Clinical outcomes and satisfaction with a pharmacist-managed travel clinic in Alberta, Canada

Houle, Sherilyn K.D.; Bascom, Christina S.; Rosenthal, Meagen

doi:10.1016/j.tmaid.2018.02.011

Cited by 26 publications

(47 citation statements)

References 12 publications

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“…The additional requirement is the completion of a formally recognised qualification in travel health, such as the Certificate of Knowledge of the International Society of Travel Medicine [16]. …”

Section: Discussionmentioning

confidence: 99%

Impact of Pharmacy Based Travel Medicine with the Evolution of Pharmacy Practice in the UK

Evans

2018

Pharmacy

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Background: Pharmacy has utilised the changes in legislation since 2000 to increase the range and supply function of services such as travel health to travellers. With the number of travellers leaving the UK and trying new destinations there is an increasing need for more travel health provision. Working models: The models of supply of a travel health service vary according to the size of the corporate body. The large multiples can offer assessment via a specialist nurse or doctor service and then supply through the pharmacy. Others will undertake an onsite risk assessment and supply through the pharmacist. The sole Internet suppliers of medication have been reviewed and the assessment standards questioned following survey and inspection. Education: There is no dedicated pharmacist-training programme in advanced level travel health. As a consequence one academic institution allows pharmacists to train on a multidisciplinary course to obtain an academic membership. With training for travel health not being mandatory for any travel health supply function the concern is raised with standards of care. Future: There is a consultation paper on the removal of travel vaccines from NHS supply due to be decided in the future. If these vaccines are removed then they will provide a greater demand on pharmacy services. Discussion: The starting of a travel health service can be made without any additional training and remains unregulated, giving cause for concern to the supply made to the traveller. Conclusions: Pharmacies in the UK offer a range of options for supplying travel health services; however these need to be with improved mandatory training and supply.

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Section: Discussionmentioning

confidence: 99%

Impact of Pharmacy Based Travel Medicine with the Evolution of Pharmacy Practice in the UK

Evans

2018

Pharmacy

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“…Having proper training and certification in travel medicine such as ISTM's CTH®, pharmacist-run travel clinic can provide consistent evidence-based care and improve patient compliance compared to primary care providers without special training [31]. In Alberta, Canada, where authorized pharmacists can prescribe medications, positive patient satisfaction and health status were reported after pharmacist-performed pre-travel consultation [32].…”

Section: Barriers In Japan and Experience In North Americamentioning

confidence: 99%

Travel Health Knowledge, Attitudes, and Practices Among Community Pharmacists in Japan

Sato¹

2019

Preprint

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(1) Background: Travel medicine practice has not been a part of practice in the community pharmacies in Japan. However, it’s getting more common for pharmacists to run travel clinic in North America. With ongoing globalization, Japanese pharmacists might be practicing travel medicine in future. This descriptive study is to examine the current knowledge, attitudes, and practices among Japanese community pharmacists. (2) Methods: Invitation to the study was sent to all pharmacies or corporates listed on Nippon Pharmacist Association member list plus one another large size pharmacy chain that was not member of NPhA. Community pharmacists working under those companies received a weblink to the survey. The survey was conducted from June to July 2017 by online questionnaire. (3) Results: The self-declared knowledge level of infectious diseases as well as travel vaccinations was generally low. The frequency of correct answer of the antibiotic resistance in South East Asia was 48.5%. Knowledge level of qunine resistance to Plasmodium falciparum malaria in Ghana and Nicaragua was very low. (4) Conclusions: Japanese community pharmacists are not familiar with travel related infectious diseases and vaccines used in travel medicine. The knowledge on the antibiotic resistance in traveler’s diarrhea and malaria prophylaxis was all low that is consistent with low degree of exposure to travel health questions from patients in daily practice and low percentage of intention to earn travel health certificates.

