Background Short-term medical missions (STMMs) are a highly debated and largely understudied form of international volunteer work. With growing dedication to health care abroad, research evaluating their impact is crucial to ensure continued interventions are effective in improving medical care. STMM care varies in length, frequency, size, location, services offered, and country of origin and destination. This makes systematic evaluation of STMMs difficult. In addition, the transient nature of patient visits makes trending STMM's impact on long-term health outcomes complex. Despite intermittent availability, primary care missions offering pharmaceutical supplies have the unique opportunity to provide continued care to the community via free prescription supplies each visit. Given the challenges with measuring long-term outcomes in this population, it is unknown if these donated medications have any impact on patient health outcomes. As medication noncompliance is known to hinder health outcomes, our study chose to evaluate patient medication habits to see if these prescription supplies were being utilized appropriately. To our knowledge, no study has surveyed medical mission patients to explore their access and utilization of medication. Methods A cross-sectional study was conducted using a patient survey to identify risks and/or factors associated with medication noncompliance in patients visiting the medical mission, Waves of Health (WOH). For over 10 years, WOH has organized biannual seven-day trips to the Dominican Republic. The multi-question survey was translated into the native language, Spanish with Dominican dialect. Noncompliance was defined through the survey question "Did you run out of your prescription medication at all during the past year?" Spanish speaking participants, of both sexes and age ≥18 years old, who visited the mission clinic in November 2019 met inclusion for this study. Patients from Haiti or age <18 years old were excluded. Participation was voluntary. Survey items were dichotomized for univariate analysis to identify factors associated with running out of medication. To explore predictors of running out of medicine, we performed multivariate logistic regression analysis by ENTER method.

Background This prospective observational study evaluated the impact of a primary care-based, international, short-term medical mission’s (STMM) impact on diabetes disease burden as represented through reductions in hemoglobin A1C (HbA1c). Methods From November 2016 to May 2017, we tracked the HbA1c’s of diabetic individuals in Dajabon, Dominican Republic through care provided by Waves of Health (WOH). Participants were provided counseling, glucose monitoring equipment, a 6-month supply of anti-diabetic medications, and received a ‘check-in’ phone call at 3 months. HbA1c’s were re-measured at 6-month follow up. We hypothesized WOH diabetic care would have a modest impact of reducing mean HbA1c by 0.5%. Results In total, 75% (n = 76) of 101 participants presented for follow-up care. Mean and median HbA1c decreased from 8.71 (SD 2.0) and 8.5% to 8.36 (SD 2.1) and 7.7%, respectively (P = 0.07). The percentage of individuals with HbA1c ≤7.5 increased by 10.4% at follow-up. The mean HbA1c decrease was 1.1%. Conclusions Though limited by sample size, our results suggest that medical STMM’s may have a clinically meaningful impact in chronic disease management when utilizing a systematic combination of education, medical therapy, clearly documented medication instructions and regular trip intervals.