Happy, healthy travels

MARCH 2018 – Patients are very willing to get their travel vaccinations from pharmacists and are overwhelmingly satisfied with the care received during their pre-travel consultations, according to the results of a research study funded by the Canadian Foundation for Pharmacy’s Innovation Fund. “We hope pharmacists are encouraged by these results, which show that they can safely and effectively prescribe and inject travel vaccines independently, and it’s a service that patients really appreciate,” says Sherilyn Houle, lead researcher and Assistant Professor at the School of Pharmacy, University of Waterloo.

The Travel Medicine and Infectious Disease Journal published full details of the study in February 2018. The study enrolled 103 patients who received care from a pharmacist-managed travel clinic in Alberta. The clinic provides pre-travel consultations, vaccinations and prescribing of oral drug therapies for travelers. The pharmacist administering the vaccinations had diploma- and certificate-level training in travel medicine, including a Certificate in Travel Health designation from the International Society of Travel Medicine. The pharmacist could also independently prescribe and administer injections. Consultations were generally 20 to 30 minutes in length.

Eighty-seven percent of patients had at least one clinical or itinerary-related factor that required additional individualized advice or recommendations. In total, 280 vaccinations were recommended and 79% were administered in the clinic.

After their return, 76% of the participating patients completed post-travel questionnaires. More than nine out of 10 (94%) were satisfied or very satisfied with the services received at the clinic. Fifteen patients reported experiencing a health issue while travelling (most commonly travelers’ diarrhea), and all but one (93%) reported feeling well prepared to address and manage this concern.

Perhaps the only negative, at least for pharmacists, is that fewer than half of patients (41%) correctly recalled it was a pharmacist who performed their consultation. The remainder identified the healthcare professional as a physician (22%) or nurse (18%), or were unsure. “As a profession we’re not known for tooting our own horn, but we need to take steps to ensure patients know they’re receiving this great level of care from pharmacists. This is definitely an area for improvement,” says Houle.

“CFP really has shown that it supports frontline pharmacy practice research that can further expand our scope of practice, and help us secure funding for services. They are a unique funder in taking that approach. We are very thankful for their support, and happy that our study on travel medicine found positive results.”

Sherilyn Houle, researcher, University of Waterloo

Within the community setting especially, “pharmacists can start those conversations when patients come in to arrange for early or extended refills prior in preparation for travel,” adds Houle. With that in mind, her research team is hoping to do more study within community practice. “We’ve determined pharmacists’ effectiveness in a specialized setting and with an expanded scope of practice, now we want to consider the barriers facing other pharmacists and how to overcome them. As far as patient satisfaction, we really expect the results to be the same.”

A closer look at interprofessional collaboration, to assess physicians’ receptiveness to pharmacists independently prescribing and administering vaccinations, is also on their wish list for research projects, pending funding. Meanwhile, a retrospective study of adherence rates in Alberta is already underway. “We’re going back to 2009 and looking at injections requiring two or three doses in order to determine if patients are more adherent when they go to a pharmacy rather than a travel clinic. Those results will hopefully be available early next year,” says Houle.