Young adults remain worse off than adolescents.

On a broad range of indicators pertaining to risk taking and access to care, young adults fare worse than younger adolescents or older adults. Vulnerable groups, such as those facing chronic illness and those with unstable living arrangements, fare especially poorly as they transition to adulthood. Fortunately, a confluence of factors, particularly the changing nature of the transition to adulthood in modern society, has led to renewed interest in this critical period of the life cycle. Health science research is increasingly focused on issues faced by young adults, and public health policies designed specifically to address the health and well-being of young adults--notably the Patient Protection and Affordable Care Act in the United States--are now being implemented. Successful efforts at improving the health and well-being of adolescents should be mirrored in efforts to support young adults. A new report based on a broad range of United States national datasets lays out the challenges that must be addressed in these efforts.

A comparison of pharmacist travel-health specialists' versus primary care providers' recommendations for travel-related medications, vaccinations, and patient compliance in a college health setting.

BACKGROUND: Pretravel medication and vaccination recommendations and receipt were compared between primary care providers (PCPs) without special training and clinical pharmacists specializing in pretravel health. METHODS: A retrospective chart review of patients seen for pretravel health services in a pharmacist-run travel clinic (PTC) compared to PCPs at a University Student Health Center. Vaccine/medication recommendations were assessed for consistency with national/international guidelines. Medical/pharmacy records were queried to determine the receipt of medications/vaccinations. RESULTS: The PTC recommended antibiotics for travelers' diarrhea were given more often when indicated (96% vs 50%, p < 0.0001), and patients seen in the PTC received their medications more often (75% vs 63%, p = 0.04). PCPs prescribed more antibiotics for travelers' diarrhea that were inconsistent with guidelines (not ordered when indicated 49% vs 6%, p < 0.0001 and ordered when not indicated 21% vs 3%, p < 0.0001). The PTC prescribed antimalarials more often when indicated (98% vs 81%, p < 0.0001), while PCPs prescribed more antimalarials that were inconsistent with guidelines (not ordered when indicated 15% vs 1%, p < 0.0001 and ordered when not indicated 19% vs 2%, p < 0.0001). The PTC ordered more vaccines per patient when indicated (mean = 2.77 vs 2.31, p = 0.0012). PTC patients were more likely to receive vaccines when ordered (mean = 2.38 vs 1.95, p = 0.0039). PCPs recommended more vaccines per patient that were inconsistent with guidelines (not ordered when indicated: mean = 0.78 vs 0.12, p < 0.0001, ordered when not indicated: mean 0.18 vs 0.025, p < 0.0001). CONCLUSIONS: A pharmacist-run pretravel health clinic can provide consistent evidence-based care and improve patient compliance compared to PCPs without special training. Pretravel health is a dynamic and specialized field that requires adequate time, resources, and expertise to deliver the best possible care.