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Impact of Counterfeit Medicine Awareness on Medicine Verification Practices among Young Adults in Nigeria

Abstract

Counterfeit and substandard medicines remain important public health concerns because the use of medicines that contain incorrect, insufficient, degraded, or undisclosed ingredients may result in treatment failure, adverse health outcomes, antimicrobial resistance, and preventable illness or death. Young adults in Nigeria may obtain medicines from pharmacies, patent and proprietary medicine vendors, online platforms, informal markets, and other sources, making medicine verification an important aspect of medicine safety. However, limited awareness of counterfeit medicines, difficulty identifying suspicious products, inadequate knowledge of verification procedures, online purchasing risks, attractive packaging, misleading product claims, and reliance on informal sources may affect young adults' ability to verify medicines before use. Counterfeit medicine awareness provides an opportunity to improve knowledge of medicine authenticity, packaging and labelling characteristics, approved sources, verification technologies, and appropriate reporting procedures. Against this background, this study investigates the impact of counterfeit medicine awareness on medicine verification practices among young adults in Nigeria. The study will be anchored on the Health Belief Model, Health Literacy Theory, and Social Cognitive Theory. The Health Belief Model explains how young adults' perceptions of susceptibility to harm from counterfeit medicines, perceived severity of medicine-related consequences, perceived benefits of verification, perceived barriers, self-efficacy, and cues to action may influence medicine verification practices. Health Literacy Theory emphasizes individuals' ability to obtain, understand, evaluate, and apply reliable information when assessing medicine authenticity and making safe medicine-use decisions. Social Cognitive Theory emphasizes observational learning, behavioural modelling, self-efficacy, reinforcement, and environmental influences in developing and maintaining safe medicine-verification behaviours. Collectively, these theoretical perspectives provide a suitable framework for explaining how counterfeit medicine awareness may influence medicine verification practices among young adults in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise young adults aged 18–35 years residing in selected urban, semi-urban, and rural communities across Nigeria. A multistage sampling technique will be used to select geopolitical zones, states, local government areas, communities, households, tertiary institutions, workplaces, and eligible young adults. Counterfeit medicine awareness will be assessed using indicators such as knowledge of counterfeit and substandard medicines, recognition of suspicious packaging, medicine labelling, batch and expiry information, manufacturer details, registration information, approved medicine outlets, risks associated with informal medicine sources, online medicine-purchasing risks, medicine-verification technologies, appropriate reporting channels, and the health consequences of using counterfeit medicines. Medicine verification practices will be assessed using indicators such as checking medicine packaging and labels, verifying registration information where applicable, checking batch and expiry details, purchasing from authorized outlets, using available medicine-verification tools or technologies, examining products for suspicious characteristics, seeking advice from qualified healthcare or pharmacy professionals, avoiding medicines from questionable sources, verifying medicines purchased online, retaining purchase information where appropriate, and reporting suspected counterfeit products to relevant authorities. Data will be collected using structured questionnaires, counterfeit-medicine knowledge assessment tools, scenario-based verification questions, medicine-verification practice scales, simulated or demonstration-based verification tasks where appropriate, and pre-test and post-test assessments where a quasi-experimental intervention is adopted. Descriptive statistics will be used to summarize participants' demographic and socioeconomic characteristics, medicine-use patterns, sources of medicines, sources of counterfeit-medicine information, awareness levels, and verification practices. Inferential statistical techniques, including chi-square tests, paired and independent t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the impact of counterfeit medicine awareness on medicine verification practices. Where a quasi-experimental design is adopted, medicine-verification practice scores before and after the awareness intervention may be compared with those of a comparison group to determine changes associated with the intervention. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that counterfeit medicine awareness has a significant positive impact on medicine verification practices among young adults in Nigeria. Young adults exposed to structured, practical, evidence-based, and accessible counterfeit medicine awareness education are expected to demonstrate greater ability and willingness to verify medicines before purchase or use than young adults without comparable exposure. Awareness may improve recognition of suspicious packaging and labelling, encourage purchasing from authorized medicine outlets, increase use of available verification technologies, and promote consultation with qualified pharmacy or healthcare professionals when authenticity is uncertain. Education may also improve young adults' ability to recognize risks associated with informal markets and online medicine purchases and encourage reporting of suspected counterfeit products. However, limited access to verification technologies, cost considerations, convenience, informal medicine markets, online purchasing, inadequate product information, low health literacy, and difficulties distinguishing genuine products from sophisticated counterfeits may reduce the effectiveness of awareness alone. The study therefore expects accessible, practical, sustained, and technology-supported counterfeit medicine awareness, combined with appropriate regulatory and medicine-distribution systems, to contribute significantly to improved medicine verification practices among young adults in Nigeria. The study is expected to contribute to the literature on counterfeit medicines, medicine verification, medicine safety, pharmaceutical regulation, pharmacovigilance, health literacy, health education, digital medicine verification, healthcare consumer behaviour, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Agency for Food and Drug Administration and Control, Pharmacists Council of Nigeria, healthcare professionals, pharmacies, patent and proprietary medicine vendors, online medicine platforms, consumer-protection organizations, public health practitioners, development partners, and policymakers regarding strategies for improving medicine safety. The study will also provide evidence-based recommendations for strengthening counterfeit medicine awareness programmes, promoting medicine verification among young adults, increasing public knowledge of available verification technologies, improving awareness of authorized medicine sources, strengthening online medicine-purchasing safety education, enhancing reporting of suspected counterfeit medicines, and developing sustainable public-health interventions that protect medicine consumers across Nigeria.

Keywords: Counterfeit medicine awareness, medicine verification practices, counterfeit medicines, substandard medicines, medicine safety, young adults, pharmaceutical safety, health literacy, pharmacovigilance, medicine verification, Nigeria, public health.