The U.S. Travel Health Pharmacists' Role in a Post-COVID-19 Pandemic Era.

Background: Many countries have enforced strict regulations on travel since the emergence of the SARS-CoV-2 (COVID-19) pandemic in December 2019. However, with the development of several vaccines and tests to help identify it, international travel has mostly resumed in the United States (US). Community pharmacists have long been highly accessible to the public and are capable of providing travel health services and are in an optimal position to provide COVID-19 patient care services to those who are now starting to travel again. Objectives: (1) To discuss how the COVID-19 pandemic has changed the practice of travel health and pharmacist provided travel health services in the US and (2) to discuss the incorporation COVID-19 prevention measures, as well as telehealth and other technologies, into travel health care services. Methods: A literature review was undertaken utilizing the following search engines and internet websites: PubMed, Google Scholar, Centers for Disease Control Prevention (CDC), World Health Organization (WHO), and the United States Department of Health and Human Services to identify published articles on pharmacist and pharmacy-based travel health services and patient care in the US during the COVID-19 pandemic. Results: The COVID-19 pandemic has changed many country's entry requirements which may now include COVID-19 vaccination, testing, and/or masking requirements in country. Telehealth and other technological advancements may further aid the practice of travel health by increasing patient access to care. Conclusions: Community pharmacists should consider incorporating COVID-19 vaccination and testing services in their travel health practices in order to meet country-specific COVID-19 entry requirements. Further, pharmacists should consider utilizing telehealth and other technologies to increase access to care while further limiting the potential spread and impact of COVID-19.

Pharmacy-Based Travel Health Services in the United States.

The aim of this paper is to review pharmacy laws and regulations, pharmacist training, clinic considerations, and patient care outcomes regarding pharmacy-based travel health services in the United States. Pharmacists and pharmacies in the United States are highly visible and accessible to the public, and have long been regarded as a source for immunization services. As international travel continues to increase and grow in popularity in this country, there is a pressing need for expanded access to preventative health services, including routine and travel vaccinations, as well as medications for prophylaxis or self-treatment of conditions that may be acquired overseas. In the United States, the scope of pharmacy practice continues to expand and incorporate these preventable health services to varying degrees on a state-by-state level. A literature review was undertaken to identify published articles on pharmacist- or pharmacy-based travel health services or care in the United States. The results of this paper show that pharmacists can help to increase access to and awareness of the need for these services to ensure that patients remain healthy while traveling abroad, and that they do not acquire a travel-related disease while on their trip. For those pharmacists interested in starting a travel health service, considerations should be made to ensure that they have the necessary training, education, and skill set in order to provide this specialty level of care, and that their practice setting is optimally designed to facilitate the service. While there is little published work available on pharmacy or pharmacist-provided travel health services in the United States, outcomes from published studies are positive, which further supports the role of the pharmacist in this setting.

Report of the 2017-2018 Strategic Engagement Standing Committee.

EXECUTIVE SUMMARY Student engagement is key to the success of schools and colleges of pharmacies in meeting their mission and programmatic needs. Student engagement in the pharmacy profession often occurs before acceptance to pharmacy school and is essential during students' formal period of study both for the student's professional growth and in meeting the mission of the school. Alumni engagement is vital to a school's continued success in regard to engaging with current students and support of their alma mater. The committee offers best practice recommendations for engaging students in service, scholarship, education, professional practice and continuing professional development.

Pharmacists' scope of practice in travel health: cregulations.

OBJECTIVES: The primary objective of this study was to assess pharmacists' authority to provide travel health services in each state and Washington, DC. Secondary objectives were to determine the need for collaborative practice agreements (CPAs), protocols, or prescriptions for this type of pharmacy practice and to identify jurisdictions where pharmacists are able to practice as travel health providers independent of CPAs or individual physician protocols. METHODS: An online survey was developed to assess pharmacists' authority to administer travel immunizations, furnish travel-related medications, and order travel-related laboratory tests. Open-ended items on scope of practice, training requirements, and pending legislation or regulations were also included. The survey was distributed to state pharmacy association executives. A member of the research team searched pharmacy laws to clarify missing or inconsistent responses. Data were analyzed using descriptive statistics. RESULTS: The survey response rate was 76.5% (n = 39). Missing (n = 12) or conflicting (n = 6) response issues were resolved. Thus, data were available for 100% of jurisdictions. In most jurisdictions, pharmacists were able to provide one or more components of this service. In 44 jurisdictions (86.3%), pharmacists were allowed to administer travel immunizations. Twenty-seven jurisdictions (52.9%) allowed pharmacists to furnish travel medications. Pharmacists in 23 jurisdictions (43.1%) could order travel health-related laboratory tests. Pharmacists can practice independently in 1 state, but CPAs or individual physician protocols are required elsewhere. CONCLUSIONS: To the authors' knowledge, this study represents the first national pharmacists' travel health scope-of-practice analysis. While pharmacists in many jurisdictions can provide some components of travel health services, only one, New Mexico, currently allows pharmacists to practice all aspects independently. Thus, pharmacists continue to have an opportunity to expand scope of practice in travel health. Additional research may help to drive increased access to and use of travel health care.

The impact of student pharmacists at health fair events.

