Home » Self-Care Promotion » Guideline on how to promote self-care: Heartburn (without indigestion) » 2. Identify and select common and specific patients’/general population self-care behaviours

2. Identify and select common and specific patients’/general population self-care behaviours

Identify and select common and specific patients’/general population self-care behaviours that you want to promote (depending on the context problem you want to address)

Identify and select common and specific patients’/general population self-care behaviours
  • Specify and describe the population/patients that you want to address with the intervention
  • Identify the general and specific patients’/general population self-care behaviours that the intervention aims to promote

2.1. Specify and describe the patients/general population that you want to address with the self-care strategy

Depending on the results of the evaluation of the context and key issues and whether the strategy is general or specific to a minor condition, one should define the patients/general population that the interventions should be addressed to.

For the case of common Heartburn (without indigestion) there is no specific target population, as all the general population is affected by it.

However there are some specific groups that should have special considerations as they might be more vulnerable to complications or misdiagnosis:


From age 65, the prevalence rises to 20%, as it is closely linked to age and progressive deterioration that affects the body, specifically the digestive system.

Almost one out of two senior patients who visit the physician for any reason is diagnosed with an acid peptic disease. Often severity of symptoms does not correspond to severity of lesions detected. In fact, less than 30 % of elderly refers their characteristic symptoms, as they seem to perceive a lesser extent of oesophageal pain than young people do. It is an under diagnosed disease among this population.


Studies suggest that more than 50 % of pregnant women may have symptoms of heartburn during pregnancy, reaching 80% in the third quarter. Most women’s symptoms of heartburn solve after delivery. It is directly related to gestational age, number of previous pregnancies and with a history of gastroesophageal reflux and an inverse correlation with the age of the mother.

2.2. Identify the general and specific patients’/general population self-care behaviours that the strategy aims to promote

A key step if you want to establish a strategy to promote self-care is to determine the ideal self-care behaviours that should be promoted. Establishing those ideal behaviours will guide the development of the strategy and it will help identifying the mechanisms that can hinder or facilitate the promotion of self-care.

Depending on the results of the analysis of your context and issues that you want to address you can identify different behaviours to promote.

The following table presents considerations specific to Heartburn (without indigestion) for each of the main phases of self-care as well as some reflections regarding the patients/general population needs to achieve those goals.

All the behaviours included are considered relevant, however this classification might help to focus the self-care promotion strategy in a specific target.

Main stages of the cycle of self-care
Main self-care behaviours to promote
Prevention and healthy lifestyles
  • Managing stress or anxiety including:
    • Mild exercise, such as walking or cycling
    • Listening to music
    • Massage
    • Relaxation techniques
  • Following lifestyle and dietary hygiene measures including:
    • Eating healthily
    • Losing weight if they are overweight
    • Not smoking
    • Avoiding known causes that may be associated with symptoms, including smoking, alcohol, coffee, chocolate, fatty foods and being overweight
    • Other factors that might help, such as raising the head of the bed and having a main meal at least 3 hours before going to bed.
Symptom recognition & evaluation
  • Identifying usual or associated symptoms for early treatment:
    • Common: burning sensation in stomach and acid regurgitation.
    • Associated: belching, nausea, hipersalivation, hiccups.
Treatment decision-making
  • Adults who present to their community pharmacist may be able to alleviate and manage their symptoms by making changes to their lifestyle and using over-the-counter (usually antacid or an alginate)
  • Deciding to visit to the GP when:
    • There are symptoms several times a week.
    • Over-the-counter medications aren’t helping.
    • The symptoms are severe.
    • Difficulty swallowing.
    • There are possible signs of a more serious problem, such as persistent vomiting, vomiting blood or unexplained weight loss.
Treatment adherence
  • Following treatment from physician, that may vary according to intensity and frequency of discomfort symptoms.
  • Monitoring symptoms after treatment discontinuation in acute cases.
  • Avoiding inadequate and permanent use of antacids without prescription or medical follow-up.
Self-monitoring & early detection of complications Unwanted side effects are very rare on both antacids and proton-pump inhibitor (PPI).
Maintaining healthy lifestyle in order to reduce the occurrence of episodes of heartburn (see Prevention and healthy lifestyles).

Heartburn is not a dangerous condition; however, according to aetiology, age of the patient or presence of co-morbidity may lead to complications where early detection will be important. Visiting GPs it is recommended should be advised if symptoms have persisted for several weeks, get worse over time, do not improve with medication or alarming symptoms.

Symptoms that act as alarm indicators on heartburn such as:

  • Disphagia
  • Odynophagia
  • Upper gastrointestinal bleeding
  • Recent clinic onset in patients older than 45 years
  • Significant weight loss
  • Pregnant women.