Due to the recent economic environment and the accompanying financial pressure on public payers, European health systems are confronted to implement cost containment measures and simultaneously maintain the quality of health care services for the population. Fostering initiatives that promote patient involvement (“self-care”) is considered as a possible policy to achieve efficiency increases.
A systematic literature review concerning the added value of selfcare showed good evidence for the effectiveness of topical treatments of athlete’s foot (i.e. allylamines and azoles), treatments of cold (i.e. Acetylsalicylic acid, nasal sprays/topical treatments, Echinacea), treatments against heartburn including lansoprazole and H2-receptor antagonists. No clear evidence could be found for the effectiveness of over-the counter (OTC) medicines against cough and also the evidence of self-care strategies for urinary tract infection (UCI) was unclear.
Existing self-care initiatives in Europe have been identified and analysed according to the RE-AIM framework (i.e. reach, effectiveness, adoption, implementation and maintenance) in order to identify best-practices, for which a cost benefit-analysis has been conducted from the patient’s, the supplier’s, the system’s and the societal perspective. The results of the cost-benefit analysis suggest that from the societal perspective NHS Choices representing internet based information systems and MAS representing legislative change being favourable policy options, with different benefit levels regarding patient groups exempt/non-exempt of paying prescription charges.
The study offers added value to existing literature on self-care, which tends to focus on pharmaceutical treatments for the use in self-care. By assessing the effectiveness of selfcare treatments, assessing self-care initiatives in cost-benefit analysis and developing a methodology for transferability of best-practice self-care initiatives, scientific evidence could be supplemented by a practical guide for policy-makers for identifying and transferring best-practices in self-care. The results highlight that political commitment to self-care is essential for the implementation and uptake of self-care. Further, it shows that for successful self-care initiatives a change in “culture” is necessary, so that patients take responsibility for their own health. In this context, patient information and clear communication is of particular relevance. Also, successful self-care requires a re-thinking of health care professionals involved related to the definition of their professional identity. This may concern particularly the cooperation between physicians and pharmacists.