Additionally, patients needed to have one or more of the following medical conditions at baseline in order to be included: diabetes, hyperlipidemia, hypertension, obesity, renal insufficiency, or a condition requiring chronic anticoagulation. Study patients’ records were reviewed to determine all chronic medical conditions at baseline, topics covered during the pre-travel visit, and any self-reported health problems or nonadherence to medications that occurred during travel. For the purposes of this investigation, medication nonadherence is defined as a patient stopping or running out of one or more medications during the travel period. In addition, the following markers of chronic disease management were compared

before and after travel using a two-sided paired t-test: hemoglobin A1c, LDL, SBP, DBP, www.selleckchem.com/screening/fda-approved-drug-library.html BMI, SCr, and INR. A linear regression analysis was performed to identify predictors of medication nonadherence, including the

following covariates: patient age, the number of medications, travel destination, duration of travel, and whether the patient received counseling on how to obtain medications to cover the duration of travel. selleck screening library A second linear regression was performed to identify factors associated with having a problem related to chronic conditions during travel, including the following covariates: patient age, travel destination, duration of travel, number of medications, documented nonadherence to medications, and whether or not the patient received counseling on chronic disease management during Casein kinase 1 the pre-travel visit. A total of 110 patients were included in our analysis (Figure 1). Patient demographics are summarized in Table 1. All patients traveled either to Asia (N = 62) or Africa (N = 48), and the median duration of travel was 59 days (range 21–303). Languages spoken are summarized in Table 1 and are representative of both country of origin and travel destinations in Asia and Africa. Key elements of pre-travel preparations are described in Table 2. A total

of 433 travel-related counseling points were documented in the medical record, averaging 4 counseling points per patient. Of these, 71% (N = 309) of all travel topics discussed were related to infectious disease prevention. Chronic disease and safety-related counseling topics comprised 16% (N = 69) and 13% (N = 55) of total health topics discussed at pre-travel visits, respectively. Table 2 further describes the percent of patients that received at least one piece of travel counseling advice in specific topic areas including: infectious disease, chronic disease, and safety. Sixty-three patients (57%) reported one or more health problems while traveling; 10 of these patients were sick enough that they sought care from a health care provider while abroad. Thirty-five patients (32% of travelers) experienced a health problem related to one or more chronic conditions diagnosed prior to travel (Table 3).