1. Quality of travel health advice in a French travel medicine and vaccine center: a prospective observational study.
- Author
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Bouldouyre MA, De Verdière NC, Pavie J, De Castro N, Ponscarme D, Hamane S, Rachline A, Ferret S, and Molina JM
- Subjects
- Adult, Africa South of the Sahara epidemiology, Ambulatory Care Facilities standards, Ambulatory Care Facilities statistics & numerical data, Antimalarials therapeutic use, Asia epidemiology, Consultants statistics & numerical data, Decision Making, Computer-Assisted, Female, Guideline Adherence statistics & numerical data, Humans, Male, Outcome Assessment, Health Care, Paris, Prospective Studies, Quality of Health Care, South America epidemiology, Surveys and Questionnaires, Travel Medicine methods, Vaccines therapeutic use, Endemic Diseases prevention & control, Hepatitis A epidemiology, Hepatitis A prevention & control, Malaria epidemiology, Malaria prevention & control, Practice Patterns, Physicians' standards, Practice Patterns, Physicians' statistics & numerical data, Travel, Vaccination methods, Vaccination statistics & numerical data, Yellow Fever epidemiology, Yellow Fever prevention & control
- Abstract
Background: The number of international trips undertaken by French citizens is rising and we wished to assess the appropriateness of advices given to travelers in a vaccine and travel medicine center in France., Methods: We conducted a 3-month prospective study in one center in Paris where prescriptions and advice to travelers are given by trained physicians in travel medicine who have access to a computerized decision support system (Edisan). A questionnaire was used to record trip characteristics, patients' demographics, and prescriptions. Main outcome measure was the adequacy of prescriptions for malaria prophylaxis, yellow fever, and hepatitis A vaccines to French guidelines., Results: A total of 730 subjects were enrolled in this study, with a median age of 28 years. Travel destinations were sub-Saharan Africa (58%), Asia (21%), and South America (18%). Among the 608 patients (83%) traveling to malaria-endemic areas, malaria prophylaxis was in accordance with guidelines in 578/608 patients (95.1%, 95% CI: 93-96.5), and doxycycline was the regimen of choice (48%). Inappropriate malaria prophylaxis was given to eight patients, one of whom developed plasmodium falciparum malaria. All 413 patients (100%, 95% CI: 99-100) traveling to yellow fever-endemic areas who needed vaccination were correctly vaccinated. However, three patients received yellow fever vaccination without indication. Also, 442 of 454 patients (97.4%, 95% CI: 95.4-98.5) eligible to receive hepatitis A vaccination were immunized., Conclusion: Appropriate advice for malaria prophylaxis, yellow fever, and hepatitis A vaccinations was provided in a travel medicine and vaccine center where trained physicians used a computerized decision support system. Even in this setting, however, errors can occur and professional practices should be regularly assessed to improve health care., (© 2012 International Society of Travel Medicine.)
- Published
- 2012
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