Conceptualisation and Role of Market Access in Pharmaceutical Industry: A Scoping Review.

BACKGROUND: Understanding the concept and dynamic process of the evolution of professional identity and roles of market access (MA) in the pharmaceutical industry (pharma) is critical to personal, interpersonal, and professional levels of development and impact. OBJECTIVE: The aim was to carry out a scoping review of the conceptualisation of MA within pharma. DATA SOURCES: BioMed Central, WorldCat.org, and Directory of Open Access Journals were searched from 2003 to 2023. STUDY SELECTION: All articles on concepts or definitions and other surrogate terms on MA in pharma were selected. DATA EXTRACTION: Keywords generated from an initial cursory literature search on MA in pharma were used in conjunction with AND/OR as search terms. Using the data charting method, key findings were mapped and summarised descriptively. inductive analysis was performed, allowing codes/themes that are relevant to the concept to emerge. DATA SYNTHESIS: Arskey and O'Malley's six-stage framework and the PRISMA extension for scoping reviews extension checklist were used as the review and reporting templates. The databases search yielded 222 results. Following title and abstract screening, a total of 146 papers were screened, and 127 of them were excluded. Full-text review was conducted for 19 papers that were deemed by two reviewers to meet the eligibility criteria. One of the authors arbitrated on disputed papers for inclusion. Only 14 of the included papers were found to meet the criteria for the final analysis. Five conceptual dimensions of MA in pharma were identified as "right products", "right patient", "right price", "right point" (time), and "right place" (setting). CONCLUSIONS: Market access in pharma is a process that commences with the development and availability of the right products that are proven to be efficacious and disease/condition-specific (including medications, medical devices, and vaccines); specifically produced for the right patients or end users who will maximise best clinical outcomes and economic value; delivered at the right point in a timely, sustained, and efficient manner, given at the right price (commercially viable or reimbursed price that represents good value); and conducted within the economic, policy, societal, and technological contexts, with the overarching goal of achieving the best patient outcomes and ensuring product profitability.

Social presence and dynamics of group communication: An analysis of a health professionals WhatsApp group chats.

WhatsApp has become a medium of communication with the potential of promoting collaborative environment with peers, patients and general population. Till date, no analysis of professional WhatsApp groups' activities exists in physiotherapy. The official WhatsApp group chats of the Association of Clinical and Academic Physiotherapists of Nigeria (ACAPN) was analyzed. A total of 20760 chats were gleaned from July 2020 to June 2021. Videos, audios and emoticons were excluded in the analysis. Administrative permission to conduct was obtained from ACAPN leadership. Two consenting physiotherapists who had never deleted their ACAPN group chats shared and exported all chats to a Gmail. The social presence theory for group communication was used as the framework of analysis. Thematic content analysis was used to analyze qualitative data. Descriptive statistics of frequency and percentages were used to summarize data. Based on social presence theory classifications, interactive messages (64.5%) followed by cohesive messages (30%) were predominant. Members used the platform more for expression of emotions affectively (100%), referring explicitly to others' messages interactively (56.6%) and for greetings (phatic and salutation) cohesively (61.8%). Qualitative themes indicate that all three categories of social presence theory communications were present sufficiently with interactive category being the most common, as members used the WhatsApp platform to interact, construct and share knowledge. Group WhatsApp platform is a veritable means of communication and an indicator of level of social presence among Nigerian physiotherapists. Communication among Nigerian physiotherapists is mostly interactive, then cohesive and affective in terms of dynamics.

Cost effectiveness of virtual reality game compared to clinic based McKenzie extension therapy for chronic non-specific low back pain.

