Pharmaceutical care model to assess the medication-related risks of travel

Int J Clin Pharm. 2014 Dec;36(6):1196-204. doi: 10.1007/s11096-014-0016-9. Epub 2014 Oct 1.

Abstract

Background: People are at greater risk of health problems when travelling and a significant number of travel-related health problems are associated with the effects of travel on pre-existing chronic diseases. Medications play a key role in the management of these conditions. However, there is a notable lack of research evaluating the potential medication-related risks associated with travel.

Objective: To apply a systematic pharmaceutical care model developed to evaluate potential pharmaceutical risks (PPRs) and pharmaceutical care issues (PCIs) in travellers.

Setting: Adult travellers leaving Cairns International Airport, Australia, for an international destination.

Method: A cross-sectional survey using semi-structured interviews, including a systematic medication history, followed by the application of a pharmaceutical care model to evaluate each participant for PPRs and PCIs.

Main outcome measure: Evaluation of standard clinical and travel-related PPRs and PCIs.

Results: Medications for chronic diseases were being taken by 47.7% of the 218 travellers interviewed. Although 75.2% of participants presented with no PPRs, a total of 274 PCIs were identified across 61.5% of the participants, with an average of 2.04 PCIs per participant. The most prevalent PCIs related to the inadequate precautions taken by some travellers visiting malaria-endemic regions. Although 91 participants recognised that they were travelling to malaria-endemic regions, 65.9% of these participants were not using malarial chemoprophylaxis, and only 16.5% were using chemoprophylaxis that fully complied with standard recommendations. The second most prevalent PCI was the need for 18.8% of participants to be educated about their medications. Other PCIs identified have the potential to increase the risk of acute, travel-related conditions, and complicate the care of travellers, if they inadvertently became unwell while overseas.

Conclusion: PPRs and PCIs were not identified in all participants. However, the impact of many of the identified medication-related issues could be substantial to the traveller. This study represents the novel application of a pharmaceutical care model to identify potential PPRs and PCIs in travellers that may not be identified by other pre-travel risk assessment methods.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antimalarials / administration & dosage
  • Antimalarials / adverse effects
  • Australia / epidemiology
  • Cross-Sectional Studies
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Malaria / epidemiology
  • Malaria / prevention & control
  • Male
  • Middle Aged
  • Pharmaceutical Services / standards*
  • Prescription Drugs / adverse effects
  • Prescription Drugs / therapeutic use*
  • Risk Factors
  • Travel*

Substances

  • Antimalarials
  • Prescription Drugs