KNOWLEDGE, ATTITUDE, PATTERN AND PERCEIVED BARRIERS TO USAGE OF TOPICAL MEDICATIONS AMONG PHYSIOTHERAPISTS IN SOUTH-WEST, NIGERIA

ABSTRACT There are arrays of topical medications available but there is an element of doubt on what determines the choice of usage among Nigerian physiotherapists. Few previous studies showed poor knowledge among physiotherapists but it is unknown if the trend of level of knowledge has changed. Also, there may be barriers that affects or hinders physiotherapists from effectively applying the appropriate topical application of medications. The aims of this study were to investigate knowledge of Nigerian physiotherapists on relevant topical medications and also identify the barriers that may hinder the effective use of topical medications. Ethical clearance was obtained for the study, in which 108 Physiotherapists were respondents in this cross-sectional survey. A modified questionnaire was used to obtain relevant information on knowledge, pattern of usage and barriers to the use of selected relevant topical medications to clinical physiotherapy practice. Descriptive statistics of frequency, percentage, mean and standard deviation were used to summarize the data. Chi-square test of Association was used to test the association between knowledge of topical medications and socio-demographic characteristics (gender, age, qualification and years of experience. The level of significance was set at 0.05. The result showed that the mean score of knowledge of topical medications physiotherapists scored was 16.29 ± 5.96 out of a maximum score of 42. The results on the choice of using voltaren (diclofenac diethyl amine) gel showed that 88 physiotherapists (81.5%) were correct on the choice for managing acute inflammatory disorders. Also, 55.6% and 41.7% of physiotherapists were recommending the application of topical medications to patients at any time of the day, and through use of generous application respectively while 66.7% respondents did not recommend a precise dose. Among those that were prescribing topical medications, 79.6% could not provide information on the methods of application. Furthermore, only 17 physiotherapists (13.0%) were using the required Finger Tip Unit (FTU) to quantify the dose of topical medications being prescribed. Similarly, only 14 physiotherapists (79.6%) responded to the specific question on how they determined the dose of the topical medications that were prescribed. Likewise, 56.5% did not respond on question on what determined choice of topical medication, showing evidence of lack of knowledge. 63.9%, 90.7% and 73.1% physiotherapists had previously prescribed piroxicam, diclofenac and methyl salicylate respectively. There was a very low prescription of menthol, glucosamine sulphate and Magnesium sulphate (38.0%, 29.6% and 19.6%) respectively. Most physiotherapists identified inadequate knowledge of pharmacology (60.2%), high patient workload (50.2%), poor knowledge of dosage specification (63.9%), high cost of drugs (67 63.0%), poor knowledge of pharmacology ingredients (55.6%) as major barriers hindering them from prescriptions. There were significant associations between knowledge of topical medications and gender (x2 = 29.763, p = 0.233)), age (x2 = 136.575, p = 0.009), qualifications (x2 = 38.217, p = 0.044) and years of experience (x2 = 177.328, p = 0.001). In conclusion, most Nigerian physiotherapists still have poor knowledge and negative attitude on usage and dosage specification for topical medications. Most physiotherapists had previously prescribed piroxicam, diclofenac and methyl salicylate. The barriers identified towards prescribing topical medications were inadequate knowledge of pharmacology, high patient workload and high cost of drugs.