Self-care is a vital concept in today’s society. However, it can be interpreted in many ways. What is your concept of self-care?
Carlton Lawson, EMEA Group President of Kenvue: At Kenvue, the world’s largest pure-play consumer healthcare company by revenue, we believe that self-care is empowering people to take their health into their own hands. Every day, there are a myriad of opportunities to positively impact not only our health and wellbeing but also our healthcare systems through everyday moments of care.
A good example of this is smoking cessation. The management of the effects of smoking is a substantial drain on healthcare resources.[i] The World Health Organization (WHO) calls the tobacco epidemic “one of the biggest public health threats the world has ever faced, killing over eight million people a year around the world”.
And while much remains to be determined about the lasting health consequences of e-cigarettes and vapes, the advice from the European Respiratory Society (ERS) and European Lung Foundation (ELF) is as follows: “The human lungs are created to breathe clean air, not toxins and carcinogens, and the human body is not meant to be dependent on addictive drugs. ERS and ELF cannot recommend any product that is damaging to the lungs and human health.”[ii]
In 2018, the National Academies of Science, Engineering and Medicine released a consensus study report that reviewed over 800 different studies. That report made clear that “using e-cigarettes causes health risks”[iii]. There is also emerging evidence of a link between e-cigarettes and vapes and heart disease and lung disorders.[iv] Recent media reports paint a frightening picture of children “so addicted to vapes they can’t last a lesson without one”.[v] I am proud that in the United Kingdom, NICORETTE® QuickMist is the first clinically proven vaping cessation therapy helping people completely quit, addressing a critical public health need.
An area of self-care that might be less obvious is oral health. Despite being largely preventable, over half of all adults in the WHO European region had a major oral disease in 2019, the highest prevalence worldwide.[vi] Severe gum disease has a considerable negative impact on healthcare resources and personal health, and it can lead to long-term health conditions like cardiovascular disease, diabetes and adverse pregnancy outcomes if left untreated. Mechanical cleaning (such as brushing and flossing) alone is not proving to be sufficient in preventing gum disease in a wide proportion of the population. Including our mouthwash LISTERINE®, with its strong antimicrobial formula, in an individual’s daily routine is clinically proven to be five times more effective than floss at reducing dental plaque, a key contributor to severe gum disease.[vii]
What role can self-care in the form of over-the-counter medicines play in ensuring a sustainable and cost-effective health system in Europe?
Self-care and over-the-counter medicines are a convenient, fair and equitable entry point to healthcare for European citizens and have a profoundly positive impact on the individual as well as the broader health system.
A recent survey by the Association of the European Self-Care Industry (AESGP) found that each year across Europe, 1.2bn cases of minor ailments are self-managed with non-prescription medication. This saves more than €36bn of expenditure in Europe that would otherwise be borne by patients and national healthcare systems.[viii] Nine out of 10 people view self-care as a vital part of the management and prevention of both minor ailments and chronic conditions and diseases, whether it is allergies, body pain or diarrhoea.[ix]
The proposal to restrict access to commonly used overthe-counter antimicrobial medications could impact people’s access to treatment options for minor ailments and would add pressure to an already overburdened healthcare system
As people manage their minor ailments using over-the-counter medicines, they have less need to see primary care physicians, allowing these medical professionals to focus on more complex cases. Without access to self-care, we would need an additional 120,000 doctors or an additional 2.4 hours per general Ppractitioner (GP) per day[x] at a time when European countries face severe challenges related to the health and care workforce.[xi]
Now, more than ever, it is vitally important to ensure access to over-the-counter medicines and maintain self-care as one of the central pillars of a modern and sustainable healthcare system.
What benefits can self-care bring to address inequalities in access to primary care?
It costs people nothing to visit the pharmacist for convenient, expert medical advice on the treatment of minor ailments. By using self-care and over-the-counter medicines, citizens can treat minor ailments themselves, and turn to more costly doctor visits or prescriptions at a later stage if needed or if advised by a pharmacist. This in turn saves governments, health systems and citizens money: on average, one euro spent on over-the-counter medicines saves national healthcare systems and economies €6.70.[xii] Depending on where in Europe you live, you can save as much as €41 by treating a minor ailment via self-care compared with visiting a physician.[xiii]
Why is the role of pharmacists so important and how can policymakers reinforce it when it comes to minor ailments?
The role of the pharmacist is crucial in modern, sustainable healthcare systems. Pharmacists provide convenient, expert medical counsel as individuals embark on their self-care journeys. In general, across Europe, it is easier and less costly to get to a pharmacy than it is to see a doctor. The vast majority of people in Europe have convenient access to at least one community pharmacy, near to where they live and work.[xiv] Pharmacies also often have longer opening hours, with some even providing access 24 hours a day, seven days a week.
Individuals know that pharmacists have the skills and training to act as a trustworthy, authentic source of professional expertise in self-care matters. Pharmacists play an important role in signposting patients, referring them to the doctor or other appropriate health care professional when medical examination or prescription treatment is considered necessary.
Pharmacists’ impact on the health of society is profound as they participate in health promotion campaigns, provide one-to-one advice on how to maintain good health and avoid illness, and advise on when self-care, including self-medication, is appropriate
Their impact on the health of society is profound as they participate in health promotion campaigns, provide one-to-one advice on how to maintain good health and avoid illness, help those who wish to quit smoking and advise on when self-care, including self-medication, is appropriate.
If we think of a critical public health need such as antimicrobial resistance, pharmacists and self-care can be key in unlocking the potential of antibiotic stewardship. As we enter the cough and cold season, we know that antibiotics are often not the best option for upper respiratory conditions or sinusitis. Over-the-counter medicines can offer an effective treatment option and symptom relief, and pharmacists are well-placed to advise patients to help them feel better.
How could the current review of European Union pharmaceutical legislation impact the way individuals can access self-care and over-the-counter medicines?
The review of EU pharmaceutical legislation is welcome and necessary. We need to be mindful, however, of the unintended public health consequences of some of the provisions. In particular, the proposal to restrict access to commonly used over-the-counter antimicrobial medications could impact people’s access to treatment options for minor ailments and would add pressure to an already overburdened healthcare system.
Let us look at the potential consequences, for example, of the proposed provisions on moving antifungal and antiviral medications that are currently available over the counter to prescription-only medicines. Many antivirals and antifungal medicines treat easily self-diagnosed conditions such as conjunctivitis or athletes’ foot. Making treatments for these infections prescription-only will negatively impact European citizens. Instead of getting advice and access to treatments in their local pharmacy, citizens would have to visit a GP for a prescription. This would increase both healthcare costs and pressure on already stretched GP surgeries and would ultimately impact how quickly a simple condition can be treated. Delaying treatment could increase transmission of these infections, further exacerbating the situation.
New requirements on environmental risk assessment of medicines could also impact patient access. In particular, new provisions that would allow authorities to refuse the launch of a medicine on the market on environmental grounds. Measures designed to minimise environmental impacts should be proportionate and not interfere with clinical priorities and benefit-risk assessments. Ensuring patient and consumer access must be at the heart of decision-making when it comes to medicinal products.
Self-care is an essential component of a modern, sustainable healthcare system. The self-care moments we all engage with every day can have an extraordinary health impact. We need to empower, facilitate and encourage people to take their health in their own hands for the benefit of all.
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