1. Identify the problem and evaluate your context
Identify the problem and evaluate your context
1.1. Define what specific issue(s) you are trying to address
The first step when deciding to launch a self-care (or any other) initiative is to clarify what is moving you to launch this initiative. Specifically, to identify what are the drivers that are moving forward this need for change.
The key drivers depend on each specific context, however a review of the literature point towards some of most common drivers relating to common cold.
Some of the key drivers could be:
- The high incidence of cold among the population.
Common cold is in fact the most frequent acute illness across the industrialized world . And the average incidence of the common cold is five to seven episodes per year in preschool children, and two to three per year by adulthood 
- Impact on the life of those affected.
Although cold is a minor self-limiting condition it can have a relevant impact on the day to day life of those affected, even if for a short period of time, which includes work and school leaves. Annual absences from school and work in the United States due to colds caused 26 and 23 million lost days, respectively . And in fact, colds account for 40 percent of all time lost from jobs among employed people .
- Economic impact.
A 2002 study in the US estimated the cost of colds in terms of productivity losses. The results found that each cold experienced by a working adult caused an average of 8.7 lost work hours (2.8 absenteeism hours; 5.9 hours of on-the-job loss), and 1.2 work hours were lost because of attending to children under the age of 13 who were suffering from colds. The authors concluded that the economic cost of lost productivity due to the common cold approached $25 billion, of which $16.6 billion were dueis attributed to on-the-job productivity loss, $8 billion were due to absenteeism, and $230 million weere due to caregiver absenteeism .
- Reduce unnecessary visits to GPs.
The high incidence of cold makes it one of the most numerous reasons for consultations to the GP. However for cases of common cold GPs can’t provide a cure, but are limited to the ease of the symptoms through different medication and treatments that are also available without prescription. Differentiating between the uncomplicated cases of common cold (that can be self-treated) and the cases of more vulnerable population (children under 3, eldery people and/or people with comorbidities) and more complicated cases would help to ease the workload of GP’s and emergency care services.
Pharmacists are healthcare professionals who have a detailed knowledge and understanding of medicines (including non-prescription medicines), responding to symptoms, treating minor ailments and providing advice on self-care. By making better use of other resources, such as for example consulting a pharmacist, we can further reduce the burden on GPs and emergency care services.
- Reduce inappropiate use of antibiotics.
It is well known that antibiotics are used in circumstances where they are not necessary. One of the circumstances when antibiotic is unnecessarily used is to treat common cold. If fact the WHO referenced as part of the key recommendations to reduce the antibiotic resistance, avoiding the use of antibiotics to treat common cold .
Those drivers for change are just suggestions and need to be adapted to each context.
1.2. Identify whether those issues are related to a specific minor conditions or a general approach to self-care
Common cold is one of the most common minor conditions in terms of number of people affected. Therefore the key issues that drive the promotion of self-care are mostly common to other minor conditions. Particularly, reducing the inappropiate use of antibiotics is an issue that should be addressed across all the health system if a strategy should be effective.
Regarding the other highlighted issues (high incidence, severity of cases, unnecessary visits to the GP) those can also be shared with other minor conditions and the strategies used to tackle those issues can also encompass other minor conditions, albeit with specific elements that should be adapted to each specific condition.
1.3. Identify stakeholders and resources available for the self-care strategy
- Stakeholders involved for the self-care strategy: A key determinant of a successful intervention can be the inclusion of the relevant stakeholders. Anyone who wants to promote self-care should identify the stakeholders that are/could be involved and what is expected of each of them. Identifying those stakeholders at an early stage can facilitate a better coordination and a better use of all the available resources. Stakeholders should be defined in each specific context.
The following, but not limited to, key groups of stakeholders should be considered:
- Healthcare and social care professionals (and professional bodies)
- Patient organisations and other NGOs
- Healthcare managers
- Policy decision makers
- Industry, self-care medication and medical devices industry
- Workplace related stakeholders
The table included in the general guideline exemplifies some of the different key stakeholders at local, regional and country level.
1.4. Identify the self-care support resources available in your context
If you want to successfully promote self-care in your context, a key step can be to identify the existing resources. Regarding the key issues that have been highlighted regarding cold the following resources could be particularly useful if available:
- Is there a plan to encourage the proper use of antibiotics in place?
- Is there already good and systematic exchange of information between community pharmacies and primary care health canters and hospitals?
- Are health information portals already active in your context? Are they well known and used?
The following table illustrates a possible way to summarize the basic characteristics of an evaluation of the context for the self-care strategy.If possible, completing this review with all stakeholders might prove useful.
Note that depending on your position (policy decision maker; healthcare professional, member of patient organisation…) you might have different possibilities and ability to involve other stakeholders.