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Initiating Comprehensive Travel Health Services in Primary Care

Research By: Karin Dixon BNSc MN-NP, Amra Dizdarevic BSc, BSN, MN-NP

Presented at: Accelerating Primary Care Conference 2014 in West Edmonton

Context

research_initiating-comprehensive-travel-health-services

Each year, more and more Canadians are travelling aboard for work, education and pleasure. This international traveler has a distinctly increased risk of becoming ill or injured while abroad, to which they are often unprepared for. Unfortunately, many primary care providers find it difficult to stay up to date on the constantly changing world of travel medicine and subsequently refer the client to external travel health resources. However, due to the additional cost, or lack of access, many clients do not seek further travel health consultation and thus are unprepared for a multitude of health and safety risks while abroad.

Objective

To provide high quality, individual -focused complete travel services using an experienced multidisciplinary team across 3 facilities in Alberta and BC within primary care clinics. Our goal was to reduce the prevalence and severity of illness and injury obtained by travelers aboard.

Methods

Centre for Disease Control (US)

  • Online Yellow Fever Module (requirement of PHAC)

Health Information for international traveler Public Health Agency of Canada

  • Yellow Fever Designation Facility

Shoreland Travax Reports

  • Customized reports for traveler and clinician based on country risk profile Structured educational in-services for providers

Travel risk assessments

  • Vaccine risk and benefit profiles
  • Antimalarial decision making tool
  • Monthly and PRN updates on epidemics and other health concerns

Results

Nurse Practitioner led launch in Vancouver 2012, followed by Nurse Practitioner led expansion to West Vancouver and Calgary in 2014. Nurse Practitioner lead responsible for;

  • Acquiring yellow fever designation
  • Developing travel health standards of care
  • Training RN staff in comprehensive individualized risk assessment and recommendations
  • Evening seminar for patients on general travel health
  • PRN seminar and email updates on travel advisories for staff

Clients who completed pre-travel risk assessment, received recommended vaccines and anticipatory guidance regarding illness prevention reported:

  • Decreased anxiety
  • Increased health knowledge and empowerment
  • Improved continuity of care with primary care provider and higher satisfaction with care

Conclusions

  • Provision of comprehensive multidisciplinary travel health services within a primary care setting to international travelers increases travelers’
  • Knowledge and preparation for travel
  • Satisfaction
  • Continuity of care

Additional research is required to quantify health outcomes of returning travelers. This is planned as the next step in evaluation of the program.

Click here to view the poster as presented at APCC 2014, including supporting figures

Click here to view the poster presented at the International Society of Travel Medicine in May 2015