OBJECTIVES: To evaluate student pharmacists' impact on health fair participant knowledge of selected disease states and to evaluate the intent of health fair participants with abnormal screening results to seek follow-up care within 1 month of screening. METHODS: Health fair participants were assessed for changes in their knowledge of specific diseases before and after screenings. Participants' intent to seek health care was assessed through a survey instrument developed using Rosenstock's Health Belief Model. RESULTS: Increases in participant knowledge of hypertension, diabetes, dyslipidemia, and body mass index were significant, and 78% of participants with abnormal results intended to contact a provider. CONCLUSIONS: Student pharmacists' had a positive impact on health fair participants' disease knowledge and intent to follow up with a provider.

Academic pharmacy and patient-centered health care: a model to prepare the next generation of pharmacists.

OBJECTIVE: To provide evidence regarding existing partnerships between academic pharmacy and primary care that focus on training practitioners in patient-centered health care (PCHC). DATA SOURCES: The report of the 2009-10 American Association of Colleges of Pharmacy Professional Affairs Committee identified 25 current U.S.-based examples of PCHC that incorporate the training and preparation of both student pharmacists and pharmacy residents. SUMMARY: The most frequently reported health care delivery model was an ambulatory care clinic followed by a Department of Veterans Affairs or military hospital clinic. Pharmacists worked alongside a variety of other health care providers in these settings. Collaboration occurred most commonly with family and internal medicine physicians but also with specialists such as psychiatrists, obstetricians/gynecologists, hematologists/oncologists, and other health care providers (e.g., nurses, physician assistants, dieticians, social workers). CONCLUSION: In light of the increasing demand for primary care services, pharmacists' documented ability to address these needs and the resulting benefits to patients, providers, and systems in these models, developing strategies for promoting pharmacist integration into PCHC is essential. Academic pharmacy provides a valuable platform for this integration through its expert faculty clinician involvement in care and practice-based research and student pharmacist and pharmacy residency training.

Intravenous artesunate for the treatment of severe malaria.

OBJECTIVE: To review the pharmacodynamics and pharmacotherapeutic use of intravenous artesunate for the treatment of severe malaria. DATA SOURCES: Literature was retrieved through PubMed (1999-March 2010), MEDLINE (1996-March 2010), and the Centers for Disease Control and Prevention (CDC), using the search terms artemisinin, artesunate, malaria, and severe malaria. In addition, reference citations from publications identified were reviewed. STUDY SELECTION AND DATA EXTRACTION: All articles in English that were identified from the data sources were reviewed. Focus was placed on postmarketing trials examining the safety and efficacy of artesunate in comparison with other regimens. DATA SYNTHESIS: The treatment of severe malaria requires prompt, safe, and effective intravenous antimalarials. Many oral and intravenous agents are available worldwide for the treatment of malaria; however, quinidine has been the only option for parenteral therapy in the US. Furthermore, this product's lack of availability as well as its adverse safety profile have created a treatment option gap. Recently, intravenous artesunate was approved by the Food and Drug Administration (FDA) for investigational drug use and distribution by the CDC. Three major studies regarding the use of intravenous artesunate are reviewed, in addition to the World Health Organization's malaria treatment guidelines. While there are no published head-to-head trials of intravenous artesunate versus intravenous quinidine for severe malaria, several international studies comparing intravenous quinine and artesunate concluded that artesunate has the highest treatment success, with lower incidence of adverse events. In addition, other literature is reviewed regarding counterfeit and other issues associated with artesunate. CONCLUSIONS: Artesunate, a new antimalarial currently available through the CDC, appears to be highly effective, better tolerated than quinidine, and not hampered by accessibility issues. If it were to be FDA approved and commercially available, it would be the preferred agent for the treatment of severe malaria in the US.

Measuring outcomes of a pharmacist-run travel health clinic located in an independent community pharmacy.

OBJECTIVES: To describe the acceptance and refusal rates of travel-related vaccine and medication recommendations in a pharmacist-run travel health clinic, to evaluate the change in patient understanding of travel-related issues, to determine patient satisfaction with this clinic, and to determine factors influencing both patient acceptance and satisfaction. SETTING: Southern California (Claremont) between July 2007 and October 2008. PRACTICE DESCRIPTION: Hendricks Pharmacy is an independently owned community pharmacy that is part of the Good Neighbor Pharmacy Provider Network. The pharmacy offers a range of services including home delivery, compounding, and blood glucose, blood pressure, and cholesterol screenings. PRACTICE INNOVATION: Comprehensive pharmacist-run travel health clinic. MAIN OUTCOME MEASURES: Patient acceptance and refusal rates of pharmacist-made recommendations, changes in patient understanding of travel-related issues resulting from pharmacist counseling, and patient satisfaction with this travel health clinic. RESULTS: In a sample of 283 patients, overall patient acceptance of pharmacist-made recommendations was 84.7%. The primary reason for patient refusal of a recommendation was self-perceived low risk for infection. A subsample of patients (n = 82) completing a patient satisfaction survey found that 96% were satisfied with their overall visit. Patient satisfaction with the clinic and pharmacist services was correlated with overall patient acceptance. CONCLUSIONS: The high rate of patient acceptance and satisfaction with this clinic supports adoption of pharmacists as nontraditional providers of travel health services.