Opinion: The role of health care professionals in supporting self-care
By: Catherine Duggan, CEO, International Pharmaceutical Federation
Self-care is not a universally well understood concept. The self-care community adopts the WHO definition of self-care as “the ability of individuals, families, and communities to promote health, prevent disease, maintain health, and to cope with illness and disability with or without the support of a healthcare provider.” However, we know from our daily practice and from conversations with our FIP members and the broader network that the notion of self-care is multifaceted and multidimensional, involving a broader set of stakeholders and subject to cultural influences.
Self-care belongs to a continuum that involves individuals, families, communities, healthcare professionals and policymakers at different levels and with different responsibilities. Individuals cannot—and should not be expected to—optimally embrace self-care practices and behaviors without the support of policymakers and healthcare providers: just as patients and consumers will need to adopt self-care tools in order to take greater responsibility for their health, policymakers and healthcare providers will need to commit to developing and providing those tools and opportunities for health literacy education.
To that end, support and trust among all stakeholders – healthcare providers, patients and consumers, and regulators and policymakers – are essential to maximizing adoption of self-care behaviors and products, regardless of what self-care means in various geographies.
At FIP, the COVID-19 pandemic has highlighted for us an opportunity to elevate and deepen the conversation on self-care, to better equip clinicians and policymakers alike with the knowledge they need to leverage self-care as a tool for empowering patients, improving health outcomes, and reducing health system costs. And, as pharmacists, we are aware of our responsibility as healthcare providers to support self-care, along with its critical prerequisites, such as patient and consumer empowerment, and health literacy.
We know that 90 percent of consumers see self-care as central to the prevention and treatment of both minor complaints and chronic conditions.[i] However, unfortunately, only two out of ten consumers report feeling “very confident” in managing their own health. That is, while consumers trust and value self-care in theory, they are less confident about adopting self-care products and behaviors in practice. This gap between consumers’ desire to practice self-care and their functional ability to do so can be addressed through policymaker and healthcare provider action.
I was thrilled to participate as a member of an Expert Advisory Committee of the soon-to-be-launched Self-Care Readiness Index. Launching in September 2021, the Index will fully examine the role of policymakers, healthcare providers, and consumers in supporting a vibrant self-care ecosystem. Policymakers play a critical role: in order for self-care to be embedded in a society, it must be institutionalized via direct changes to public policy advancing self-care programs. And, consumers and healthcare providers have a symbiotic role to play in the self-care ecosystem – consumers need healthcare provider support to feel confident adopting self-care behaviors, and healthcare providers need consumers to adopt self-care behaviors in order to reap the maximum benefits of health promotion and chronic disease treatment plans.
A 2019 study well described the need for change and confirmed what we have heard over and over again from our pharmacist members—consumers’ lack of knowledge about health issues and worries about mistakes are key barriers to the self-management of minor ailments. [ii]
As a global association serving clinicians, FIP wants to change this narrative. We know that healthcare providers want to be supportive of self-care. And, we believe that health systems and medical associations have a responsibility to patients and providers to put forward educational resources on self-care: if clinicians are not comfortable making self-care recommendations or coaching patients on self-care practices and products, patients and consumers are much less likely to adopt those beneficial behaviors. Patients and consumers look to trusted clinician partners—oftentimes their primary care provider or pharmacist—for guidance on self-care products
Pharmacists play a frontline role in empowering people for responsible self-care at the community level, interacting daily with patients and consumers making decisions about self-care products and behaviours in pharmacies around the world. The WHO previously defined four specific roles for pharmacists in supporting self-care and FIP has built on these with the following, noting evidence of outcomes is collected for all:
- As health promoters: participating in health promotion campaigns to raise community awareness of health issues and disease prevention and providing advice to individuals to help them make informed health choices
- As collaborators: linking into health system and community care teams
- As communicators: asking key questions to patients and starting a dialogue on medical history in order to provide objective and evidence-based advice about self-medication
- As coaches: adoption of methodologies to support health literacy and social prescribing
- As prescribers: ensuring the safe prescription of medicines and counter prescribing
- As quality suppliers of products, diagnostics and vaccinations: sourcing and properly storing quality health products to ensure consumer safety
At FIP, we are committed to ensuring that pharmacists stand ready and equipped to offer that guidance on self-care. With the launch of the Index in September, we look forward to continuing this important conversation. In the lead-up to the launch, we invite you to watch our “Shaping the Future of Self-Care, Through Pharmacy.” We will also launch a toolkit in November to support pharmacists in supporting responsible self-care choices.