Self-Care Policies and the Primary Role of Pharmacists in Healthcare

This report delves into self-care policies and the pivotal role of pharmacists in healthcare, examining strategies and programs implemented in countries like England, Australia, and Scotland. It explores various promotional strategies, including governmental policies, public health campaigns, and statistical tools like Patient Activation Measures. The report highlights the importance of supportive care networks, financial resources, and educational resources in enhancing self-care practices. It discusses the effectiveness of these policies and programs, emphasizing the pharmacist's role in minor disease management and promoting health literacy. The report references initiatives such as the Scottish Government's self-management strategy, the Western Australian Chronic Conditions Self-Management Strategic Framework, and the NHS's Supported Self-Management program, along with educational resources like ALISS and the 'Making it Easier' health literacy plan. Overall, the report underscores the significance of comprehensive self-care policies in improving public health outcomes and empowering individuals to manage their health effectively.

Running head: SELF-CARE POLICIES AND PRIMARY ROLE OF PHARMACISTS
SELF-CARE POLICIES AND PRIMARY ROLE OF PHARMACISTS
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Introduction
According to the World Health Organization (2020), self-care is implied as the capability
of an individual, a family or a community to effectively engage in practices of health promotion,
disease prevention, maintenance of health, illnesses and disability coping practices, mainly in the
presence or in the absence of a healthcare professional or provider. It is worthwhile to note that
almost individual and family engage in prevalent practices of self-care such as: healthy dietary
intake, regular sleep, exercise participation or implementation of recreational activities, to name
a few. Despite their proven effectiveness, the above practices are more often than not, not
adequate to prevent illness and negative health outcomes in individuals inflicted with chronic or
minor diseases (Devarajooh and Chinna 2017).
While seemingly simple and obvious, the comprehensive impact of self-care is often
ignored. When individuals are educated collectively on the importance and strategies of regular
implementation of self-care practice, the same is likely to result in overall positive public health
outcomes with respect to the entire community (Basu et al. 2018). Individuals well versed in
relevant self-care practices are likely to possess higher health literacy with respect to availability
health care services, resources and providers which in turn, renders them well-equipped to
personally manage their minor or chronic health condition (Miller et al. 2018).
While it is true that self-care practices ought to be managed at the individual level, the
potential role of pharmacies and pharmacists in ensuring and enhancing compliance and
effectiveness of the same, must not be overlooked. Self-care policies, strategies and interventions
at the public health level are thus recommended to target both pharmacists as well as individuals.
Such strategies not only enhance a person or a community’s confidence to consult pharmacists as

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the first line of treatment but also improves the role of pharmacists to provide immediate
evidence-based treatment without the need for individuals to wait for time consuming and
financially unfeasible specialists services (Dionne-Odom et al. 2017). The following paper will
thus provide an elaborate and extensive discussion on the prevalently used policies and programs
of self-care, their evidenced effectiveness till date and the key competence and measures
mentioned with respect to the role of pharmacists in minor disease management, in the context of
countries like England, Australia and Scotland.
Discussion
Promotion of Self-Care and evidence effectiveness
Various self-care policies and programs are prevalent or underway for implementation
across countries like England, Scotland and the United Kingdom. Some of the most common
health promotional strategies found to be used across these nations with respect to dissemination
of self-care policies, which will be discussed in the succeeding sections, include: federal and
state levels policies, public health campaigns by non-profit, non-governmental, private or
independent public health and community groups and organizations and even promotional events
and campaigns organized by government funded healthcare organizations (Maijala, Tossavainen
and Turunen 2016).
On a global scale, the WHO’s (2020), program recommendations on self-care and
proposed self-care models recommends a range of promotional and supportive strategies with
which, an organizational or nation’s government can ensure the prevalence of an environment
compliant to enable self-care for all individuals and populations and community groups. These
include: the presence of skilled and capable workforce, healthcare educational resource,

