A collaborative role of pharmacists in travel health

Abstract

Introduction The current increase in the number of Australians engaging in international travel has led to concerns regarding imported infectious disease that have been acquired overseas. Related concerns include threats of infectious disease among local populations due to segmented and inefficient travel health practice models. Traditionally, travel health is practiced in multiple contexts, to render pre-travel care to travellers who embark on complex itineraries (visiting multiple countries and unusual or remote destinations),undertaking activities that put them at unusual risks (such as adventure travel and missionary postings). Health problems encountered include illnesses due to infectious disease, injury, and exacerbation of pre-existing chronic conditions. General practitioners (GPs) in general practice settings operating in a number of practice models contribute to the provision of travel health services. A minority of prospective travellers visit these clinics. These models of service delivery highlight gaps in travel health practice that are inefficient and ‘consumer’ unfriendly. A prospective traveller may start with a visit to a general practice, then have to attend a pharmacy for dispensing of prescribed medicines and vaccines, only to return to the general practice for administration of the vaccine. Other limitations range from low access to specialist travel health practitioners to the cost of the travel health service. This situation begs for innovation in travel health service delivery. Objective This research aims to describe a potential role of the pharmacist to support the GP in preparing international travellers in order to minimise health risks and complications during and after international travel. Method Canberra-based community pharmacists participated in a training program to prepare for a role in travel health practice. The training program addressed the elements of pre-travel health care together with a model of a collaborative relationship between travel health practitioners. Training was delivered in a classroom style workshop including lectures and group discussion. Training content also included implementing a collaborative project to address gaps in travel health practice and travel health care. The effectiveness of training instruction was evaluated through prospective pre-post quizzes that were administered to participants only once. Trained pharmacists participated in a pilot study to test the feasibility of a travel health service, to be undertaken in collaboration with GPs, to prepare individuals for international travel. Pre-travel assessments were undertaken through a pre-determined referral pathway. Specially designed tools were utilised to guide and facilitate documentation of the pretravel- related health evaluation for participants prior to travel. Results Thirty-two community pharmacists participated in the training. Results revealed a significant increase in the pharmacists’ knowledge base with respect to the elements of pretravel health assessments. Participating pharmacists self-recorded high satisfaction with the training activity. In addition, pharmacists indicated confidence in learnt skills to test and implement a collaborative travel health service with GPs. In the collaborative travel health pilot study,56 prospective travellers participated. Pharmacists referred 54% of travellers to a GP for vaccination and prescriptions for additional medications to cover their duration of travel. An additional 23% were treated by pharmacists, and 16% travellers on the verge of departure who were provided with information on health risk management strategies for travelling abroad. For 7% of the assessed travellers, pharmacist’s intervention was undocumented. Feasibility of the pilot study was rated at between 50–75% based on a pre-determined feasibility criterion. Study pharmacists who were already providing other professional services (e.g. blood pressure monitoring) in their pharmacies recorded higher performance scores than their peers. Pharmacists expressed high level of satisfaction with the collaborative travel health practice model.

Date of Award	2017
Original language	English
Supervisor	Gabrielle Cooper (Supervisor), Greg Kyle (Supervisor) & Mark NAUNTON (Supervisor)