Guidelines for the Practice of Travel Medicine

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Guidelines for the Practice of Travel Medicine Manitoba 7 th Annual Travel Health Conference April 23, 2009 Alexandra Henteleff RN, BN, MEd Certificate in Travel Health

Presentation Overview CATMAT The Practice of Travel Medicine Purpose Complexities Who is practicing? Who is accessing these services?

Presentation Overview..cont Quality of Pre-Travel Health Services Attributes of the Practitioner Travel Clinic Management Maintenance of Competence Certification Conclusion

Committee to Advise on Tropical Medicine and Travel (CATMAT) - Mandate Provide recommendations for the prevention and treatment of infectious diseases and other health hazards Disseminate and support utilization of recommendations and other travel related health information; Advise on priorities for epidemiologic research and other activities related to travel health or tropical medicine

Definition Travel medicine is the field of medicine concerned with the promotion of health and the prevention of disease or other adverse health outcomes in the international traveller.

The Practice of Travel Medicine What are the distinguishing features?

Purpose of the Guideline To improve the quality of travel medicine services to Canadians who seek pre-travel health services. Practice Framework attributes of the practitioner, the knowledge base needed, travel clinic management, maintenance of competence and certification.

The Practice of Travel Medicine What makes the practice complex?

The Practice of Travel Medicine Who is practicing?

The Practice of Travel Medicine In what settings is travel medicine being practiced?

The Practice of Travel Medicine Who is accessing the service? Why are they travelling? Where are they going?

Canadians travel for business, pleasure, adventure and to visit family and relatives in countries of origin. They travel to urban and rural locations in exotic, tropical and remote destinations.

Quality of Pre-Travel Services Travellers continue to receive travel advice that is ill informed inconsistent This has led to severe consequences There is a need for travel medicine guidelines that support practitioners in the delivery of travel health services. This could be achieved through a standardized travel medicine curriculum

Steps to improve quality of pre-travel services The initial Canadian Guidelines for the Practice of Travel Medicine published by CATMAT (1999). Since that time there has been much progress in the field. The Body of Knowledge for the Practice of Travel Medicine (2002) The Infectious Diseases Society of America: Evidence-based guidelines for the practice of travel (2006)

The Practice of Travel Medicine What are the attributes of the practitioner?

The Practice of Travel Medicine What is the knowledge base needed to practice?

The Practice of Travel Medicine What are some key components of a pre-travel assessment?

Travel Clinic Management Clinic Facilities Travel Medicine Resources Documentation Consent Office Facilities Office policies Products

The Practice of Travel Medicine How do practitioners develop and maintain competence?

Maintenance of Competence In order to be effective, the health care practitioner must be willing to keep up with new developments in the field and remain current with the most up-to-date travel medicine resource references. Practitioners should refer to the CATMAT Statement on Travel Medicine Resources for Canadian Professionals (2006) for resources to support up-todate and competent practice.

The Practice of Travel Medicine Identify available certification courses or programs

Conclusions CATMAT is finalizing the Guidelines for the Practice of Travel Medicine, 2009 CATMAT firmly believes that travel medicine requires more than a "cookbook" approach. Up-to-date knowledge about the global epidemiology of infectious and non-infectious health risks and models of health education for effective health outcomes is essential

Conclusions Health care practitioners must carry out a detailed individual risk assessment for each international traveller to be able to advise on the most appropriate intervention(s) These interventions may include a change in planned travel, behaviour modification, immunizations, chemo suppressive drugs (e.g. antimalarials)

Conclusions With the continuously changing distribution of drugresistant infections, epidemics of disease and advances in our therapeutic repertoire, travel medicine has become a complex specialty. Since travel medicine is primarily a form of preventive health care, the client's health and safety depend to a large extent on the health care practitioner's level of expertise, communication skills and enthusiasm for the subject.

Conclusions Those who choose to enter this exciting field are cautioned to take the responsibility seriously.