By Nathan Malan
Findings in the UK have shown that there are around 57 million GP consultations a year for minor ailments at a total cost to the National Health System (NHS) of £2 billion[i]. These consultations take, on average, an hour a day of every GP’s time. As health systems across the EU look to a future of budgetary strains[ii] and health professional shortages[iii] related to the aging population[iv],patient empowerment and the expansion of self-care provides an interesting solution that could bring benefit to both the patient and health system alike.
A recent EU study described self-care as, “what individuals, families and communities do with the intention to promote, maintain, or restore health and to cope with illness and disability with or without the support of health professionals such as pharmacists, doctors, dentists and nurses. It includes but is not limited to self-prevention, self-diagnosis, self-medication and self-management of illness and disability.”[v]
The Self Care Continuum
The above figure shows the sliding scale of self-care used in the UK [vi]. On one side, you have pure self-care and on the other pure medical care. In single payer systems, this scale can often be heavy on the side of medical care. People are very happy to control the basic things, the “daily choices” associated with their lifestyles (person hygiene, eating and drinking habits, and exercise decisions), however other health related choices they quickly cede to the professionals.
Because medicine has been marketed as too complex for the mass, patients often feel unqualified or under-prepared to implement self-care. They feel marooned by the complex language of acronyms and lingo; and they feel overwhelmed with the choices in medicines and procedures. That is why a recent EU report on self-care promoted the need for a change in “culture”.[vii]
To help empower the individual, medicine needs to provide support. The language needs to be simplified and patients need easy to understand education about minor ailment and their long-term conditions. They need opportunities to practice skills, resolve potential issues, and ask questions. The patient needs to feel more in control so that they can take more responsibility further along the continuum. This will allow them to live healthier and more independent lives, and allow health professionals to spend more time and resources on the patients that cannot help themselves.
What action is being taken on the European level?
To improve self-care the European Commission has funding two separate European level projects. Each of these projects approach self-care in different way.
- EMPATHiE (December 2013 – September 2014)
This project worked at empowering patients in the management of their chronic diseases by identifying models of best practice, analysing those models, developing methods to validate the transferability of good practices (across disease areas and in different countries’ contexts), and in developing potential scenarios for future European collaboration.[viii]
- PiSCE (September 2014-May 2017)
This was a pilot project that just ended on the promotion of self-care systems in the European Union. In PISCE they did a cost/benefit analysis of patient self-care oriented health systems in the European Union and the current frameworks in place to enhance self-care oriented heath care systems and patients’ empowerment. Then they created a panel of experts in self-care and healthcare, including representatives of healthcare providers, patient groups, healthcare professionals, academics, communication experts and other relevant stakeholders with experience in policy making both at EU and national level. This platform of experts then produced guidelines to promote self-care and proposed action and collaborations to help the implementation of self-care for these five minor conditions: Athlete’s foot, Cold, Cough, Heartburn (without indigestion), and Lower urinary tract infection.[ix]
Read more about self-care in Europe
- Cost/benefit analysis of self-care systems in the European Union – http://ec.europa.eu/health//sites/health/files/patient_safety/docs/2015_selfcaresystemsstudy_en.pdf
- EMPATHiE final report – http://ec.europa.eu/health//sites/health/files/patient_safety/docs/empathie_frep_en.pdf
- PiSCE platform of experts – http://www.selfcare.me/?page_id=5
- AESGP presentation on self-care – http://www.aesgp.eu/self-care/about-self-care/
Other interesting and related topics
- A patient friendly medical language – http://www.wapatientsafety.org/downloads/GHC-Plain-Language-Toolkit.pdf
- The underutilization of pharmacist – https://www.pharmacists.ca/cpha-ca/assets/File/education-practice-resources/Translator2013V7-2EN.pdf