Background: Low-back pain (LBP) is a major public health problem globally and its direct and indirect healthcare costs are growing rapidly. Virtual reality involving the use of video games or non-game applications are alternatives to conventional face-to-face physical therapy for LBP. The purpose of this study was to assess the cost-effectiveness of Back Extension-Virtual Reality Game (BE-VRG) compared to Clinic-based McKenzie therapy (CBMT) for chronic non-specific LBP in Nigeria. Methods: Patients with chronic non-specific LBP were randomised into either BE-VRG or CBMT group. Patients' level of disability was assessed using Oswestry Disability Index (ODI) at week 4 and week 8. ODI was mapped to SF-6D to generate quality adjusted life years (QALYs) used for cost-effectiveness analysis. Resource use and costs were assessed based on rehabilitation services from a healthcare perspective. Cost-effectiveness analysis which included direct healthcare costs was conducted. Incremental cost per QALY was also calculated. Results: Forty-six patients (BE-VRG, n = 22; CBMT, n = 24) with the mean (±SD) age of 32.6 ± (11.5) years for BE-VRG and 48.8 ± (10.2) years for CBMT intervention completed in this study. The mean direct health costs per patient were USD100.67 and USD106.3 for BE-VRG and CBMT, respectively. The mean quality adjusted life years at week 4 and week 8 were (BE-VRG, 0.0574 ± (0.002); CBMT, 0.0548 ± (0.002)); and (BE-VRG; 0.116 ± (0.002); CBMT; 0.114 ± (0.004)), respectively. Incremental cost-effectiveness ratio showed that BE-VRG arm was less costly and more effective than CBMT. Conclusion: The findings of this study suggest that BE-VRG was cost saving for chronic non-specific LBP compared to CBMT. This evidence could guide policy makers, payers and clinicians in evaluating BE-VRG as a treatment option for people with chronic non-specific LBP.

Prevalence, pattern and risk factors for work-related musculoskeletal disorders among Nigerian plumbers.

Plumbing work is more manually driven in low-and-middle income countries (LMICs), and the prevalence of work-related musculoskeletal disorders (WMSDs) among workers who engage in plumbing in LMICs may be worse than earlier reports from developed countries. This study aimed to assess the prevalence, pattern and risk factors for work-related musculoskeletal disorders (WMSDs) among Nigerian plumbers. A total of 130 consenting plumber participated in this cross-sectional study. The Nordic Musculoskeletal questionnaire and the Job Factor Questionnaire were used to assess information on prevalence and pattern of WMSDs; and perceptions regarding work-related risks factors for WMSDs. Descriptive (mean, frequency, range, percentage and standard deviation) and inferential (Chi-square) statistics were used to analyze data. Alpha level was set at p<0.05. The mean age of the respondents is 36.56 ± 10.418 years. The mean years of experience and working hours per day are 14.15 ± 9.161 years and 8.28 ± 2.512 hours. Job characteristics were mostly installation of pipes and fixtures (99.2%), equipment and fixtures prior to installation (96.9%), and testing of plumbing system for leaks (88.5%). 12-month and 7-day prevalence of WMSDS were 84.6% and 50.8%. Low-back (63.8%), neck (55.4%) and knee (50%) were the most affected body sites. Having WMSDs limits normal activities involving the low-back (32.3%), knee (25.4%) and neck (23.8%). There was significant association between 12-month prevalence of WMSDs and use of saws and pipe cutters (χ2 = 4.483; p = 0.034), while sites of affectation had significant association with 12-month and 7-day prevalence of WMSDs (p<0.05) respectively. Nigerian plumbers have a high prevalence of WMSDs affecting most commonly the low back, neck and knee. Plumbing job factors pose mild to moderate risk to developing WMSDs, and use of saws and pipe cutters significantly influence WMSDs.

Translation, Cross-Cultural Adaptation, and Psychometric Testing of Yoruba Version of the EQ-5D Questionnaire in Patients With Musculoskeletal Disorders.

Background: The EuroQol-5 Dimension (EQ-5D) is a generic self-administered questionnaire used for the measurement and economic valuation of a wide range of health conditions, which necessitates its existence and adaptation in different languages. Currently, the tool does not exist in any Nigerian language. This study aimed to translate, cross-culturally adapt, and determine the reliability and validity of the Yoruba version of the EQ-5D-5L questionnaire. Methods: The International Quality of Life Assessment (IQOLA) project guidelines, involving forward translation, reconciliation and harmonization, backward translation, and reconciliation of problematic items were used in the Yoruba translated version of the EQ-5D-5L (EQ-5D-Yor). A total of 113 and 109 persons with musculoskeletal disorders participated in the validity and 7-day test-retest reliability testing of the EQ-5D-Yor. Convergent and discriminant validity of the EQ-5D-Yor were determined using the Yoruba version of the 12-Item Short-Form Health Survey (SF-12) (SF-12-Y) and Visual Analog Scale (VAS). Data were analyzed using descriptive and inferential statistics of Spearman correlation, Intra-Class Correlation, Cronbach alpha, and multi-trait scaling analysis. Alpha level was set as p < 0.05. Results: The construct validity of the EQ-5D-Yor yielded Spearman rho ranging from 0.438 to 1.000, with the EQ-VAS having the highest co-efficient (r = 1.000; p = 0.001). The convergent validity of the EQ-5D-Yor index with scales and domains of the SF-12-Y yielded no significant correlations (p < 0.05), except for the physical functioning scale (r = -0.709, p = 0.001). On the other hand, the divergent validity of the EQ-5D-Yor index with VAS yielded a moderate negative correlation (r = -0.482; p = 0.001). The Intra-class Correlation Coefficient (ICC) and Cronbach's alpha for the test-retest reliability of the EQ-5D-Yor were 1.000 and 0.968. The confirmatory factor analysis showed the factor loadings were poor when including VAS in the model. Conclusion: The EQ-5D-Yor has acceptable validity and reliability and can be used as a valid tool among Yoruba speaking population with musculoskeletal disorders.

