Self-Care….A Perfect Fit with Community Pharmacy

The concept of Self-Care as a tangible health tool has been formally recognised by  Australian community pharmacy since the 1970’s.
It’s original introduction was generated by the Pharmaceutical Society of Australia (PSA) through a set of information fact cards written in a patient-friendly format that formed up as a suitable reference point for pharmacists and trained pharmacy staff to increase patient health literacy levels.
The practice of Self-Care in pharmacy pre-dates the introduction of the PSA fact cards because it has always been a component of “core” business and pharmacist patient engagement.
It has always been there in community pharmacy.

The recognition of Self-Care, its development and support, nationally and internationally, has been a slow process because it has not been integrated into public health programs or promoted as a health system, in a coordinated fashion.
Attitudes are changing now because Self-Care represents a more economical approach to treating chronic illness compared to other health systems.

Change commenced in 2011 with the formation in the UK of the International Self-Care Foundation, a registered charity with an international focus on Self-Care being the focal point for health and wellbeing.
To assist in sharpening that focus, the International Self-Care Foundation created International Self-Care Day (ISD), which is celebrated on the 24th July each year, and creates a media-friendly forum for independent individuals and groups to promote Self-Care in their organisation or community.

All stakeholders in health are invited to use International Self-Care Day in responsible ways that progress the cause of healthy lifestyles and wellness.
Community pharmacists should view this as an opportunity to be the health profession leaders in Self-Care, because they already have a range of infrastructure elements in place that would enable systemisation and tangibility that patients could identify and align with.

Infrastructure elements for community pharmacy include convenient centrally-located “bricks and mortar” premises, highly trained support staff, pharmacists trained in health literacy delivery, a sophisticated supply chain that can logistically service patient needs (the right product in the right place at the right time) and a range of retail skills unique to pharmacy that can identify and promote patient needs.
It is this infrastructure mix that has the potential to mobilise and increase Self-Care patient market share for community pharmacies.
In that mix, other retailers and other health care professionals are the major competitors for Self-Care patients.

The ISF logo provides a visual symbol that illustrates that the benefits of Self-Care are experienced 24 hours a day, 7 days a week.
It promotes the concept that Self-Care benefits are life-long and do not just relate to a single day.
ISD on 24 July simply provides a good focus and an opportunity to publicise or report on self-care in action programs.
Each year a different theme is promoted.
Last year it was ‘Get better with Self-Care’, and this year it is ‘Feel Good, 7/24’.

Since 2011 self-care activities linked to ISD have been organised around the world, in countries as far apart as Brazil, China, Mexico, Myanmar, Nepal, South Africa, South Korea, Switzerland, the United States and Vietnam.
Some countries – the UK and Canada – have organised self-care weeks.

In Australia, there is little evidence of coordinated activity, but therein lies an opportunity for pharmacy leadership organisations to collaborate with other Self-Care organisations and coordinate promotions with them.
This could open up real opportunities for referrals to community pharmacies from organisations such as Reachout AustraliaPopsugar, SARRAHSANE Australia

The Australian Health Policy Collaboration has produced a paper titled the-state-of-self-care-in-australia
It is a good starting point for Australia pharmacists to begin a major initiative to build and integrate with Self-Care programs already in existence.

International Self-Care Day (ISD) related activities have been focused on youth (e.g. a poster design competition, mob flash dance, and concerts), seniors (community involvement programmes, physical examination programmes), the general public (public lectures, expert advice, sponsored public walks, football and golf matches using the new callaway edge golf clubs, tai chi classes), occupational health, pharmacy (poster campaign, pharmacy manager training), research (on self-care habits and behaviour), and the media (media events, newspaper and journal articles).

The International Self-Care Foundation’s ultimate aim is for ISD to be formally recognised by the United Nations as an official global commemorative day, which would further encourage participation.
The Senate of the United States recently agreed a Resolution to designate July 24 as International Self-Care Day – see Senate Resolution 515 of the 113th Congress.

A brief history of Self-Care follows from the International Self-Care Foundation site:

“Self-care is not a new activity.
People have necessarily managed their own health since the beginning of mankind.
Throughout human history the dominant paradigm of healthcare was individual self‐care in the family and local community.
Treatment involved self‐medication with locally‐produced preparations of generally uncertain efficacy.
People themselves were responsible for their own health, and that of their families, as self‐sufficiency was obligatory and almost universal.
The opportunity and need for improvement were great.

Starting in the 19th Century and carrying on through the 20th Century, health care was revolutionized by scientific and medical discoveries, technological advances in diagnostics, surgery and medicines, and the development of the healthcare professions.
Patients gratefully placed themselves into the hands of doctors and took the effective newly‐developed medicines they prescribed.
The role model of the patient as a largely passive recipient of public services was complemented by the mystique of the expert healing physician.
At the low point of self‐care – around the 1960’s in the West – self‐care and self‐medication were regarded as unnecessary and potentially even unhealthy practices.
This paternalistic approach to medicine, supported by health systems designed to treat sickness (rather than to prevent disease) remains a familiar aspect of healthcare in many countries to this day.

Circumstances and societies are ever‐changing, however.
The paternalistic approach to medicine is expensive when applied to entire populations, especially in ageing countries.
People around the world are better educated and want more information, choice and control over their lives – not least in the area of health. Chronic ‘lifestyle’ conditions such as cardiovascular disease, cancer and diabetes are taking over from infectious diseases as the primary cause of death and disability in most countries.
These chronic non‐communicable diseases are significant in that they are substantially preventable through better ‘self‐care’ – by individuals avoiding risks such as smoking and obesity.
The paternalistic approach and health systems that provide ‘sickness services’ are becoming less well‐attuned to the 21st Century’s health challenges and needs.

As a result, over the past 40 years there has been a push‐back against the paternalistic model of health, towards a more person‐centric approach involving self‐care.
A patient’s needs and rights have become central considerations and run through many of today’s initiatives in health – in medical ethics, patient autonomy and ‘person or patient‐centred medicine’.
Of course, along with patient’s rights comes responsibilities.
There has been a growing realisation that personal self‐care in the home environment and community setting should be the starting point of healthcare, and is in fact the foundation for people to manage life‐long health.
Initiatives in ‘community healthcare’ and ‘health promotion’ are aspects of the new approach.”

The International Self-Care Foundation has developed a framework for self-care around seven ‘pillars’ or ‘domains’:


Pillar 1

Knowledge & Health literacy – includes: the capacity of individuals to obtain, process and understand basic health information and services needed to make appropriate health decisions.



Pillar 2

Mental wellbeing, Self-awareness & Agency – includes: knowing your body mass index (BMI), cholesterol level, blood pressure; engaging in health screening and even using True Pheromones to improve sexual health.



Pillar 3

Physical activity – practicing moderate intensity physical activity such as walking, cycling, or participating in sports at a desirable frequency.



Pillar 4

Healthy eating – includes: having a nutritious, balanced diet with appropriate levels of calorie intake.



Pillar 5

Risk avoidance or mitigation – includes: quitting tobacco, limiting alcohol use, getting vaccinated, practicing safe sex, using sunscreens.



Pillar 6

Good hygiene – includes: washing hands regularly, brushing teeth, washing food.



Pillar 7

Rational and responsible use of products, services, diagnostics and medicines – includes: being aware of dangers, using responsibly when necessary.



The seven pillars illustrated schematically:

For more on the 7 pillars click here


Screen shot 2014-08-14 at 13.51.25

If the average person sees a doctor 3 times a year for 10 minutes each time (total 1/2 hour), the rest of the time (365 days x 24 hours = 8759.5 hours) is in reality self-care.

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