AOR = 7.38;95%CI: (3.78 – 14.40; P-value <0.005) and practice (AOR = 131.56; 95%CI: 53.50 – 323.51; p-value
<0.005) than those with above 10 years of experience after controlling for the effects of other variables. The most
frequently reported barrier to referral was fear of losing clients while most referrals were for laboratory investigations.
Conclusion: Most PPMVs reported moderate knowledge, attitude, and practice of patient referral. PPMVs were aware
of the benefits of referrals but concerned about losing their clients to formal healthcare facilities.