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prevalence of affordable and accountable healthcare services, prevalence of healthcare products
of optimum quality and availability of healthcare policies, laws, regulations and comprehensive
support at the psychosocial level.
Policies and Programs
As rightly mentioned above by the WHO (2020), one of the major reasons contributing to
lack self-care resources, strategies and services within a nation is the absence of relevant policies
or programs from the government to guide a country’s healthcare providers and organizations to
direct their resources in achieving the same. The establishment of policy protocols not only
inform relevant healthcare providers on the ways in which self-care strategies can be taught to
consumers but also educate consumers and communities themselves, via media and news
coverage, on the nation’s available healthcare services (Aishwarya, Malhotra and Mandal 2019).
Demonstrating relevance to the same and for the purpose of enhancing awareness on self-care
strategies and dissemination of self-care policies and regulations, the Scottish Government
(2016) in collaboration with the Health and Social Care Alliance of Scotland (the ALLIANCE)
have developed a federal level self-management strategy which aimed to provide person centered
educational and self-care support across five clinical area of diagnosis, progression, living for
today, end of life and transitions.
Self-care associated governmental policies and programs can be found largely across
countries like Australia and England. The Government of Western Australia (2015) in
collaboration with the Department of Health, aims to address and encourage populations to
understand the importance of self-care across populations via the implementation of its Western
Australian Chronic Conditions Self-Management Strategic Framework. As per this model, the
Western Australian Government postulates the importance of available health resources and

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tools, awareness, community culture and services in building individual capacity, accessibility to
referrals and care services, availability of person centered resources and comprehensive needs-
based healthcare services which in turn, contributes to improve skills of self-care and healthcare
self-management across populations, communities and individuals (Government of Western
Australia 2015). Likewise, the Department of Health and Human Resources of the Tasmanian
Government (2012), addresses the enhancement of self-care abilities across the population as
part of ‘A framework to support Self-Management’, via the inclusion of ‘Core Underpinning
Principles of Self-Management’. As per the same, the Tasmanian Government evidences the
positive relationship between enhance self-care skills and interrelated functioning of principles
like ‘profession’, ‘person’ and ‘synthesis (Department of Health and Human Resources of the
Tasmanian Government 2012). Indeed in addition to inclusion of policies and programs on self-
care practices, the inclusion of relevant, structured healthcare promotional models are an
effective and convenient way with which governments and healthcare organizations can translate
their proposed policies systematically into real life practice – which has been used efficiently in
Australia as mentioned above (Werfalli et al. 2019).
Comprehensive self-care policies and programs are also present across England in the
form of the ‘Supported Self-Management’ program as a part of the National Health Service’s
(NHS 2018) commitment to ‘Long Term Plan’. This self-care program is based on the principle
that enhancing an individual’s healthcare associated skill and knowledge instills long term multi-
faceted benefits in the form of improved personal care management abilities as well as saving the
medical expenditures incurred by the nation’s current healthcare system. The aim of this self-
care program is to prioritize the development of individualized self-care plans by healthcare
professionals and organizations. To enhance achievement of the same, the program incorporates

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a comprehensive set of intervention such as health coaching, self-care education, support
services and statistical tools (NHS 2018).
Statistical Tools
To further enhance the effectiveness of governmental policies with respect to promoting
the importance of self-care strategies across the nation, it is not uncommon to find public health
organizations and governments to include statistical and analytical tools. A key example of the
same is the inclusion of the ‘Patient Activation Measures’ as a part of the self-care promotional
and educational self-care interventions of the NHS’s SSM program (NHS 2018). This
intervention comprises usage of a tool which calculates a person’s level of knowledge, skills and
awareness and overall scores of self-care in order to determine their ability to personally manage
chronic conditions at home. Such self-care strategies are effective due to their deliverance of
objective and quantifiable data which can be used to accurately determine client’s diagnosis and
self-care abilities which otherwise would be difficult in terms of qualitative or subjective
information (Stapley et al. 2019).
Supportive Care Networks
A key promotional and educational self-care strategy found to be incorporated in NHS’s
SSM program is the ‘Peer Support’ intervention (NHS 2018). Despite the widespread prevalence
of comprehensive policies, educational and promotional self-care resources, individuals may still
find it difficult to implement self-care practices in real life, especially when they are living alone.
The prevalence of self-help or support group based interventions is an interesting educational
and promotional self-care strategy which can be used to combat the same and is used extensively
in the NHS’s self-care program (Doull et al. 2017). In ‘Peer Support’ programs participants and
get the opportunity to interact, work, collaborate and communicate with a range of likeminded

