Pre travel consultation in individuals with chronic illnesses: perception of the risk in doctors and patients

Abstract

Background: Travel medicine is based on the concept of the reduction of risk (the possibility of harm during the course of a planned trip). Some risks may be avoidable, and others may not, and certain travelers may confront special risks according to destination or the presence of chronic illnesses. However, the perception of risk not always is “perceived” adequately by the patient or the physician. Objective: To evaluate the common behavior in people with chronic illnesses regarding the risk of travel and the needs of preventive measures. Methods & Materials: A preliminary on line survey with 10 brief questions was performed and put it in the institutional web site, for free and voluntary access. Latin America, Asia and Africa was considered “at risk” destinations. Results: During April to June/2016 a total of 202 individuals answer the survey. Mean age: 55 yo; 91/202 (45%) were >60 yo. Male: 94/202 (46.5%). Almost 70% refers some underlying diseases (most frequent: cardiovascular, diabetes, respiratory). Ninety three percent (188/202) visited a doctor at least once in the last year (85.6% >2 visits). Although 127/188 (67.5%) had any underlying diseases, only 50/127 (39.4%) were advice about some vaccine during the visit. One hundred and seventy eight persons (88%) traveled at least once in the last 2 years; 65% (116/178) with any underlying diseases and 66/178 (37%) traveled to at least one destination “at risk”. However only 36/66 (50%) individuals carry out a medical consultation before travel (24 with any underlying diseases and 12 healthy). Conclusion: The pre travel consultation is the major opportunity to educate the travelers about health risks at the destination and to develop plans that minimize these risks. Also is a special scenario to advice about vaccine prevention according the traveler health status. Each traveler will have individual concepts about the risks and benefits of vaccines, prophylaxis, and behavior modification. The pre travel consultation provides another setting to remind travelers of basic health practices during travel and check the current medication. Physicians should take into account the risks of travel in patients with chronic illnesses and to promote travel consultation specially in individuals at risk.