Debate over whether community pharmacists should provide full travel medicine services
Whether community pharmacists should provide travel medicine services was the subject of a lively debate at the British
Travel Health Association annual scientific conference held in London last month.
Peter Chiodini, consultant parasitologist and director of the Health
Protection Agency malaria reference laboratory, said that he
believes all antimalarials should be available from pharmacists. “Most
people will visit the pharmacist before travelling, even if they [just]
need to buy sunblock or sunglasses. At the moment, if they do that, all
the pharmacist is allowed to give them is chloroquine and proguanil.”
He
argued that making all antimalarials available through pharmacies would
be an important way to increase access to prescription-only medicines
that are needed by travellers, particularly to Africa. In addition, Caroline
Hind, pharmacist facilitator for NHS Grampian, presented positive data
from a pilot study of pharmacist-run travel clinics in Scotland (see Vision for
pharmacy, p47).
Participants heard that access to travel medicine services, immunisations
and antimalarials varies and, since the new general medical services
contract was introduced, some GPs have stopped providing them completely.
Larry Goodyer, head of school at Leicester School of Pharmacy, De Montfort
University, and superintendent of Nomad Travel Pharmacy, suggested that
pharmacists, with their accessibility, consultation areas and newly acquired
independent prescribing rights, could provide travel health services,
either commissioned by primary care trusts or privately.
However, Richard Dawood, a travel medicine writer who runs an independent
travel medicine service in North London, expressed concern that short
training courses, such as those undertaken by pharmacists in the Scottish
pilot study, may not confer the knowledge to deal with challenging situations
across different age ranges and circumstances.
Ron Behrens, a consultant at the Hospital for Tropical Diseases Travel
Clinic in London, agreed, commenting that a traveller going to Bangkok,
for example, could be dealt with by a pharmacist but difficult cases
would be passed on. “If 90 per cent of the easy problems were taken
away [from our clinic] and we dealt with only the 10 per cent of problem
cases it would have a huge impact on our ability to survive. Everyone
should be able to provide a comprehensive service,” he said.
It was acknowledged that training in travel medicine is currently voluntary
and suggested that standards of competence should be set, and compliance
with these monitored, for all health professionals delivering these services. |
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