Development and Testing of a Clinical Practice Framework for Pharmacists to Assess Patients' Travel-Related Risks:...

Area of Science:

• Pharmacy Practice
• Travel Medicine
• Clinical Decision Support

Background:

• Pharmacists play a crucial role in public health, including travel medicine.
• A need exists for structured tools to guide pharmacists in assessing travel-related health risks.
• Existing tools may not be tailored to the specific scope of practice for community pharmacists.

Purpose of the Study:

• To develop and validate a clinical practice framework for pharmacists to identify patients requiring travel medicine management.
• To differentiate between patients manageable by pharmacists and those needing referral to specialists.
• To enhance pharmacist confidence and involvement in travel medicine services.

Main Methods:

• Expert panel (physicians, pharmacists with travel health certification) developed the framework through electronic consensus.
• Framework items were validated using the Item and Average Content Validity Index.
• Piloted in eight Ontario pharmacies with self-identified beginner pharmacists using pre- and post-test surveys.

Main Results:

• The validated framework, "The 5W Approach to Travel Risk Identification," comprises 64 essential items across 5 domains (Who, What, Where, When, Why).
• Achieved an Average-Content Validity Index of 0.91, indicating high expert agreement.
• Pharmacists found the tool simple, structured, and useful for patient interactions, though potentially less beneficial for highly experienced practitioners.

Conclusions:

• "The 5W Approach" provides a validated tool for pharmacists to assess travel medicine risks and patient disposition (referral or management).
• It empowers pharmacists with less travel medicine experience to utilize professional judgment effectively.
• Future research will focus on the feasibility of this framework in Canadian community pharmacy settings.