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Kc B, Alrasheedy AA, Leggat PA, Mohamed Ibrahim MI, Christopher CM, Sapkota B, Shrestha S. Types and outcomes of pharmacist-managed travel health services: A systematic review. Travel Med Infect Dis 2023; 51:102494. [PMID: 36400319 DOI: 10.1016/j.tmaid.2022.102494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/21/2022] [Accepted: 11/04/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND AIM Pharmacists have an important role in providing travel health services and medications to travelers. However, given the limited literature on this topic, the aim of this study is to systematically review the types and outcomes of pharmacist-managed travel health services. METHODS A comprehensive literature search was performed in four electronic databases, namely Scopus, Web of Science, PubMed and ProQuest to identify studies published in English from 1999 to July 2022. The inclusion criteria included the studies that reported an experience of providing dedicated travel health services by pharmacists and reported the outcomes and/or evaluation of these travel health services. RESULTS Nine studies were identified from the literature and included in the review. The pharmacists have provided a wide range of general and specialized travel health services including pre-travel risk assessment, routine and travel-related vaccination service, prescribing or recommending medications for travel-related illnesses, counseling and travel health advice. Overall, 94-100% of the patients were satisfied or very satisfied with pharmacist-managed travel health services. In addition, a good acceptance rate of pharmacist recommendations for vaccines and travel-related mediations was reported with most studies reporting an overall acceptance rate of ≥75% (acceptance rate range: 48%-94.2%). In addition, high rates of acceptance of other nonpharmacological advices were noted. CONCLUSION Pharmacists with training in travel medicine have successfully provided a wide range of general and specialized travel health services. Most travelers were highly satisfied with the pharmacy-based travel health services and accepted the pharmacist recommendations.
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Affiliation(s)
- Bhuvan Kc
- Faculty of Pharmacy and Pharmaceutical Sciences, Monash University Parkville Campus Parkville, VIC, 3052, Australia; College of Public Health, Medical & Veterinary Sciences, James Cook University, Townsville, QLD, Australia.
| | - Alian A Alrasheedy
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Buraidah, 51452, Saudi Arabia.
| | - Peter A Leggat
- College of Public Health, Medical & Veterinary Sciences, James Cook University, Townsville, QLD, Australia; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; School of Pharmacy, Monash University Malaysia, Subang Jaya, Selangor, Malaysia
| | | | | | - Binaya Sapkota
- Department of Pharmaceutical Sciences, Nobel College, Affiliated to Pokhara University, Kathmandu, Province Bagmati, Nepal
| | - Sunil Shrestha
- School of Pharmacy, Monash University Malaysia, Subang Jaya, Selangor, Malaysia
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Assessing the Travel Health Knowledge of Australian Pharmacists. PHARMACY 2020; 8:pharmacy8020094. [PMID: 32486440 PMCID: PMC7356681 DOI: 10.3390/pharmacy8020094] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 05/22/2020] [Accepted: 05/29/2020] [Indexed: 11/17/2022] Open
Abstract
Worldwide, the numbers of travellers are increasing, with pharmacists having the potential to play a significant role in the provision of pre-travel health services to a large number of these travellers. However, studies examining whether pharmacists have the travel health knowledge to provide these services are limited. This study thus aimed to explore the travel health knowledge of Australian pharmacists. Surveys assessing pharmacists’ knowledge of travel health were distributed through the Pharmaceutical Society of Australia and community pharmacies for self-completion. Overall, the travel health knowledge of participants was found to be good. However, although the majority of participants were aware of the common causes of morbidity and mortality in travel health, some slightly overestimated the prevalence of malaria and were less knowledgeable about the global distribution of some diseases. Most participants also demonstrated an ability to give appropriate advice on the management of traveller’s diarhoea, the selection of appropriate items for inclusion in travel first aid kits, vaccinations, and malarial chemoprophylaxis for travellers visiting endemic areas. This study highlights that Australian pharmacists have the knowledge to deliver travel health advice, with the potential to improve both access and outcomes for travellers.
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Knowledge, Attitudes, and Practices towards Infectious Diseases Related to Travel of Community Pharmacists in Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17062147. [PMID: 32213832 PMCID: PMC7143491 DOI: 10.3390/ijerph17062147] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 03/19/2020] [Accepted: 03/21/2020] [Indexed: 01/06/2023]
Abstract
Pharmacists should be educated about travel medicine, since they could influence their own choices and those of the individuals they encounter. This study aims to investigate the knowledge, attitudes, and behaviors towards infectious diseases related to travel among community pharmacists in Italy. The data was collected from September 2018 to September 2019 using semi-structured telephone interviews. Only 1.8% answered correctly to all seven questions regarding the infectious diseases related to travel. Community pharmacists who had heard about travel medicine and those who had received information were more likely to have good knowledge. More than two-thirds of the respondents believed that it is important to provide information to the public about travel medicine. Pharmacists who worked a higher number of hours per week, were more knowledgeable about the more frequent infectious diseases related to travel, believed that travel medicine was a pharmacist competency, believed that they could give advice to the public, and had received information from scientific journals and educational activities were more likely to have this positive attitude. More than two-thirds often/always informed the public about the importance of having travel health center counseling. Pharmacists who had heard about travel medicine and those who believed that they could give advice to the public were more likely to inform. Interventions are needed to improve knowledge in order that community pharmacists can play an active role in counseling the public.