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individuals, with similar healthcare needs and conditions (NHS 2018). Such interventions
encourage and empower individuals to engage in self-care by providing a supportive and
motivational environment where goals and burdens are shared together (Kwan et al. 2017).
Financial Resources
To further empower individuals to acquire knowledge and implement strategies of self-
care across all the above sections, the Scottish Government (2016) has provided finding grants in
the form of a ‘Self-Management Fund’. As per the same, the federal government has funded
third sector organizations – which include voluntary sectors, charities, self-help associations,
cooperatives and social enterprises – an amount of £ 2 million so as to enable dissemination of
educational services and resources with which individuals can be educated, provided and
encouraged to engage in relevant strategies of self-care. Such promotional methods, in the form
of financially supportive resources have been evidenced to be beneficial especially in remote,
rural or economically underprivileged areas where adequate healthcare resources, services or
healthcare providers are not available for individuals or groups to avail (Muramatsu et al. 2019).
Educational Resources
One of the most traditional, prevalently used and effective forms with which individuals
and communities can be educated on prevalent self-care practices and policies, include the
availability and dissemination of healthcare educational resources. In addition to lack of financial
resources as mentioned above, inadequate levels of health literacy or poor levels of knowledge
and awareness concerning effective self-management strategies are reasons why individuals and
groups or unable to efficiently engage in the same (Nutbeam, McGill and Premkumar 2018).
Dissemination and promotion of self-care strategies in the form of educational resources not only
enhance an individual’s literacy regarding understanding of the same but also enlighten on

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prevalent support services with which he or she can effectively take control and maintain their
health (Russel et al. 2017). To ensure the same, the Scottish Government has developed and
implemented ‘A Local Information System for Scotland’ - or ALISS. ALISS is a project
initiative by the Scottish Government (2017) which recognizes the role of quality, abundant and
accessible healthcare information in encouraging community level self-management practice.
ALISS thus, translates this understanding, by demonstrating the role of an educational portal
accessible by the community with which individuals can educate, inform and procure data for
themselves concerning management of personal or familial health issues and concerns (Scottish
Government 2017). Additionally, to further encourage healthcare organizations to enhance
consumer health literacy by developing and promoting self-care strategies in the form of
educational resources , the Scottish Government (2017) has developed a policy for the same, in
the form of ‘Making it Easier - A Health Literacy Action Plan for Scotland, 2017 to 2025’. As a
part of this strategy, the Scottish Government (2017) had necessitated state and local healthcare
organizations to research on relevant barriers to health literacy, recognize the beneficial role of
health literacy in ensuring long term positive health outcomes and lastly, translate the same to
practice by disseminating healthcare information in the form of innovative and update
educational resources and forms. With respect the same, a key way with which the Make It
Easier strategy encourages organizations to address population healthcare literacy is via the
creation of an online webpage comprising of all healthcare self-management educational content
which can be accessed by consumers with respect to their personal healthcare concerns (Scottish
Government 2017). Indeed, in addition to printed or pictorial based healthcare resources, the
availability of online healthcare resources and educational tools are not only effective in
increasing the healthcare literacy of consumers but in fact, are more feasible since it saves

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individuals the costs and time require to avail transport required for accessing healthcare
educational resources (Solhi et al. 2019).
The usage of educational resources for the purpose of educating consumers on self-care
health management strategies have also been found to be exercise by the federal and state
governments of Australia (Duggan, Chislett and Calder 2017). The Government of Western
Australia (2015) in collaboration with the Department of Health, as part of implementations
mentioned in its Western Australia Health Annual Report 2014 and its ‘Chronic Conditions Self-
Management Strategic Framework’ recognized the importance of enhancing individual’s
healthcare skills and knowledge in improving their capacity to participate in health based self-
care practices. To address the same, Western Australia’s website can be found to comprise of
online self-care resources for both consumers and healthcare providers. To further ensure
consumer convenience and ease of accessing healthcare information with respect to patient
centered approaches, consumers can access self-care health resources in their governmental
online webpage categorized in groups of chronic condition management, aboriginal health,
partnerships with healthcare providers, accessibility and locations of healthcare services and
contact information concerning additional supportive healthcare resources (Government of
Western Australia 2015). Additionally, the Government of Western Australia (2015) has also
include educational resources on self-care in the form of videos. The availability of such
innovative and diverse health based self-care resources can be considered beneficial in enhancing
healthcare literacy due to their attractive nature and especially for individuals with limited
linguistic abilities who need to educate using lay language (Poureslami et al. 2017).
However, in criticism, it must be denoted that the prevalence of merely online based
health literacy self-care resources, as demonstrated above, may serve as a key limitation with

