Home » Self-Care Promotion » Guideline on how to promote self-care: Cough » 1. Identify the problem and evaluate your context

1. Identify the problem and evaluate your context

Describing the context in terms of the key issue that you want to address, the stakeholders that can be affected by the issue and the existing resources that exist/could be used to address the issue.
This exercise would give a general idea of the starting point.

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Identify the problem and evaluate your context

  • Define what specific issue(s) you are trying to address
  • Identify whether those issues are related to a specific minor conditions or a general approach to self-care
  • Identify key stakeholders for the development of the self-care strategy
  • Identify self-care promotion resources for the selected conditions in your area

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 cough.

Some of the key drivers to start a promotion strategy to improve self-care behaviours for cough could be:

  • The high incidence of cough and its impact among the population:
    Most adults experience episodes of coughing between two and five times a year, and about one in five people suffers from coughs during winter months. [2]. Furthermore, although cough is almost always harmless and usually starts to improve within three weeks, it can be distressing (both for patients and others living or working with them) and a nuisance because it often lasts for several weeks affecting quality of life. [2]
  • Reducing costs associated to cough:
    Due to its high frequency cough can drive high costs. For example it is estimated that the cost of acute cough to the UK economy is at least £979 million. This comprises £875 million to loss of productivity and £104 million cost to the healthcare system and the purchase of non‐prescription medicines.
    Regarding the costs related to healthcare system it is relevant to highlight the volume of cough-related visits to GP. For example in the UK over half the population consult their doctor each year for a minor symptom, and acute respiratory symptoms (eg, cough, sore throat) are the most common cause of consultation. [3]
  • Reducing improper use of antibiotics in cough:
    Antibiotics do not work against viral infections, which cause most acute coughs. Promotion campaigns could be triggered because an inadequate or overuse of antibiotics associated to cough is being observed. [2]

1.2. Identify whether these issues are related to a specific minor conditions or a general approach to self-care

Common cough is one of the most common minor conditions in terms of number of people affected and can often be closely linked to cold. Therefore, the key issues that drive the promotion of self-care are mostly common to other minor conditions and cold, more specifically.
Particularly, reducing inappropriate use of antibiotics for cough caused by viral infections and self-medication with drugs for which there is not enough evidence on effectiveness 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, quality of life …) these can also be shared with other minor conditions and the strategies used to tackle these issues can encompass other minor conditions as well, although specific elements 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 professionals, basically GPs (and professional bodies)
    • Industry, self-care medication and medical devices industry
    • Pharmacist
    • Mass media
    • Healthcare managers
    • Policy decision makers
    • Workplace related stakeholders

The table included in the general guideline shows 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, to identify existing resources is a key step.

Regarding the key issues that have been highlighted about cough, the following resources could be particularly useful when available:

  • Economic resources
    Budget allocated for material to be developed, personnel required to implement self-care strategy, etc.

  • Structural
    Existence of network of community pharmacists.
    General access of the population to internet (to access web portals or similar services), etc.

  • Professional training
    Training in specific skills, particularly communication skills of professionals that could be involved in the strategy (GPs, primary care nurses, pharmacists, professionals staffing phone and online consultations…).
    If the professionals don’t have the training in the specific skills needed for your self-care promoting strategy consider whether training could be developed and included in continuous professional development schemes or similar schemes.

  • Technology
    Existence of health web portals, health advice lines, etc. in your context (could be from public institutions but also consider Patient Organisations web portals, etc.).

    Consider also:

    Are there any tools/information to help promote patterns and healthy lifestyles (health education)? Are they well-known and used?
    Are these websites multi-lingual and take into consideration most frequent languages in the communities that you want to address?

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.

1.1. Define issues
Key issues
(suggestion of key issues that might impulse the need for promotion of self-care related to cough)
Incidence and impact
Associate costs
Improper use of antibiotics
1.2. Charact. General/specific issue
Specific
General
General
Level to address the issue
(national/regional/local)
All
All
All
1.3.1 Identify key stakeholder Healthcare and social care professionals (and professional bodies)
Educators
Patient/consumer organizations and other NGOs
Policy decision makers
Healthcare managers
Industry, self-care medication pharma industry
Workplace related stakeholders
Others
1.3.2. Identify key resources Economic resources Budget allocated for material to be developed, personnel required to implement self-care strategy, etc.
System / structural resources Existence of network of community pharmacists.
General access of the population to internet (to access web portals or similar services), etc.
“Delayed prescription” systems.
Professionals training Training in specific skills, particularly communication skills of professionals that could be involved in the strategy (GPs, primary care nurses, pharmacists, professionals staffing phone and online consultations…).
Technology Existence of health web portals, health advice lines, etc. in your context (could be from public institutions but also consider Patient Organisations web portals, etc.)