A Comparison of Pharmacist Travel-Health Specialists\u27 versus Primary Care Providers\u27 Recommendations for Travel-Related Medications, Vaccinations, and Patient Compliance in a College Health Setting

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\u27 diarrhea were given more often when indicated (96% vs 50%, p \u3c 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\u27 diarrhea that were inconsistent with guidelines (not ordered when indicated 49% vs 6%, p \u3c 0.0001 and ordered when not indicated 21% vs 3%, p \u3c 0.0001). The PTC prescribed antimalarials more often when indicated (98% vs 81%, p \u3c 0.0001), while PCPs prescribed more antimalarials that were inconsistent with guidelines (not ordered when indicated 15% vs 1%, p \u3c 0.0001 and ordered when not indicated 19% vs 2%, p \u3c 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 \u3c 0.0001, ordered when not indicated: mean 0.18 vs 0.025, p \u3c 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 car