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respect to economically underprivileged areas where internet resources may be scarce. To
combat the same with respect to promotion of self-care practices and policies, governments must
exercise alternatives modes of communication. These may include deliverance or availability of
healthcare educational resources at the individual level or at the concerned healthcare institutions
(Nutbeam, McGill and Premkumar 2018). The inclusion of such alternative self-care educational
strategies can be found to be prevalent in England, in the NHS’s ‘Supported Self-Management’
(SSM) program. These are included in the form of ‘Health coaching’ and ‘Self-Management
Education’ in the program. The NHS’s Health coaching self-care services comprising of
recruitment of healthcare staff members who have been educated and trained specifically
concerning the appropriate usage of self-care strategies, tools, services and resources. Such
healthcare coaches are then employed across clinical or primary healthcare organization and
settings for the purpose of mediating between individuals and healthcare providers in the
development of a collaborative self-care plan. Additionally, the NHS (2018)SSM program also
includes ‘Self-management education’ as a key promotional and educational strategy of self-care
across consumers. As a part of this initiative, healthcare organizations in collaboration with
Quality Institute of Self-Management Education and Training Interventions, encourages
healthcare providers to not just educate but also to train patients with chronic illnesses to
effectively engage in long term, home-based self-care strategies (NHS 2018). Such alternative
educational and promotional interventions have been evidenced to demonstrate greater
effectiveness in terms of empowering individuals to engage in self-care practices personally in
comparison to merely educational resources. This is because such strategies incorporate patient
centered approaches to healthcare promotion and educational interventions via recognition of the

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individual’s health literacy, personal goals and strengths followed by deliverance of a
customized self-care training plan (Mackey et al. 2016).
Pharmacy and Practitioner Public Health Campaigns
The implementation of community level, public health or community level campaigns are
effective ways in which self-cares strategies can be promoted across groups and individuals with
a faster and wider reach (Schwartz et al. 2017). A common example of such a promotional
campaign was found to be implemented across England, in the year 2017, by the NHS Brighton
and Hove Clinical Commissioning Group. The campaign, known as ‘#HelpMyNHS’ was
developed with respect to the principle that individual engagement in long term self-care
practices paves the way for national savings in terms of population wide medical expenditures
associated with preventable or minor heath conditions. To disseminate and promote awareness
across the public concerning relevant strategies of healthcare, the campaigned delivered
education on the high costs incurred in the acquisition of general practitioner based prescriptions
which otherwise are also available in the absence of a prescription across pharmacies, as over-
the-counter (OTC) medications. Additionally, for the purpose of educating healthcare providers,
practitioners as well as pharmacists on the strategies with which they can adopt self-care and
self-management as a part of their professional practice, this campaign also released a
practitioner centered resource pack available both electronically as well as institutionally. The
given pack covers educational resources on relevant lists of OTC medicines, the development of
self-care based prescriptions to be delivered to consumers, essential non-medicinal tips of
individual self-care as well as range of self-care based educational leaflets to be delivered across
consumers with specific healthcare concerns, namely colds, coughs, piles, hay fever, pain,

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nutritional supplementation and household medication administration (NHS Brighton and Hove
CCG – General Practice 2017).
From the above information, it can be observed that this self-care promotional campaign
as a part of the NHS, educates the public as well as practitioners on the role of the pharmacist
and the ways in which individuals can utilize the services provided by local level pharmacies
(Solunke, Deshmukh and Mohire 2017). The inclusion the role of pharmacists in the education
and promotion of self-care strategies in only a limited number of interventions as mentioned
above, demonstrates how relatively unexplored this area is. Inclusion of the role of pharmacies
and pharmacists in the form of pharmacist competencies and measures have been evidenced to
significantly improve the effectiveness of self-care strategies, policies, programs and
interventions, which will be discussed in detail in the succeeding sections (Bell et al. 2016).
Effectiveness
Competencies and Measures
According to the WHO (2020) report ‘The Role of the Pharmacist in Self-Care and
Medication’, the roles and responsibilities of pharmacists have been undergoing dynamic
changes and expansion, especially with respect to patient centeredness. The role of pharmacists
are no longer limited to merely the physical distribution of medications but is also now
considered as an important component in the multidisciplinary care team, with equal
responsibility in ensuring positive outcomes in a patient’s health. Thus it is unsurprising to find
involvement of pharmacists’ and pharmacies role as a key component within self-care plans,
programs and strategies (Sinopoulou, Summerfield and Rutter 2017).