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Opportunities to promote self care

We welcome the article by Amisha Patel and Hemant Patel (PJ 2014;292:484), which focuses on self care of long-term conditions, how healthcare professionals should engage with it and the role community pharmacy should have in promoting this.

The authors usefully present the Department of Health’s definition of self care and highlight potential benefits of why healthcare professionals should promote and support self care in the community. They also describe some of the evidence supporting the positive impact of many self care programmes on patient outcomes.

For people with long-term conditions, self care is inevitable and healthcare professionals are now being encouraged by the DH and the NHS to develop effective self care support strategies as a component of long-term conditions management in clinical practice. In an article we published previously in The Journal, we highlighted the fact that community pharmacy is yet to be fully engaged in the self care agenda (PJ 2012;289:573). There are obvious capabilities and indeed opportunities in community pharmacy, through more traditional contacts with patients when dispensing medicines, as well as the introduction of many newer services which focus on public health and the needs of patients with long-term conditions. However, community pharmacy’s contributions to the self care support agenda and any impact its contribution may have on patient outcomes still remain a potential, with little research evidence for support.

The authors stressed the importance of sharing patient health data among healthcare teams across different settings and how this is being used by a clinical commissioning group in north London. Although data sharing and access to patient records may help a shift towards a patient-centred approach in community pharmacy, the impact of using this and working with multidisciplinary teams need to be evaluated. The authors also discussed the importance of embedding behaviour change counselling approaches (such as health coaching) in healthcare professionals’ interactions with patients and how specific types of patients (ethnic minorities) could be targeted and engaged. Currently, community pharmacy’s approach to supporting patients with long-term conditions is described as “product-centric” rather than “patient-centred” (ibid). Self care support of long-term conditions should look at each patient holistically, rather than just by the medicines which they are using.  

The action plan by the North East London Local Pharmaceutical Committee to embed self care as a standard of practice across community pharmacies is a welcome development. But again, there is a need for robust evidence for this within a multidisciplinary setting, including an understanding of potential barriers, so that future models of care can be designed with this in mind. This is a call to action for community pharmacy to develop research evidence of self care support and find its place in the holistic self care agenda.

Currently, research at the University of Manchester is under way to explore what community pharmacists understand self care and self care support to be, what contributions they make and where potential barriers to effective implementation may be in this self care support agenda.  The research also explores the views of people with long-term conditions, so we aim to provide a perspective from both service providers and service users.  

Oladapo J. Ogunbayo

PhD student

Ellen I. Schafheutle

Lecturer in Law and Professionalism in Pharmacy

Christopher Cutts

Professor of Professional Development and Practice

Director, Centre for Pharmacy Postgraduate Education

Peter R. Noyce

Professor of Pharmacy Practice

Manchester Pharmacy School

The University of Manchester

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2014.11138882

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