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“…Given extensive postgraduate training and experience in practice, pharmacists can positively impact health outcomes among travellers [7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

“…These pharmacists exhibit confidence in their care, demonstrated through the creation of their own travel health clinics, perceived self-competence, and strong patient outcomes. Pharmacists with travel medicine expertise have been found to consistently make evidence-based recommendations concordant with guidelines and their patients report a high level of satisfaction, including acceptance of recommendations and a sense of preparedness to manage health conditions that arise while travelling [7][8][9][10][11]. However, the literature indicates deficiencies when evaluating care provided by pharmacists without additional travel medicine training.…”

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confidence: 99%

“…For example, although approximately half of Ontarians with diabetes received an annual MedsCheck for Diabetes review, only 2.7-4.1% received a follow-up assessment, despite the use of potentially complex medications regimens for diabetes and comorbid conditions that warrant ongoing monitoring [36]. Although clinical effectiveness and high patient satisfaction have been observed from pretravel consultations performed by pharmacists with expertise in travel medicine [7][8][9][10][11], it remains to be determined if similar quality and consistency is observed when these services are offered by non-expert pharmacists. As one participant commented, "it would be a dis-service to the community if pharmacists are giving inadequate or bad advice.…”

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confidence: 99%

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Development and Testing of a Clinical Practice Framework for Pharmacists to Assess Patients’ Travel-Related Risks: The 5W Approach to Travel Risk Identification

Fernandes¹,

Houle²

2019

Pharmacy

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Objective: To assist with identifying patients who may be managed by pharmacists without additional travel medicine training, versus those who may benefit from referral, we developed and validated a clinical practice framework. This framework was then piloted in eight pharmacies in Ontario, Canada, from March to August 2019. Methods: A panel of experts, comprised of physicians and pharmacists from Ontario, Canada, holding a Certificate in Travel HealthTM from the International Society of Travel Medicine was recruited. This panel participated electronically in the development of the framework in three stages: (1) Sharing their current approach when performing information gathering and assessing risk in a traveling patient; (2) judging of items collated from all panellists on the basis of how essential they are to a risk assessment; and (3) validation of items deemed essential by the panel using the Item and Average Content Validity Index. The framework was then released to community pharmacies, where pharmacists that self-identified as beginners to travel medicine completed pre- and post-test phase surveys to determine the utility of the framework. Key Findings: A total of 64 items for consideration were deemed essential enough to proceed to content validation, organized into 5 ‘W’ domains: Who, What, Where, When, and Why. Each item was ranked by the experts according to its relevancy, resulting in an Average-Content Validity Index of 0.91. The resulting framework was titled “The 5W Approach to Travel Risk Identification.” This clinical practice framework is the first published assessment tool for travel medicine tailored for pharmacy’s scope of practice that has been content validated. Pharmacists reported that the framework is simple to use and provides structure for interactions with travelling patients. However, it may not be as beneficial for those with a higher level of travel medicine expertise than the average pharmacist. Conclusion: The 5W Approach tool allows pharmacists inexperienced in travel medicine to collect information when required to use their professional judgement when assessing traveling patients as either high-risk (requiring a referral to a travel medicine specialist) or low-risk. With the aim of supporting pharmacists to be more confident in caring for traveling patients and increasing their involvement in travel medicine, future research will test this framework for feasibility in Canadian community pharmacy practice.

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Clinical outcomes and satisfaction with a pharmacist-managed travel clinic in Alberta, Canada

Abstract: This study reports positive patient satisfaction and health status while travelling following a pharmacist-performed pre-travel consultation including authorization to prescribe and to administer vaccines. These results support the continued expansion of pharmacists' scope in this area.

Cited by 26 publications

References 12 publications

Impact of Pharmacy Based Travel Medicine with the Evolution of Pharmacy Practice in the UK

Impact of Pharmacy Based Travel Medicine with the Evolution of Pharmacy Practice in the UK

Travel Health Knowledge, Attitudes, and Practices Among Community Pharmacists in Japan

Development and Testing of a Clinical Practice Framework for Pharmacists to Assess Patients’ Travel-Related Risks: The 5W Approach to Travel Risk Identification

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