A systematic review of economic models for cost effectiveness of physiotherapy interventions following total knee and hip replacement.

BACKGROUND: Osteoarthritis is a primary cause of pain and disability, and it places a considerable economic burden on individuals and the society. In the management of total knee or hip replacement (TKHR), the long-term effectiveness of physiotherapy interventions may slowly accumulate over a period. OBJECTIVES: To evaluate all the model-based cost-effectiveness (CE) of physiotherapy interventions for patients with (TKHR). DATA SOURCES: A literature search was carried out on AMED, MEDLINE, CINAHL, DARE, HTA, NHSEED and cost-effectiveness registry databases from inception to May 2021. STUDY SELECTION: Studies that assessed model-based CE of physiotherapy interventions following TKHR and were published in English language. The methodological quality of the included studies were assessed using the Philips Checklist criteria. DATA EXTRACTION/DATA SYNTHESIS: Two reviewers, using a predefined data extraction form, independently extracted data. A descriptive synthesis was used to present the results. RESULT: Eight hundred eighty-six studies were identified, and the only 3 that met the inclusion criteria were included. Different model structures and assumptions were used in the included studies. The included studies were conducted in the United States of America (n=1), Singapore (n=1) and Italy (n=1). The societal (n=2) and healthcare (n=1) perspective were adopted in the studies. The included studies reported an incremental cost effectiveness ratio (ICER) of $57,200 and 27,471 Singapore dollar (SGD) per quality-adjusted life years in a time horizon of lifetime and three months, respectively. Physiotherapy (hydrotherapy) interventions were potentially cost-effective. CONCLUSION: Based on the best available evidence, the findings of this review suggest that physiotherapy interventions were CE and cost saving. However, it is important to note that among others the CE of the interventions was a function of the healthcare system, duration of interventions, patient compliance and price. SYSTEMATIC REVIEW REGISTRATION NUMBER CRD: CRD42019151214.

Itinerário terapêutico de pacientes com dor lombar crônica atendidos em ambulatório de fisioterapia / Therapeutic itinerary of patients with chronic low-back pain attending outpatient physiotherapy clinic

Objetivo: avaliar o itinerário terapêutico de pacientes com lombalgia crônica. Métodos: estudo qualitativo envolvendo a utilização de entrevista semiestruturada em profundida-de, para coleta de dados sobre o itinerário terapêutico de dez pacientes com lombalgia crônica atendidos em clínica de fisioterapia de um hospital terciário. Os dados foram analisados por meio da análise de conteúdo temática. Re-sultados: os temas emergentes foram: início da dor lombar, sintomas que iniciaram a jornada para o cuidado, etapas to-madas para encontrar alívio para a dor, percepção do entre-vistado sobre o atendimento recebido, interferência da dor na vida normal, família e relações, práticas múltiplas nas quais pacientes com dor lombar crônica se envolvem, per-cepção da eficácia das múltiplas práticas e obstáculos para buscar atendimento. Conclusão: pacientes com dor lombar crônica seguem caminhos diferentes em busca de atendi-mento. A dor lombar crônica alterou significativamente a vida dos pacientes e os tornou propensos a praticar o plu-ralismo médico. (AU)

Awareness, Attitude and Expectations of Physiotherapy Students on Telerehabilitation.

