Home' Australian Pharmacist : Australian Pharmacist March 2014 Contents Australian Pharmacist March 2014 I ©Pharmaceutical Society of Australia Ltd. 71
and travel destination regardless of
the individual race or immigration
status.8 It is generally accepted that
the term refers to immigrants from
a developing country that reside in
a developed country and are now
returning to their country of birth to
visit friends and relatives. People in this
group often travel last minute, fail to
seek healthcare care before travelling
and travel while pregnant, often with
children and travel for extended periods.
The clinical significance of travel for
an extended period is maximised
risk of exposure to illness and injury.
Financial considerations often limit the
use of travel health services among
VFRs. Language barriers, health beliefs
and poor perception of risk affect
pre-travel health care At the country of
destination, individuals in this group
travel to rural and remote destinations,
consume local food and drink and
use local public transport systems.
This category of travellers is at increased
risk of malaria, typhoid, hepatitis A,
hepatitis B and tuberculosis.
Community pharmacies frequented
by individuals from VFR communities
may display brochures, posters, include
promotional inserts in billings and
other mailing as a service to customers.
In addition VFR communities could
be engaged through promotional
education campaigns during
multicultural festivals, public clubs and
Returning travellers and recently
Proportionate morbidity from travel
clinics indicates that 8% of returned
international travellers from developing
countries often remain out of work
upon return due to travel-related
health issues.3 Issues around this are
multifactorial ranging from traveller
perception to travel-related disease
to lack of access to a travel health
provider. Psychosocial issues and culture
shock can arise in these individuals.
Community pharmacists can play a role
to and identity at risk individuals and
refer them for specialised advice and
support. The convenient location and
extended opening hours in community
pharmacies provides easy access to the
pharmacist by returned travellers for
travel-related health enquiries.
Fly-in- y-out workers
Individuals in this group often travel and
remain at their job sites for extended
periods of time. Specific members in this
group may include miners, fishermen
and field researchers. The issue with this
highly mobile group is inability to plan
and provide adequate health services.
Significant health concerns revolve
around high risk behaviours and mental
health issues. Individuals in this group
can be reached through newsletters
and promotional campaign though
through employers, mailings and
Collaborative care and screening
Travel health services have been
available from pharmacies in the
United States for over a decade
under collaborative protocols with
medical practitioners.9 Recently,
the UK National Health Service (NHS)
funded vaccination services through
community pharmacies. The vaccines
most frequently available through
community pharmacies are seasonal
flu and travel vaccines.10 Hosting other
clinicians to immunise in pharmacies
is a practical approach that could
be considered in Australia, pending
pharmacist vaccination trials and
approval. Certain groups of clients
could benefit from pharmacy-based
vaccination services, including last
minute travellers, those who regularly
visit pharmacies and those needing
specific medicine directions.
The practical aim for pharmacists
in travel health is to provide advice,
information and healthcare solutions
to travellers whose health concerns
may not warrant a trip to the general
practitioner. In addition to health
promotion, pharmacists should
focus on screening patients at risk of
Travellers in certain groups including
the elderly, pregnant, children,
with underlying medical conditions
including individuals with disabilities are
at increased risk of travel-related illness.
The goal of the pharmacist here is to
identify those at risk of travel-related
illness and refer them for pre-travel
health assessment and appropriate
care. In order to establish a sustainable
venture, a mechanism must be put in
place to regularly take time to review
progress and address challenges.
In summary, pharmacy as a practical
travel health destination can drive
customer service, experience and
loyalty. This article describes the
opportunities that can be embraced to
start a clinical travel health service in
community pharmacies. Collaboration
between pharmacists and medical
practitioners is paramount with the
primary healthcare aim to providing
information and practical solutions
to prevent travel related illness and
health misadventure in a timely and
1. Australian Bureau of Statistics. Feature article: International
movements-2012--13. Canberra: 2013.
2. Steffen R, Lobel HO. Epidemiologic basis for the practice
of travel medicine. Journal of Wilderness Medicine.
3. Freedman DO, Weld LH, Kozarsky PE, Fisk T, Robins R, von
Sonnenburg F, et al. Spectrum of disease and relation
to place of exposure among ill returned travelers. New
England Journal of Medicine. 2006;354(2):119--30.
4. The Pharmacy Guild of Australia. Serving Australians: a
system of community pharmacy. Canberra: Pharmacy
Guild of Australia; 2012.
5. Burger ET. Preparing adult patients for international travel.
The Nurse Practitioner. 2001;26(5):13--5.
6. Begg K, Roche P, Owen R, Liu C, Kaczmarek M, Hii A, et
al. Annaul Report of the National Notifiable Diseease
Survelillance System 2008.
7. Leggat PA, Zwar NA, Hudson BJ. Hepatitis B risks and
immunisation coverage amongst Australians travelling
to southeast Asia and east Asia. Travel Medicine and
Infectious Disease. 2009;7(6):344--9.
8. Leder K, Lau S, Leggat P. Innovative community-based
initiatives to engage VFR travelers. Travel Medicine and
Infectious Disease. 2011;9(5):258--61.
9. Durham MJ, Goad JA, Neinstein LS, Lou M. A comparison
of pharmacist travel-health specialists' versus primary
care providers' recommendations for travel-related
medications, vaccinations, and patient compliance
in a college health setting. Journal of Travel Medicine.
10. Francis M, Hinchcliff A. Vaccination services through
community pharmacy: a literature review. Wales: Public
Health Wales NHS Trust; 2010.
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