Eliminating pharmacist’s prescribing errors in travel medicine

The need: There is a shortage of travel clinics providing travel health care.Covid-19 has taken its toll on dedicated travel clinics in many areas of the country. In our post-Covid world patients are returning to travel in great numbers, including a significant growth in the number of older travelers. However, with the declining number of dedicated travel clinics, these patients face challenges accessing the care they need. Fulfilling these patient needs requires pharmacists to have the appropriate travel medicine knowledge and competency. The problem: Inappropriate pharmacist prescribing in travel medicine.Every few weeks at our Travel Health Clinic I see a patient who has already visited a healthcare practitioner for a pre-travel assessment, and who has left that appointment confused about the advice and the expensive list of vaccines and medications that were recommended for them. This usually happens because the practitioner failed to do a proper assessment of the patient’s health risks based on their health/vaccine history and travel itinerary. Recently, one such patient had seen a community pharmacist for their assessment. I was concerned that the resulting recommended prescription had several errors, including hydroxychloroquine for malaria prevention. It also failed to meet the needs of the traveler by recommending Yellow Fever vaccine without providing the patient a path to obtain the vaccination. (Yellow fever vaccine can only be provided by a designated yellow fever vaccination centre.)While there is a growing demand for pre-travel health services, to properly fill this need the profession must ensure that pharmacists providing these services have a consistent knowledge and demonstrated competency in pre-travel health care. The first step towards a solution: Pharmacists need to ensure they have the knowledge required to provide pre-travel care. Many of the patients we see at our travel clinic come by way of referrals from the physicians and nurses in our community. These practitioners recognize that, beyond the most straightforward travel cases, their patients need the care of an experienced travel health professional. If you are seeing a need for travel health services in your practice and would like to learn more about what’s involved, a great place to start is with this article: Travel Medicine: What’s involved, when to refer (Aw B, Boraston S, Botten D et al. Canadian Family Physician. 2014 Dec;60(12):1091-103). This article outlines the practice of travel medicine, and provides the basics of what’s involved in a pre-travel consultation. It also offers guidance on the type of patient who may benefit from referral to a more experienced travel health provider.For pharmacy in Canada, a number of provincial regulatory bodies require that pharmacists pass the certificate of travel health (CTH) exam administered by the International Society of Travel Medicine (ISTM) if they wish to provide pre-travel assessments. This travel medicine exam is designed to ensure that successful candidates have the knowledge they need to practice in this area. It is an internationally recognized certification, and a recognized base and first step to establishing competency to practice in this area.Several hundred pharmacists in Canada already hold the CTH certification, including those who are involved in both writing exam questions for the CTH and guiding policy supporting pharmacist’s provision of pre-travel care. In a substantial recognition of Canadian pharmacists’ role in pre-travel care, ISTM will be offering the exam in Toronto in April 2024. Why not join your colleagues in ensuring quality pre-travel care by gaining CTH certification this year!Get details about the upcoming ISTM exam here.Brian Stowe established the travel clinic at the Prescription Shop on Carleton University campus in 2001. He was one of the first pharmacists to take the ISTM exam receiving his CTH certification in 2003. He is currently a member of the ISTM examination committee.

Eliminating pharmacist’s prescribing errors in travel medicine

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