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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. PHARMACY 2019; 7:pharmacy7040159. [PMID: 31779115 PMCID: PMC6958478 DOI: 10.3390/pharmacy7040159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 11/18/2019] [Accepted: 11/22/2019] [Indexed: 11/17/2022] Open
Abstract
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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Affiliation(s)
- Christina Bascom
- Travel Health Network: Vaccination Clinic and
Consultants, St. Albert, Alberta
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A Review of Guidelines/Guidance from Various Countries Around the World for the Prevention and Management of Travellers' Diarrhoea: A Pharmacist's Perspective. PHARMACY 2019; 7:pharmacy7030107. [PMID: 31382691 PMCID: PMC6789525 DOI: 10.3390/pharmacy7030107] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 06/20/2019] [Accepted: 07/23/2019] [Indexed: 01/23/2023] Open
Abstract
International travel is growing and pharmacists are well placed to provide travel health services for the prevention and management of travellers’ diarrhoea (TD). Legislation changes in many countries has enabled pharmacists to access prescription only medicines and vaccinations to provide advice and over the counter medicines for the prevention and management for travel health services; this makes sense since pharmacies are easily accessible to the public and are the patient’s first port of call in the event of any illness. Currently, whilst many guidelines/guidance exist worldwide for the prevention and management of TD, there is no review that focuses on similarities and differences between these and between guidelines on TD and travel related and non-travel related acute diarrhoea. There is also a lack of publication on legislation and the need for evidence based training for all prescribers to provide travel health services. The aims of this work were to review guidelines/guidance for the prevention and management of TD from across the world which were compared with each other as were the TD guidelines compared to that for travel related and non-travel related acute diarrhoea for similarities and differences, with a focus on any relevant pharmacy legislation, needs assessments and training that may impact upon provision of travel health services by pharmacists focusing mainly on TD in adults. The PubMed, Google Scholar and Cochrane database were used to carry out an online search for publications on TD, acute diarrhoea and the guidance pharmacists have in the prevention and management of diarrhoea. The literature reviewed in this article indicates that where no specific guidelines/guidance existed, some pharmacists used the WHO guidelines (WHO), highlighting a need for local, regional and national evidence based guidelines in these countries.
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Kc B, Khan TM, Xuan WY, Alrasheedy AA, Mohamed Ibrahim MI, Leggat PA. Travel health-related activities and services provided by community pharmacies in Selangor, Malaysia: A cross-sectional analysis. Travel Med Infect Dis 2019; 33:101463. [PMID: 31376464 DOI: 10.1016/j.tmaid.2019.07.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 07/25/2019] [Accepted: 07/26/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Millions of tourists visit Malaysia annually while a large number of Malaysians travel overseas. Taking care of travellers' healthcare needs is important aspect of the healthcare system. Community pharmacies are ideally positioned to provide travel health-related services. However, studies are lacking in this area. Therefore, this study aims to explore the nature and type of travel health-related services provided by Malaysian community pharmacies. METHODS A survey was carried out at 135 community pharmacies in nine districts of Selangor, Malaysia, from November 2017 to February 2018, using a self-administered standardized questionnaire. RESULTS The majority (n = 95, 85%) of community pharmacies reported to have provided services to both international travellers and outbound Malaysian travellers. The common healthcare services provided to international travellers were monitoring of chronic diseases including hypertension and diabetes, and advice on minor ailments, supplements and medical devices. The key health services provided to outbound Malaysian travellers were advice on vaccination requirements, better management of chronic diseases and necessary medications to manage illness during travel. Most of the respondents supported the provision of travel health-related services through the community pharmacies. CONCLUSION The study findings showed that Malaysian community pharmacies provided several travel health-related services to both international and Malaysian outbound travellers. Pharmacists in Malaysia are ideally positioned to have an increased role in travel medicine. They have the training to advise on complex medication issues especially with regard to interactions and polypharmacy. However, further training and courses should be provided that are tailored specifically for the needs of this professional group.
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Affiliation(s)
- Bhuvan Kc
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Selangor Darul Ehsan, Malaysia.
| | - Tahir Mehmood Khan
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Selangor Darul Ehsan, Malaysia; Institute of Pharmaceutical Science, UVAS Lahore, Pakistan.
| | - Wong Yin Xuan
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Selangor Darul Ehsan, Malaysia.
| | | | | | - Peter A Leggat
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia; Faculty of Science, University of Nottingham Malaysia Campus, Jalan Broga, 43500, Semenyih, Selangor Darul Ehsan, Malaysia.
