Abstract
Objetivos
Mejorar la captación de viajeros a zonas de riesgo sanitario por los farmacéuticos comunitarios y evaluar dicha actuación sanitaria
Diseño
Estudio observacional prospectivo
Emplazamiento
Farmacias comunitarias de Asturias, Barcelona, Madrid y Valencia
Participantes
Un total de 483 viajeros a zonas de riesgo que iban a las farmacias participantes y que dieron su consentimiento verbal para participar en el estudio
Intervenciones
Asesoramiento por parte de los farmacéuticos comunitarios a los viajeros sobre las vacunas, la quimioprofilaxis y el botiquín de viaje necesarios según el destino, la duración y las características de los viajeros (medicación concomitante, embarazo, comorbilidades, edad, etc.)
Mediciones principales
Destino y duración del viaje, cumplimiento de vacunas y/o quimioprofilaxis recomendadas, reacciones adversas a ellas. Problemas de salud durante el viaje y al mes del regreso
Resultados
El 6,3% de los viajeros estaba protegido correctamente (todas las vacunas y quimioprofilaxis que necesitaban). El 36,2% de los viajeros tuvieron algún problema de salud durante el viaje, siendo la diarrea el más frecuente (15,7%). El botiquín de viaje fue recomendado sobre todo por el farmacéutico comunitario (89-95%)
Conclusiones
Los farmacéuticos convenientemente formados están capacitados para asesorar a los viajeros sobre las vacunas, la quimioprofilaxis y el botiquín de viaje necesarios. Hay que mejorar la coordinación con los departamentos de medicina exterior y los médicos de familia correspondientes. Conviene disminuir las trabas burocráticas (visado de inspección) para la obtención de estos medicamentos. Los viajeros internacionales aún no van correctamente vacunados a las zonas de riesgo sanitario
Palabras clave: Atención primaria, Farmacia comunitaria, Enfermedades tropicales, Quimioprofilaxis, Vacunación, Viajes internacionales
Abstract
Objectives
To improve and evaluate the travel advice by community pharmacists
Design
Cross-sectional and prospective study
Setting
Community pharmacies from Asturias, Barcelona, Madrid y Valencia
Participants
483 travellers to high health risk countries who visit the community pharmacies and were agreed with the aims of the study
Method
Community pharmacists gave information regarding immunization and prophylaxis about travel-related disease according to the destination, type and duration of travel and other features of the tourist (age, taking medicines, diseases, etc.).Main measurements. Destination, adherence to the prophylaxis and vaccinations recommended, adverse effects and diseases the tourists have in the travel and one month after they are back
Main measurements
Destination, adherence to the prophylaxis and vaccinations recommended, adverse effects and diseases the tourists have in the travel and one month after they are back
Results
Only 6.3% of the travellers were effective vaccinated and took prophylaxis (all vaccines and prophylaxis according to the destination). 36.2% of the travelers experienced an illness while abroad. The commonest disease were travellers' diarrhea (15.7%). The pharmacists were the only source of information about sunscreens, repellents, and other sanitary goods
Conclusions
The community pharmacists can give accurate information regarding immunization and prophylaxis about international travels. It is necessary to improve the communication between family physician, the tropical travel clinic and community pharmacists in order to improving compliance. It is necessary keep the bureaucratic barriers away to get this kind of drugs. The international tourists still travel without the necessary vaccines and prophylaxis to the high health risk areas
Key words: Primary care, Community pharmacy, Tropical diseases, Prophylaxis, Vaccination, International travels
