How do people choose between self-care, supported self-care and GP consultation in minor illness?
Lead Research Organisation:
University of Aberdeen
Department Name: Biomedical Sciences
Abstract
As demand for health services continues to increase, the ways in which services are provided may need to change to meet that demand. Traditionally in the UK the GP is the focus for health service provision but, increasingly, people are being encouraged to practise more self-care. Health professionals, such as community pharmacists and practice nurses, are offering services that support patients in the self-management of both minor and chronic illnesses. The success of such services will partly depend on the extent to which the public is willing to accept them as alternatives to GP consultations. It is therefore important to understand how people decide between self-care, supported self-care and GP consultation.
My PhD work showed that the choice between self-care and professional advice is influenced by many factors, inter-related in a complex way. Future research will aim to further explore these relationships. Results so far suggest that when designing ways to increase and improve self-care, flexible services that meet individuals‘ needs should be provided. Specifically, by enhancing the way pharmacy services are organised, it is hoped that patients undertaking self-care will experience improved access to support, delivered in a way that meets their needs and preferences and optimises outcomes.
My PhD work showed that the choice between self-care and professional advice is influenced by many factors, inter-related in a complex way. Future research will aim to further explore these relationships. Results so far suggest that when designing ways to increase and improve self-care, flexible services that meet individuals‘ needs should be provided. Specifically, by enhancing the way pharmacy services are organised, it is hoped that patients undertaking self-care will experience improved access to support, delivered in a way that meets their needs and preferences and optimises outcomes.
Technical Summary
Increasing demand for health services in the UK means that traditional methods of supplying health care may no longer be appropriate. Government policies place increasing emphasis on self-care by individuals. It is, therefore, important to understand how people choose between self-care and consulting a health professional. This thesis aimed to investigate decision-making in the management of minor illness, in the context of symptoms associated with analgesic use.
A cross-sectional survey was mailed to a random sample of the Scottish population (n=3000) asking about their use of medicines, particularly over-the-counter (OTC) analgesics. Qualitative interviews with 24 respondents to the survey asked about how and why people manage symptoms of minor illness associated with analgesic use in particular ways. Another survey containing a discrete choice experiment (DCE) was mailed to a further 652 respondents to the original survey, to establish preferences for self-care and different services that might be used to manage minor illness.
The survey showed that analgesics were the most commonly used OTC medicines and community pharmacies were most people‘s usual source of analgesics. Up to 8% of the population were judged to be potentially at risk from inappropriate use of OTC analgesics.
Interviewees responded to symptoms associated with analgesic use by consulting health care professionals, practising self-care or doing nothing. Reasons for practising self-care included convenience, influence of others, avoidance of medical interventions, supplementation of medical treatments, and perceived appropriateness. Factors influencing how people managed symptoms mapped well onto Andersen‘s Behavioral Model of Health Services Use, suggesting that this theoretical model may be useful in explaining self-care behaviour.
The DCE found that people preferred to manage flu-like symptoms using unsupported self-care, and were willing to pay almost £23 to do so. When professional advice was required, people preferred pharmacy advice, followed by GP consultation. Other types of advice (practice nurse consultation, complementary therapist and NHS 24 advice) were less preferred. People preferred paying less money and waiting less time to manage symptoms.
All three studies showed that most people liked to use self-care to manage symptoms of minor illness associated with analgesic use. The relationship between self-care behaviour and factors influencing it is complex. Interventions that aim to improve self-care should focus on providing flexible support for those who need it.
In this fellowship, I aim to further disseminate my PhD findings, gain new research skills and develop project proposals to enable further investigation and explanation of self-care behaviour.
A cross-sectional survey was mailed to a random sample of the Scottish population (n=3000) asking about their use of medicines, particularly over-the-counter (OTC) analgesics. Qualitative interviews with 24 respondents to the survey asked about how and why people manage symptoms of minor illness associated with analgesic use in particular ways. Another survey containing a discrete choice experiment (DCE) was mailed to a further 652 respondents to the original survey, to establish preferences for self-care and different services that might be used to manage minor illness.
The survey showed that analgesics were the most commonly used OTC medicines and community pharmacies were most people‘s usual source of analgesics. Up to 8% of the population were judged to be potentially at risk from inappropriate use of OTC analgesics.
Interviewees responded to symptoms associated with analgesic use by consulting health care professionals, practising self-care or doing nothing. Reasons for practising self-care included convenience, influence of others, avoidance of medical interventions, supplementation of medical treatments, and perceived appropriateness. Factors influencing how people managed symptoms mapped well onto Andersen‘s Behavioral Model of Health Services Use, suggesting that this theoretical model may be useful in explaining self-care behaviour.
The DCE found that people preferred to manage flu-like symptoms using unsupported self-care, and were willing to pay almost £23 to do so. When professional advice was required, people preferred pharmacy advice, followed by GP consultation. Other types of advice (practice nurse consultation, complementary therapist and NHS 24 advice) were less preferred. People preferred paying less money and waiting less time to manage symptoms.
All three studies showed that most people liked to use self-care to manage symptoms of minor illness associated with analgesic use. The relationship between self-care behaviour and factors influencing it is complex. Interventions that aim to improve self-care should focus on providing flexible support for those who need it.
In this fellowship, I aim to further disseminate my PhD findings, gain new research skills and develop project proposals to enable further investigation and explanation of self-care behaviour.
People |
ORCID iD |
| Terry Porteous (Principal Investigator / Fellow) |