L14: Self-care

• Self-care


  The independent act of preventing, diagnosing, and treating one's own illness without seeking professional advice
• Self-care


  Taking control of your own health and well being
• Reasons why self-care is increasing

  • Lifestyle (e.g. weight loss, smoking cessation)
  • Easy access to drugs
  • Public health and environmental factors
  • Increased potential to manage certain illness through self care
• Types of self-care


  • Preventative self care
  • Sickness self care
• Preventative self-care


  • Involves maintaining well-being and appearance through exercise and a healthy lifestyle
  • For many individuals, a healthy lifestyle includes controlling their diet, taking vitamins, minerals, herbal supplements and maintaining their appearance by using dental, skin and hair-care products
• Sickness self-care

  • Involves diagnosing their conditions and obtaining products for relieving symptoms
• Examples of sickness self-care

  • Home blood glucose meters and pregnancy tests
  • First-aid bandages, nebulizers
  • Self diagnostic test kits - iron deficiency, thyroid function, urinary tract infection
• Sources of information for self-care

  • Internet
  • Newspaper/magazines
  • Books
  • Friends/family
  • Social media
• Self medication


  The practice whereby individuals treat their ailment and conditions with medicines which are approved and available without prescription and which are safe and effective when used as directed
• Self medication plays an increasing role as adjunctive therapy for chronic diseases that are managed by prescription medication
• Self-medication is the most sought after first level of self care
• Worldwide, self medication has been promoted as a means of reducing the health care burden on the public budget
• Options for Self-Medications


  • Non prescription medicines (OTC)
  • Nutritional dietary supplements
  • Natural products and homeopathic remedies
• OTC (Over-the-counter medicine)


  Medicine that patients can buy without prescription
• OTC medicines are safe and effective when a patient follows the directions on the label and as directed by health care professionals including pharmacists
• Advantages of OTC medicines

  • Can save money - cheaper prescription charge
  • Time and opportunity - booking an appointment with doctor
  • Savings for the NHS
  • Empowering for patients
• From a regulatory perspective, certain criteria must be met before shifting from POM to OTC: safety, efficacy, provision of information leading to safe use - warning and duration of use
• Examples of common conditions treated with OTC medicines

  • pain
  • cough/cold/flu/sore throat
  • allergy/sinus problems
  • heartburn, indigestion
  • constipation/diarrhoea
  • minor infections
  • skin problems
• Risks with self medication

  • wrong dose/product
  • drug-drug interaction
  • abuse of OTC products
  • adverse drug reactions
  • overdiagnosis/underdiagnosis
• Examples of drug-drug interactions

  • Aspirin with warfarin/methotrexate may cause increased risk of bleeding and methotrexate toxicity
  • Fluconazole with gliclazide/simvastatin may cause hypoglycaemia and myopathy
  • Ibuprofen with warfarin/lithium may cause increased risk of bleeding and lithium toxicity
• Role of pharmacist

  Most accessible form of healthcare

  
• Communication skills


  • Active listening
  • Questioning techniques (open ended, closed ended, mnemonics)
  • Empathy
  • Differentiation between minor and more serious symptoms
  • Evidence based treatment choices
• How pharmacists can combat the misuse of non-prescription drugs


  • Ensure patients able to read and understand product labelling/dosage
  • Help patients avoid drug interactions
  • Warn about potential allergic reactions and side effects
  • Discuss appropriate drug storage and handling
• WWHAM


  • W: who is the patient?
  • W: what are the symptoms?
  • H: how long symptoms have been present?
  • A: action taken
  • M: medication being taken
• Risk groups for OTC medicines


  • Children
  • Pregnant and breast feeding women
  • Elderly
  • People with long term conditions
• Pseudoephedrine


  Should be avoided by hypertensive patients
• Sedative effects of drugs prescribed for anxiety, depression and psychosis


  May be enhanced by antihistamines
• Proxy visits

  1. Think about type of patient - elderly, children, pregnant or breastfeeding?

  2. Excessive use? laxatives/painkillers
• Assessing symptoms

  1. Need to find out nature of problem

  2. Intensity? severe or mild

  3. Location of symptoms
• Assessing duration of symptoms

  1. Minor ailments are self-limiting (few days)

  2. Long standing so may need referral

  3. Repetitive in nature?
• Assessing action taken


  1. What other drugs have they tried?

  2. Did they work?

  3. Avoid offering same advice
• Assessing other medication


  1. Many patients will be taking other medication, prescribed or OTC

  2. Did they Request by product name

  3. Still under obligation to ask questions but can be harder discussion to undertake
• When to refer


  1. Dependent of signs, symptoms and duration e.g. blood on coughing or cough longer than 3 weeks

  2. Avoid raising fears - don't say 'cancer'