Estudio financiado parcialmente por GlaxoSmithKline
Bibliografía
- 1.Rodríguez-García R. The health development link: travel as a public health issue. J Community Health. 2001;26:93–112. doi: 10.1023/a:1005225129295. [DOI] [PubMed] [Google Scholar]
- 2.Hughes NJ., Carlisle R. How important a priority is travel medicine for a typical British family practice? J Travel Med. 2000;7:138–141. doi: 10.2310/7060.2000.00045. [DOI] [PubMed] [Google Scholar]
- 3.López Vélez R., Viana A., Pérez-Casas C., Martín-Aresti J., Turrientes MC., García-Camacho A. Clinicalepidemiological study of imported malaria in travelers and immigrants to Madrid. J Travel Med. 1999;6:81–86. doi: 10.1111/j.1708-8305.1999.tb00837.x. [DOI] [PubMed] [Google Scholar]
- 4.Bruni M., Steffen R. Impact of travel-related health impairments. J Travel Med. 1997;4:61–64. doi: 10.1111/j.1708-8305.1997.tb00781.x. [DOI] [PubMed] [Google Scholar]
- 5.Reed J.M., McIntosh I.B., Powers K. Travel illness and the family practitioner: a retrospective assessment of travel-induced illness in general practice and the effect of a travel illness clinic. J Travel Med. 1994;1:192–198. doi: 10.1111/j.1708-8305.1994.tb00594.x. [DOI] [PubMed] [Google Scholar]
- 6.Harvey K. Travel agents’ misleading health advice [letter] Br J Gen Pract. 2000;50:830. [PMC free article] [PubMed] [Google Scholar]
- 7.Lawlor D.A., Burke J., Bouskill E., Conn G., Edwards P., Gillespie D. Do British travel agents provide adequate health advice for travellers? Br J Gen Pract. 2000;50:567–568. [PMC free article] [PubMed] [Google Scholar]
- 8.Montañes Alcántara F., Mejías García T., Gascón Brustenga J., Corachan Cuyas M. Consejos al viajero desde las embajadas y consulados. Rev Clin Esp. 1997;197:819–821. [PubMed] [Google Scholar]
- 9.Keystone J.S., Dismukes R., Sawyer L., Kozarsky PE. Inadequacies in health recommendations provided for international travellers by North American travel health advisors. J Travel Med. 1994;1:72–78. doi: 10.1111/j.1708-8305.1994.tb00566.x. [DOI] [PubMed] [Google Scholar]
- 10.Thomas R.E. Preparing patients to travel abroad safely (part 2): updating vaccinations. Can Fam Physician. 2000;46:655–656. [PMC free article] [PubMed] [Google Scholar]
- 11.Hatz C., Krause E., Grundmann H. Travel Advice: a study among Swiss and German general practitioners. Trop Med Int Health. 1997;2:6–12. doi: 10.1046/j.1365-3156.1997.d01-130.x. [DOI] [PubMed] [Google Scholar]
- 12.Genton B., Behrens R.H. Specialized travel consultation (part I): travelers’ prior knowledge. J Travel Med. 1994;1:8–12. doi: 10.1111/j.1708-8305.1994.tb00549.x. [DOI] [PubMed] [Google Scholar]
- 13.Genton B., Behrens R.H. Specialized travel consultation (part II): acquiring knowledge. J Travel Med. 1994;1:13–15. doi: 10.1111/j.1708-8305.1994.tb00550.x. [DOI] [PubMed] [Google Scholar]
- 14.Kodkani N., Jenkins J.M., Hatz C.F. Travel advice given by pharmacists. J Travel Med. 1999;6:87–93. doi: 10.1111/j.1708-8305.1999.tb00838.x. [DOI] [PubMed] [Google Scholar]
- 15.McNicholl I.R., Raebel M.A. Malaria epidemiology and economics in a pharmacist-managed international travel clinic. Pharmacotherapy. 1999;19:1363–1368. doi: 10.1592/phco.19.18.1363.30899. [DOI] [PubMed] [Google Scholar]
- 16.Peetermans W.E., Van Wijngaerden E. Implementation of pretravel advice: good for malaria, bad for diarrhoea. Acta Clinica Belgica. 2001;56:284–288. doi: 10.1179/acb.2001.042. [DOI] [PubMed] [Google Scholar]
- 17.Valerio L.I., Guerrero L., Martínez O., Fabregat A., Lorente L., Catalá R. III Congreso de la Sociedad Española de Medicina Tropical y Salud Internacional(SEMTSI) Cuenca; 28 febrero-2 marzo de 2002. Efectos secundarios y cumplimiento de la medicación antipalúdica en viajeros internacionales. [Google Scholar]