Pharmacists' scope of practice in travel health: cregulations

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.

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.

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.

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.