BACKGROUND AND OBJECTIVE: Explosion in information technology knowledge and utilization among young people, referred to as digital natives, seems less explored in the health sector and training. This study was aimed to assess awareness, attitude and expectations of physiotherapy students on telerehabilitation. METHODS: This cross-sectional survey employed systematic probability sampling technique to recruit 200 physiotherapy students. A self-developed questionnaire which was tested for its face and content validity was used to obtain data. Data was analysed using descriptive and inferential statistics. Alpha level was set at p < 0.05. RESULTS: The mean age of the respondents was 21.2 ± 2.04 years. There was higher prevalence of moderate awareness (43%) and positive attitude towards telerehabilitation (39%). Majority of the respondents (62%) had high expectation towards future telerehabilitation products and services. There was significant association between level of awareness of telerehabilitation and age (X 2 = 7.119; p = 0.001). DISCUSSION: The responding students in this study are by age in the class of digital natives, who should be conversant with technology. This could account for the higher moderate level of awareness of telerehabilitation. However, the higher rates of negative attitude towards telerehabilitation could be attributed to prevailing barriers to its utilization in Nigeria. Nonetheless, a large percentage of the students had high expectations for the future of telerehabilitation. CONCLUSION: Nigerian physiotherapy students have moderate awareness and high expectation for future telerehabilitation applications. However, a larger number of them hold negative attitude towards it use.

Validation of the Yoruba Version of the Pain Self-Efficacy Questionnaire in Patients with Chronic Low Back Pain.

STUDY DESIGN: Cultural adaptation and psychometric analysis. OBJECTIVE: This study determined the test-retest reliability, acceptability, internal consistency, divergent validity of the Yoruba pain self-efficacy questionnaire (PSEQ-Y). It also examined the ceiling and floor effects and the small detectable change (SDC) of the PSEQ-Y among patients with chronic low back pain (LBP). SUMMARY OF BACKGROUND DATA: There are various indigenous language translations of the PSEQ and none adapted to African language. However, translations of the PSEQ into Nigerian languages are not readily available. METHODS: The validity testing phase of the study involved 131 patients with LBP, while 83 patients with LBP took part in the reliability phase. Following the Beaton recommendation for cultural adaptation of instruments, the PSEQ was adapted into the Yoruba language. The psychometric properties of the PSEQ-Y determined comprised: internal consistency, divergent validity, test-retest reliability, and SDC. RESULTS: The mean age of the participants was 52.96 ±â€Š17.3 years. The PSEQ-Y did not correlate with the Yoruba version of Visual Analogue Scale (VAS-Y) scores (r = -0.05; P = 0.59). The values for the internal consistency and the test-retest reliability of the PSEQ-Y were 0.79 and 0.86, with the 95% confidence interval of the test-retest reliability ranging between 0.82 and 0.90. The standard error of measurement (SEM) and the SDC of the PSEQ-Y were 1.2 and 3.3, respectively. The PSEQ-Y had no floor or ceiling effect, as none of the respondents scored either the minimal or maximal scores. CONCLUSION: This is the first study in Nigeria to culturally adapt PSEQ. The PSEQ-Y showed adequate psychometric properties similar to existing versions. Therefore, the tool can be used to assess pain self-efficacy in clinical and research settings and help to improve the health outcomes of patients chronic LBP.Level of Evidence: 3.

Economic Impact of COVID-19 lockdown on households.

INTRODUCTION: this study evaluated the economic impact of the COVID-19 lockdown on individuals and households. METHODS: a cross-sectional online survey was used to collect data. Nigerian citizens who were domiciled or restricted from travelling abroad for no less than one month since the COVID-19 restrictions and lockdown were recruited into the study through focal persons purposively selected across the different states in Nigeria. Using WhatsApp® platform, the respondents completed the survey on household income and expenditure before and during the lockdown. Economic burden of COVID-19 lockdown on individuals and families was estimated using a prevalence-based cost of illness approach. RESULTS: four hundred and four (male = 242; female = 162) individuals have participated in the study. The mean (SD) age of the respondents was 30.98 (10.92) years. Monthly income showed no statistically significant difference (p = 0.73) before and during lockdown. The overall household expenditure before and during the lockdown periods were USD 320 and USD 290. The total mean monthly costs for COVID-19 and non-COVID-19 health related problems were ₦11746.25 (USD30.79) and ₦11784.9 (USD 30.89), respectively. Household expenditure for hand sanitizers, facemasks, hand gloves, and disinfectants increased significantly during the COVID-19 restriction lockdown (p < 0.05). However, expenditure on education, water, electricity, fuel, internet data, clothing and wears, toiletries decreased significantly during the lockdown period (p < 0.05). CONCLUSION: this study suggests that the costs of continuing COVID-19 restrictions could have huge economic consequences on households and health system.

