A retrospective comparison of pharmacist-managed versus infectious-diseases managed travel health services at an academic medical center.

PURPOSE: International travel is increasing, creating a need for accessible, high-quality travel health services. Pharmacists are positioned to expand access; transitioning services from infectious disease (ID) clinics to pharmacist-managed models may improve access and streamline the delivery system. This study compared vaccine acceptance and travel health recommendations between ID clinician and pharmacist-managed clinics at an Academic Medical Center. METHODS: This was a retrospective cohort study of electronic health record data for adults ≥18 years. ID clinician-managed visits (February-August 2023) were compared to pharmacist-managed visits (February-August 2024). The primary outcome was travel-related vaccine acceptance. Secondary outcomes included routine CDC vaccine acceptance, over-the-counter recommendations, and prescribed pharmacotherapy. RESULTS: A total of 337 patients were included (167 pharmacist-managed; 170 ID-managed). Travel vaccine recommendations were largely comparable, with no significant differences in acceptance for frequent recommendations like typhoid (84% vs 85%; P=0.88) and hepatitis A (47% vs 46%; P=0.83). However, routine CDC vaccine recommendations differed by clinic type; pharmacists more frequently recommended COVID-19, influenza, and herpes zoster vaccines (P<0.001). Pharmacists more frequently prescribed traveler's diarrhea treatment (59% vs 24%; P<0.001). Rates of anti-malarial prophylaxis prescriptions were high in both groups and did not differ significantly (62% vs 58%; P=0.50). CONCLUSIONS: Pharmacist-managed travel clinic achieved travel-related vaccine acceptance rates comparable to ID-managed clinics. Pharmacists more frequently recommended routine ACIP vaccines and prescribed traveler's diarrhea treatment. These findings suggest that pharmacist-managed travel health services under a collaborative practice agreement can deliver guideline-concordant care while possibly expanding institutional capacity.