Although health care had traditionally been categorised as either primary care or hospital care, self care had now been brought into the picture, said Ms Gopa Mitra (head of public affairs, PAGB). Innovative ways of empowering individuals to look after themselves had to be sought.
Ms Mitra told the conference that the PAGB had built up a bank of data on the extent of demand for care of minor ailments, including attitudes of general practitioners and consumers. Adults suffered an average of 5.2 minor ailments - headache, colds, coughs, indigestion, muscle aches and pains - in a two-week period. Interestingly, 46 per cent of these were left untreated, 9 per cent were treated with a home remedy, 25 per cent with an over-the-counter (OTC) non-prescription medicine and 14 per cent with a prescription medicine already in the home.
However, it was the 10 per cent of minor ailments taken to the general medical practitioner that needed closer consideration because of their impact on primary care. Of these, 65 per cent resulted in a prescription, but 17 per cent of patients were advised to do nothing, suggesting that all the patient required was reassurance from the GP. Patient surveys confirmed this need for reassurance, but GPs felt that the consultation was not geared for this, thus resulting in a large number of prescriptions.
It was therefore clear that both GPs and patients needed support to behave differently, and last winter's coughs and colds campaign, with its consistent message, had represented the first concerted effort to do this on a national basis.
Other recent developments in providing information on self care and self medication were NHS Direct and the PAGB OTC directory, which would be going on line soon. In addition, Prodigy included options for use of OTCs and self care, and the National Institute for Clinical Excellence (NICE) had, as a result of its review of Relenza, acted as a trigger for self care on colds and 'flu.
One problem was that research in self care did not show up on medical databases because it was not peer-reviewed. The PAGB was aiming to address this by financing three research projects, the results of which would be ready next year. The first was looking at why people consulted with headache and what the pharmacist or doctor did, the second was an assessment of help-seeking behaviour for children's ailments and the third was a comparison between pharmacists and GPs in dealing with minor ailments.
The PAGB was also helping to fund a self care project in the Tyne and Wear health action zone. This involved general medical practices, pharmacies, NHS Direct and a walk-in centre, all working to the same triage system. The National Prescribing Centre was also developing a self care guideline for dyspepsia, which was eventually expected to become a NICE guideline.