Exploração qualitativa do itinerário terapêutico de crianças com deficiência física na Nigéria usando análise de conteúdo temática / Exploración cualitativa del itinerario terapéutico de niños con discapacidades físicas en Nigeria utilizando análisis de contenido temático / Qualitative exploration into therapeutic itinerary of children with physical disabilities in Nigeria using thematic content analysis

Resumo Objetivo Explorar o itinerário terapêutico na busca de cuidados para crianças com deficiências físicas pelos cuidadores. Métodos Um plano qualitativo descritivo que recrutou nove cuidadores de crianças com deficiência física, com consentimento, que frequentavam um Hospital Universitário Nigeriano. Foi utilizado um guia de entrevista semi-estruturado para coletar dados sobre o itinerário terapêutico, que foi definido como os caminhos percorridos pelos indivíduos para resolver o seu problema de saúde. As entrevistas foram gravadas em áudio e transcritas literalmente. Os dados foram analisados utilizando a análise do conteúdo temático. Resultados os temas emergentes revelaram que os cuidadores iniciaram o itinerário terapêutico para os respetivos filhos após a observação de quaisquer deficiências que vão para além de doenças casuais. A falta de capacidade dos hospitais privados, que servem como ponto inicial de entrada na busca de cuidados, encorajou a procura por cuidados nos hospitais públicos, lares espirituais, e clínicas tradicionais. A entrada na fisioterapia dependia de auto-referências, referências por parentes e médicos. Cuidar de crianças com deficiência física prejudicou de modo significativo a vida social, as finanças, o trabalho do cuidador; e expectativas não alcançadas de que a criança melhorasse o mais cedo possível encorajaram um pluralismo contínuo. Conclusão e implicações para a prática O fato de ter crianças com deficiências e de ter havido atraso nos progressos levou os cuidadores a práticas múltiplas e complexas na busca de cuidados de saúde.

Resumen Objetivo Explorar el itinerario terapéutico para la búsqueda de cuidado de niños con discapacidad física por parte de los cuidadores. Métodos Un diseño cualitativo descriptivo que recluta a nueve cuidadores de niños con discapacidades físicas que asisten a un hospital universitario de Nigeria. Se utilizó una guía de entrevista semiestructurada para recopilar datos sobre el itinerario terapéutico que se definió como los caminos que recorren los individuos para abordar su problema de salud. Las entrevistas fueron grabadas en audio y transcritas textualmente. Los datos se analizaron mediante análisis de contenido temático. Resultados Los temas emergentes revelaron que los cuidadores iniciaron un itinerario terapéutico para sus hijos al observar cualquier impedimento que vaya más allá de las enfermedades casuales. La falta de capacidad en los hospitales privados, que sirve como punto inicial de entrada en la búsqueda de atención, fomenta la vacilación en los hospitales públicos, hogares espirituales y clínicas tradicionales. La entrada en fisioterapia dependía de las autorremisiones, las derivaciones de familiares y médicos. El cuidado de niños con discapacidad física afectó significativamente la vida social, las finanzas y el trabajo del cuidador; y las expectativas no satisfechas de que un niño se recupere lo antes posible fomentaron el pluralismo continuo. Conclusión e implicaciones para la práctica El hecho de que los niños presentaran discapacidades e hitos retrasados condujo a múltiples prácticas complejas de búsqueda de atención médica entre los cuidadores. Por lo tanto, estos cuidadores se vuelven médicos pluralistas y encubiertamente no se adhieren a las prescripciones de tratamiento hospitalario.

Abstract Objective To explore the therapeutic itinerary for seeking care for children with physical disabilities by caregivers. Methods A descriptive qualitative design recruiting nine consenting caregivers of children with physical disabilities attending a Nigerian Teaching Hospital. A semi-structured interview guide was used to collect data on therapeutic itinerary which was defined as the paths taken by individuals to address their health problem. Interviews were audio-recorded and transcribed verbatim. Data was analyzed using thematic content analysis. Results Emerging themes revealed that caregivers commenced therapeutic itinerary for their children upon observation of any impairments that go beyond casual illnesses. Lack of capacity in private hospitals, which serves as initial point of entry into care seeking, encourage vacillation into public hospitals, spiritual homes, and traditional clinics. Entry into physiotherapy was dependent on self-referrals, referrals by relatives, and physicians. Caring for children with physical disability significantly affected caregiver's social life, finances, work; and unmet expectations for a child to get well as soon as possible encouraged continuous pluralism. Conclusion and implications for the practice Having children presenting with impairments and delayed milestones led to complex multiple health care seeking practices among caregivers. Thus, these caregivers become medical pluralists and covertly non-adherent to hospital treatment prescriptions.

