Pharmacy-Based Travel Health Services
Disclosure of Potential Conflict of Interest Speaker: Doug Thidrickson B.Sc.Pharm, CTH Presentation: Collaborative Practice for Pharmacists Working in Travel Health I have no actual or potential conflict of interest in relation to this program/presentation.
Pharmacy-based travel services are unique Are pharmacists ready? Moving forward together
We are located on a university campus and there is a high demand for travel assessments so we have marketed our services aggressively. When patients are sitting down with one of our pharmacists, they often will comment that they had no idea that pharmacists could give injections, prescribe medication, and/or assess travel risk. I have had several patients return to me after receiving a travel consultation to get their flu shot, prescribe for a minor ailment or perform a different assessment (ie. smoking cessation).
Over the past 6 months, probably 30-40% of my consultations would be considered short notice that probably was the only way the traveler would have been seen (ie. by a pharmacist offering the convenience). Being able to provide all the services including injecting, OTC sales, some prescribing, passports, and the opportunity to connect with the traveler more than once (return visits for additional injections or medication pick ups) all provide excellent convenience.
Fewer trips to providers, one-stop for advice, prescriptions, injections, nonprescription items such as sunscreen and insect repellent and real-time adjudication to help the decision making process (whether or not to a particular vaccine is covered by their plan, etc.)
Pharmacy-based travel services are unique ACCESSIBILITY CONVENIENCE ENGAGEMENT
Pharmacy-based travel services are unique Are pharmacists ready? 1 COMPETENCY 2 CHALLENGES TO DELIVERY
Are Pharmacists Ready for a Greater Role in Travel Health? An Evaluation of the Knowledge and Confidence in Providing Travel Health Advice of Pharmacists Practicing in a Community Pharmacy Chain in Alberta, Canada Christina S. Bacom, BSc Pharm, DTM, Meagen M. Rosenthal, MA, PhD, and Sherilyn K.D. Houle, BSP, PhD Travel Health Network, St.Albert, Alberta, Canada J Travel Med. 2015: 22(2): 99-104
KNOWLEDGE ASSESSMENT PRE-TRAVEL ASSESSMENT: 98% TRAVELERS DIARRHEA: 40% TRAVELING AT ALTITUDE: 2% CONFIDENCE NOT CONFIDENT: 8% CONFIDENT: 21% CONFIDENCE TO SOURCE ANSWERS: 66% RECOMMENDATION: NEED FOR UNDERGRADUATE TRAINING & CONTINUING PROFESSIONAL DEVELOPMENT PROGRAMS
Pharmacists without specialized travel health training may not always possess the knowledge and confidence to provide these services.
A comparison of pharmacist travelhealth specialists versus primary care providers recommendations for travel-related medications, vaccinations and patient compliance in a college health setting. Durham MJ, Goad JA, Neinstein LS, Lou Mimi. J Travel Med. 2011: 18(1):20-25.
PHARMACIST RX ANTIBIOTICS FOR TD 46% MORE LIKELY TO PRESCRIBE WHEN INDICATED 18% LESS LIKELY TO ORDER WHEN NOT INDICATED 43% LESS LIKELY TO NOT ORDER WHEN INDICATED PHARMACIST RX ANTI-MALARIALS 17% MORE LIKELY TO PRESCRIBE WHEN INDICATED 17% LESS LIKELY TO ORDER WHEN NOT INDICATED 14% LESS LIKELY TO NOT ORDER WHEN INDICATED PHARMACIST TRAVEL SERVICES PATIENT MORE LIKELY TO PICK-UP ANTIBIOTIC PATIENT MORE LIKELY TO RECEIVE VACCINES DOCUMENTATION 44% MORE LIKELY
A pharmacist-run pre-travel health clinic can provide consistent evidence-based care and improve patient compliance compared to primary care providers without special training.
2 CHALLENGES TO DELIVERY PRESCRIBING INTEGRATION INTO WORKFLOW ACCESS TO PROVINCIAL RESOURCES
ALBERTA Fewest prescribing rules Requires additional authorization in specific specialty to prescribe ISTM certification not required
NEW BRUNSWICK & NEWFOUNDLAND Pharmacists with ISTM certification can prescribe additional travel vaccines, antibiotics and anti-malarials.
NOVA SCOTIA & PRINCE EDWARD ISLAND Pharmacists can prescribe some additional vaccines with injection authorization
MANITOBA Proposed: Pharmacists with ISTM CTH designation can prescribe all vaccines and medications related to travel.
Pharmacy-based travel services are unique Are pharmacists ready? Moving forward together
Recommendations from the Travel Health Working Group COLLEGE OF PHARMACISTS OF MANITOBA