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Pharmacy Travel Health Services in Canada: Experience of Early Adopters. PHARMACY 2019; 7:pharmacy7020042. [PMID: 31035567 PMCID: PMC6631395 DOI: 10.3390/pharmacy7020042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 04/23/2019] [Accepted: 04/23/2019] [Indexed: 12/02/2022] Open
Abstract
Since 2007, community pharmacists in Canada have become increasingly involved in delivering Travel Health services, including the recommendation and administration of vaccines. This qualitative scoping survey examines some of the activities and opinions of those early pharmacist adopters delivering these services. A Survey Monkey free text questionnaire was emailed to pharmacists who were involved in delivering travel medicine services. 21 pharmacists responding represented seven Canadian provinces. Only 5 pharmacists estimated that they were seeing five or more patients a week on average. Amongst the challenges they faced the most quoted was lack of time when running a busy pharmacy (62%) a lack of prescribing authority, (52%), and lack of access to public health vaccines (52%). ‘Word of mouth’ was widely quoted as a means of developing the service, indicating a good patient satisfaction. Also expressed were the advantages of convenience in terms of being a ‘one stop shop’, ease of billing to insurance companies and convenient appointment times. There are a number of challenges which are still to be faced which may be resolved by further legislation allowing access to public health vaccines and more widespread prescribing rights. The relatively low level of consultations reported by some is of concern if those pharmacists are to maintain competence.
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Omecene NE, Patterson JA, Bucheit JD, Anderson AN, Rogers D, Goode JV, Caldas LM. Implementation of pharmacist-administered pediatric vaccines in the United States: major barriers and potential solutions for the outpatient setting. Pharm Pract (Granada) 2019; 17:1581. [PMID: 31275506 PMCID: PMC6594428 DOI: 10.18549/pharmpract.2019.2.1581] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 06/14/2019] [Indexed: 11/14/2022] Open
Affiliation(s)
- Nicole E Omecene
- School of Pharmacy, Virginia Commonwealth University. Richmond, VA (United States).
| | - Julie A Patterson
- School of Pharmacy, Virginia Commonwealth University. Richmond, VA (United States).
| | - John D Bucheit
- School of Pharmacy, Virginia Commonwealth University. Richmond, VA (United States).
| | - Apryl N Anderson
- School of Pharmacy, Virginia Commonwealth University. Richmond, VA (United States).
| | - Danielle Rogers
- School of Pharmacy, Virginia Commonwealth University. Richmond, VA (United States).
| | - Jean V Goode
- School of Pharmacy, Virginia Commonwealth University. Richmond, VA (United States).
| | - Lauren M Caldas
- School of Pharmacy, Virginia Commonwealth University. Richmond, VA (United States).
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Houle S. Is travel health a new destination for pharmacy practice and business? An examination of revenue opportunities from pre-travel consultations. Can Pharm J (Ott) 2018; 151:383-387. [PMID: 30559913 DOI: 10.1177/1715163518803972] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Heslop IM, Speare R, Bellingan M, Glass BD. Australian Pharmacists' Perceptions and Practices in Travel Health. PHARMACY 2018; 6:pharmacy6030090. [PMID: 30135400 PMCID: PMC6165192 DOI: 10.3390/pharmacy6030090] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 08/14/2018] [Accepted: 08/20/2018] [Indexed: 11/27/2022] Open
Abstract
Worldwide, pharmacists are playing an increasing role in travel health, although legislation and funding can dictate the nature of this role, which varies from country to country. The aim of this study was to explore the current and potential future practices in travel health for pharmacists in Australia, as well as the perceived barriers, including training needs, for the provision of services. A survey was developed and participation was sought from a representative sample of Australian pharmacists, with descriptive statistics calculated to summarise the frequency of responses. A total of 255 participants, predominantly female (69%), below 50 years (75%) and registered less than 30 years completed the survey. Although over two-thirds (68%) provided travel-related advice in their current practice, the frequency of advice provision was low (less than 2 travellers per week) and limited to responding to travellers questions. Although Australian pharmacists are currently unable to administer travel vaccines and prescription only medications without prescription, they still consider travel health to be an appropriate role and that their clients would seek travel health advice from pharmacies if offered. Currently, key roles for Australian pharmacists are advising travellers who do not seek advice from other practitioners, reinforcing the advice of other health practitioners and referring travellers needing vaccinations and antimalarials. In order to expand these services, the barriers of workload, time, staffing and the need for training in travel health need to be addressed. In summary, the travel health services provided by pharmacies in Australia still have a way to go before they match the services offered by pharmacies in some other countries, however Australian pharmacist are keen to further develop their role in this area.
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Affiliation(s)
- Ian M Heslop
- Pharmacy, College of Medicine and Dentistry, James Cook University, Townsville 4811, Australia.
| | - Richard Speare
- Public Health and Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville 4811, Australia.
| | - Michelle Bellingan
- Pharmacy, College of Medicine and Dentistry, James Cook University, Townsville 4811, Australia.
| | - Beverley D Glass
- Pharmacy, College of Medicine and Dentistry, James Cook University, Townsville 4811, Australia.
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