Health advice given by general practitioners for travellers from New Zealand.
OBJECTIVE
To investigate where general practitioners (GP's) in New Zealand view travel health advice best given and where they refer for this advice, the prevalence of travel health advice reported to be given, and the prevalence of written advice, including a doctor's letter.


METHODS
This was a descriptive cross-sectional study, using self-report questionnaires, sent to 400 GPs randomly selected from the register of the New Zealand Medical Council.


RESULTS
Three hundred and thirty-two GPs (83%) responded. Most GPs reported that they saw travel medicine as best practised in general practice (241/308, 78%) or in a combination of locations, usually including general practice (28/308, 9%). Most GPs (223/308, 72%) did not refer travellers for travel health advice. Health advice concerning malaria (310/310, 100%), immunisation (309/310, 100%), travellers' diarrhoea (296/305, 97%), insect avoidance (287/ 299, 96%), sexually transmitted diseases/human immunodeficiency virus (233/283, 82%), water purification (235/293, 80%) and other areas (35/75, 47%) was given. Written advice was usually given by 23% of GPs (69/302). Written advice was significantly more likely to be provided by those GPs with an interest in travel medicine (chi2=5.67, df=1, p<0.005), experience in tropical medicine/developing countries (chi2=6.69, df=1, p<0.001), a policy on travel medicine (chi2=21.4, df=1, p<0.001), a written policy on travel medicine (chi2=302.0, df=1, p<0.001), who saw a higher number of travellers per week (t=-2.51, df=296, p<0.05) and who saw a significantly higher proportion of patients who were travellers (t=-3.27, df=-295, p=0.001). Almost all GPs (303/310, 98%) reported giving their travelling patients a doctor's letter at least sometimes but only 7% (23/310) always gave travellers a doctor's letter. GPs with training in travel medicine/related area were significantly more likely to provide travellers with a doctor's letter (chi=11.61, df=3, p<0.01).


CONCLUSIONS
This study confirmed that GPs in New Zealand see travel health advice as best given in general practice. Travel health advice, as recommended by New Zealand guidelines, should continue to be given. With limited time in general practice to advise travellers, GPs should also consider giving written advice, including a doctor's letter, more often. Epidemiological and specialist support by public health units and commercial groups, continuing medical education and training in travel medicine for GPs are among the major considerations. Further studies are needed concerning the adequacy and currency of destination-specific advice for travellers.
Leggat
P A
PA
School of Public Health and Tropical Medicine, James Cook University, Townsville, Australia. Peter.Leggat@jcu.edu.au
Heydon
J L
JL
Menon
A
A
D016009:Chi-Square Distribution; D015709:Correspondence as Topic; D003376:Counseling; D003430:Cross-Sectional Studies; D003967:Diarrhea / Q000517:prevention & control; D005194:Family Practice; D005260:Female; D015658:HIV Infections / Q000517:prevention & control; D006266:Health Education; D006801:Humans; D007114:Immunization; D007299:Insect Bites and Stings / Q000517:prevention & control; D008288:Malaria / Q000517:prevention & control; D008297:Male; D009520:New Zealand; D015995:Prevalence; D012017:Referral and Consultation; D012749:Sexually Transmitted Diseases / Q000517:prevention & control; D011795:Surveys and Questionnaires; D014195:Travel; D018508:Water Purification