1. IPHA Switch-on to Self-Care From Primary Care to Self-Care
Marita Kinsella
Chief Pharmacist
March 25th 2009

2. What is self-care?
“Self Care in health refers to the activities individuals, families and communities undertake with the intention of enhancing health, preventing disease, limiting illness, and restoring health. These activities are derived from knowledge and skills from the pool of both professional and lay experience. They are undertaken by lay people on their own behalf, either separately or in participative collaboration with professionals”
“Self-Care in Health Promotion”
Ilona Kickbusch, WHO Euro Regional Office, 1983

3. Benefits of Self-care Benefits for patient health and other outcomes
–increased life expectancy
–better control of symptoms including pain, anxiety and depression levels
–improved quality of life with greater patient independence
–reduced absenteeism from work
Implications & benefits for healthcare system
–improved quality of consultations
–visits to GPs can be reduced
–hospital admissions & length of stay can be reduced
–A&E and outpatient visits can be reduced
–medicine utilisation and compliance can be improved
UK Dept of Health

4. Core elements of self-care
Empowering patients to take responsibility for their own health and well-being in:
Prevention:
taking action to prevent ill-health, illness & accidents e.g. staying healthy, both physically and mentally
Chronic Illnesses:
better care of long term conditions
Minor Ailments:
better care & treatment of minor ailments
Better use of medicines is a core element of self-care

5. National policy
Primary Care, A New Direction, Quality & Fairnes – A Health System for You, DoHC, 2001
Aim to strengthen primary care system as central & first point of contact for patients with health system
Change in emphasis from secondary care to primary care

6. National policy
Building a Culture of Patient Safety, Report of the Commission on Patient Safety and Quality Assurance, DoHC, 2008
Development of proposals for health service-wide system of governance
Vision for a patient safety and quality framework in Ireland: Knowledgeable patients receiving safe and effective care from skilled professionals in appropriate environments with assessed outcomes
Chapter 4 contains 25 recommendations on patients, carers and service user participation
R4.13: Specific programmes should be developed by the HSE aimed at supporting patients with chronic conditions, helping them to understand and manage their conditions and to participate in decision-making regarding their clinical management.

7. National policy
Tackling Chronic Disease, A Policy Framework for the Management of Chronic Disease, DoHC, 2008
Sets out broad principles on disease prevention and disease management programmes
Contains 14 recommendations on management of chronic disease
Recommendation 10: patients should actively participate in mgt of their condition
Patient participation in disease mgt improves health outcomes & reduces dependency on health services
Patients’ understanding of symptoms, disease & treatment essential parts of self-care
Aspects of self-care: patient education & awareness, self-monitoring & self-treatment
Action: HSE to continue development of self-care programmes for patients with chronic diseases

8. National policy
Economies in Drug Usage in the Irish Healthcare Setting, Report to Minister for Health & Children, 2009
Report commissioned by Minister & chaired by Dr. Barry, Clinical Directive of National Centre for Pharmacoeconomics
To consider efficient and cost-effective prescribing of medicines
Report noted that potential to change status of medicines from POM to supply under pharmacist supervision used in other Member States & recommended that wider clinical issues need to be considered prior to move in this direction

9. National policy HSE Publications in the area of Self-care
Selfcare Guide for People with Diabetes, 2008

10. Thank you