title: A comparison of pharmacist travel-health specialists' versus primary care providers' recommendations for travel-related medications, vaccinations, and patient compliance in a college health setting.
abstract: BACKGROUND
  Pretravel medication and vaccination recommendations and receipt were compared between primary care providers (PCPs) without special training and clinical pharmacists specializing in pretravel health.
  
  
  METHODS
  A retrospective chart review of patients seen for pretravel health services in a pharmacist-run travel clinic (PTC) compared to PCPs at a University Student Health Center. Vaccine/medication recommendations were assessed for consistency with national/international guidelines. Medical/pharmacy records were queried to determine the receipt of medications/vaccinations.
  
  
  RESULTS
  The PTC recommended antibiotics for travelers' diarrhea were given more often when indicated (96% vs 50%, p < 0.0001), and patients seen in the PTC received their medications more often (75% vs 63%, p = 0.04). PCPs prescribed more antibiotics for travelers' diarrhea that were inconsistent with guidelines (not ordered when indicated 49% vs 6%, p < 0.0001 and ordered when not indicated 21% vs 3%, p < 0.0001). The PTC prescribed antimalarials more often when indicated (98% vs 81%, p < 0.0001), while PCPs prescribed more antimalarials that were inconsistent with guidelines (not ordered when indicated 15% vs 1%, p < 0.0001 and ordered when not indicated 19% vs 2%, p < 0.0001). The PTC ordered more vaccines per patient when indicated (mean = 2.77 vs 2.31, p = 0.0012). PTC patients were more likely to receive vaccines when ordered (mean = 2.38 vs 1.95, p = 0.0039). PCPs recommended more vaccines per patient that were inconsistent with guidelines (not ordered when indicated: mean = 0.78 vs 0.12, p < 0.0001, ordered when not indicated: mean 0.18 vs 0.025, p < 0.0001).
  
  
  CONCLUSIONS
  A pharmacist-run pretravel health clinic can provide consistent evidence-based care and improve patient compliance compared to PCPs without special training. Pretravel health is a dynamic and specialized field that requires adequate time, resources, and expertise to deliver the best possible care.
authors.affiliation: Titus Family Department of Clinical Pharmacy and Pharmaceutical Economics & Policy, University of Southern California School of Pharmacy, 1985 Zonal Avenue, Los Angeles, CA 90033, USA. mdurham@usc.edu
authors.forename: Melissa J
authors.initials: MJ
authors.lastname: Durham
authors.forename: Jeffery A
authors.initials: JA
authors.lastname: Goad
authors.forename: Lawrence S
authors.initials: LS
authors.lastname: Neinstein
authors.forename: Mimi
authors.initials: M
authors.lastname: Lou
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000458:organization & administration; D018890:Chemoprevention / Q000379:methods; D003140:Communicable Disease Control / Q000458:organization & administration*; D003157:Community Pharmacy Services / Q000458:organization & administration*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D010595:Pharmacists / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000458:organization & administration*; D024382:Professional Role; D011369:Professional-Patient Relations; D012189:Retrospective Studies; D014195:Travel; D057236:Travel Medicine / Q000458:organization & administration; D014481:United States; D014611:Vaccination / Q000706:statistics & numerical data; D055815:Young Adult