Supporting patients self care in Europe, in primary care and beyond

1
Supporting patients self care in Europe, in
primary care and beyond

• Professor Ruth Chambers
• Sara Buckley
• Diederik Aarendonk

2
Aims of the position paper

• To inform policy makers in WHO, the EU and member
  states re importance of self care to health and
  well being
• Describe how to increase frequency and extent of
  self care
• Describe potential benefits of expanding self
  care
• Present evidence and arguments for policy makers

3
Aims of the position paper

• Provide an opportunity for exchange of knowledge
  and experience, discussions and aspirations
  between European countries
• Gain a common understanding of challenges to the
  implementation and application of self care
• Strengthening the evidence base
• Share lessons on how to do it

4
What is self care

• Self care is the basic level of health care in
  any society, comprising an estimated 80 of all
  care episodes
• Self care is about peoples attitudes and
  lifestyle, as well as what they can do to take
  care of themselves when they have a health
  problem
• Supporting self care is about increasing peoples
  confidence and self esteem, enabling them to take
  decisions about the sensible care of their health
  and avoiding triggering health problems

5
Components of self care
6
Case Study 1 Asthma Care

• Proactive self care support for people with
  asthma
• Involvement 50 general practices from 25 primary
  care trusts in England
• Proactive telephone outreach service to support
  self care
• Regular calls from nurse, smoking cessation
  advice, preventer therapy
• Referrals to their asthma nurse or GP when needed

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Case study 1-PART model

• Prevention of worsening asthma by more effective
  use of preventative therapy and smoking cessation
  advice
• Relief of symptoms through better use of
  medication
• Evaluation showed
• 69 improvement in asthma
• 39 better compliance with preventer medicine
• 40 reduced amount of reliever medication

8
Case study 2 Education and advice

• Sure Start and 4 local pharmacies collaborated to
  make greater use of pharmacies as health advice
  centres
• Aim to increase parent education on health issues
  in lt3yr olds in an under-doctored area
• Parents registered with local pharmacies for
  advice-leaflets provided on 6 specific ailments,
  medicines provided free of charge

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Case study 2-PART model

• Awaiting resolution
• Relief of childrens minor ailments
• Tolerance
• Results to date
• 10-15 of cases no medicine supplied
• Approx 50 cases pharmacists felt advice
  sufficient remaining required referral for
  medical advice

10
Self care advice and guidance for back pain
Prevention, Await resolution, Relief and
Tolerance of symptoms

• P programmes run by public health, governmental
  or voluntary agencies or by employers. Primary
  care organisations, general practice teams or
  pharmacies may want to run their own. Education
  projects in schools could help make children more
  aware of posture. Workplace initiatives can help
  back pain.

11
Self care advice and guidance for back pain
Prevention, Await resolution, Relief and
Tolerance of symptoms

• A most people with acute back pain will have
  sufficient improvements in one month to return to
  work. Low levels of pain and disability can
  persist 3-12 months, recurrence
• Safety net of advice on warning signs of more
  serious conditions needed

12
Self care advice and guidance for back pain
Prevention, Await resolution, Relief and
Tolerance of symptoms

• R take it easy, avoid strain, heat or ice pack
  to lower back. Keep active, small amounts
  frequent exercise. Seek advice, book or website
  on back care, osteopath or chiropractor
• T much of the advice e.g. take it easy etc also
  applicable to Tolerating symptoms

13
Issues and recommendations for position paper

• In order to increase the frequency and extent to
  which people in Europe practise self care- what
  do you feel is important to include with respect
  to
• Education?
• Clinical services?
• Community development?
• Health at work?
• Public health?
• Health policy?