Knowledge, Attitude, and Practice of Patient Referral among Patent and Proprietary Medicine Vendors in Obio-Akpor, Rivers State.

Background: With the limited number of trained health care 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.