The Clinical and Cost-Effectiveness of Telerehabilitation for People With Nonspecific Chronic Low Back Pain: Randomized Controlled Trial.

BACKGROUND: Telerehabilitation can facilitate multidisciplinary management for people with nonspecific chronic low back pain (NCLBP). It provides health care access to individuals who are physically and economically disadvantaged. OBJECTIVE: This study aimed to evaluate the clinical and cost-effectiveness of telerehabilitation compared with a clinic-based intervention for people with NCLBP in Nigeria. METHODS: A cost-utility analysis alongside a randomized controlled trial from a health care perspective was conducted. Patients with NCLBP were assigned to either telerehabilitation-based McKenzie therapy (TBMT) or clinic-based McKenzie therapy (CBMT). Interventions were carried out 3 times weekly for a period of 8 weeks. Patients' level of disability was measured using the Oswestry Disability Index (ODI) at baseline, week 4, and week 8. To estimate the health-related quality of life of the patients, the ODI was mapped to the short-form six dimensions instrument to generate quality-adjusted life years (QALYs). Health care resource use and costs were assessed based on the McKenzie extension protocol in Nigeria in 2019. Descriptive and inferential data analyses were also performed to assess the clinical effectiveness of the interventions. Bootstrapping was conducted to generate the point estimate of the incremental cost-effectiveness ratio (ICER). RESULTS: A total of 47 patients (TBMT, n=21 and CBMT, n=26), with a mean age of 47 (SD 11.6) years for telerehabilitation and 50 (SD 10.7) years for the clinic-based intervention, participated in this study. The mean cost estimates of TBMT and CBMT interventions per person were 22,200 naira (US $61.7) and 38,200 naira (US $106), respectively. QALY gained was 0.085 for TBMT and 0.084 for CBMT. The TBMT arm was associated with an additional 0.001 QALY (95% CI 0.001 to 0.002) per participant compared with the CBMT arm. Thus, the ICER showed that the TBMT arm was less costly and more effective than the CBMT arm. CONCLUSIONS: The findings of the study suggested that telerehabilitation for people with NCLBP was cost saving. Given the small number of participants in this study, further examination of effects and costs of the interventions is needed within a larger sample size. In addition, future studies are required to assess the cost-effectiveness of this intervention in the long term from the patient and societal perspective.

Prevalence and correlates of bullying in physiotherapy education in Nigeria.

BACKGROUND: Bullying is an unexpressed part and parcel of medical education but it is largely unexplored in physiotherapy. This study assessed the prevalence and socio-demographic correlates of bullying in physiotherapy education in Nigeria. METHODS: Two hundred and nineteen clinical physiotherapy students from three purposively selected Federal Universities in Nigeria participated in this study. Following a cross-sectional design, the Students Perception of Professor Bullying Questionnaire (SPPBQ) was used to obtain information on bullying. The SPPBQ includes a working definition of lecturer bullying followed by other sections inquiring about lecturers bullying experiences. Data was collected on socio-demographic characteristics, bullying experiences and availability of adequate policy and support on bullying. Descriptive and inferential statistics were used analyze data. Alpha level was set at p < 0.05. RESULTS: Lifetime and point prevalence of bullying in physiotherapy education were 98.6 and 99.1%. 94.5% of the respondents had witnessed physiotherapy students bullying and there was a 100% rate of 'no attempt' to stop a physiotherapy lecturer from bullying. 38.4 and 44.7% of the respondents believed there was adequate school policy and support available on bullying. There was no significant association between bullying and each of age (휒2 = 0.117, p = 0.943), gender (휒2 = 0.001, p = 0.974), level of study (휒2 = 0.000, p = 0.995) and any specific university (휒2 = 1.343, p = 0.511). CONCLUSION: There is high lifetime and point prevalence of bullying in physiotherapy education in Nigeria, which are largely unchallenged or redressed. Being a clinical physiotherapy student ordinarily predisposes to bullying without necessary contributions of intrinsic and extrinsic factors.