The rational and responsible use of health products and services as part of self-care involves individuals safely and effectively managing their health (and any everyday ailments or minor conditions), where appropriate with medicines, products or services. Self-care products and services are the ‘tools’ of self‐care, supporting health awareness and healthy practices, and may include the use of:

• ·Prescription medicines (in conjunction with a doctor)
• ·Non-prescription medicines
• ·Preventative health products, e.g. dental care, mosquito netting, sleep aids
• ·Natural health products, traditional medicines and vitamins, minerals and supplements
• ·Devices and diagnostics, e.g. home blood pressure monitors
• ·Substance control products, e.g. nicotine gum for tobacco cessation
• ·Wellness services, e.g. nutrition planning, gym memberships
• ·Health services, e.g. acupuncture, chiropracty, smoking cessation programmes

Rational and responsible use of these products or services involves several factors. Firstly, only products and services of safety, quality and efficacy should be used to self-manage health and wellness. Secondly, when treating an illness, products and services are best used for self-recognisable conditions, and for chronic or recurrent conditions following initial medical diagnosis.

Pillar 7 focuses on the knowledgeable, safe and effective use of health products and services by individuals in order to better manage their own health.

Rational and responsible use of products and services is important because…

• The correct use of health products and services – the tools of self-care – is an important element of maintaining health and wellness. Rational and responsible use of products or services can delay or prevent the development of many conditions and encourages greater independence in managing any illness that does develop. Understanding why and what products a person should use has been shown to strongly empower patients, increase quality of life and improve self-perceived health.
• The impact of healthcare products and services is often underestimated. For example, adequate use of a fluoride-containing tooth paste, flossing and fluoridation of drinking water can prevent the vast majority of dental caries, yet 60 – 90% of adolescents and almost 100% of adults are affected by dental caries (Peterson et al, 2005). Commonly-available wellness services are similarly effective: enrolment in a group exercise programme, which are now regularly offered through gyms and health centres, has been shown to significantly improve strength, cardiovascular fitness, cognitive function, prevent falls and increase over-all self-perceived health.
• In 1988 a WHO Report on a study of the role of non-prescription medicines made clear that self-management with healthcare products is an important form of self-care. It stated that “lay self-care is a comprehensive undertaking that includes health promotion, disease prevention, diagnosis, the treatment of minor illnesses and injuries, the management of chronic disease, and rehabilitation (…) without doubt self-medication is a major, if not the most important, form of self-care”.
• The WHO defines the rational use of medicines as where “patients receive medications appropriate to their clinical needs, in doses that meet their own individual requirements, for an adequate period of time, and at the lowest cost to them and their community”.

Poor or improper use of health products and services is the cause of…

• Health products or services can be associated with various types of risks.
  It is possible that with more people undertaking self-care and being more self-aware, levels of hypochondria (sometimes referred to as health phobia or health anxiety) may increase. Hypochondria is an excessive preoccupancy or fear of having a serious illness. A person measuring their own blood pressure once a week or once a month is undertaking responsible self-care. A person measuring their blood pressure five times a day, is not.
• The risks associated with medicines are well known, and can include overuse, misapplication, the use of excessive dosages, prolonged duration of use, inappropriate use of antimicrobials, often in inadequate dosage, for non-bacterial infections; drug interactions and polypharmacy.

Irrational use of medicines is a major problem worldwide. WHO estimates that more than half of all medicines are prescribed, dispensed or sold inappropriately, and that half of all patients fail to take them correctly. The overuse, underuse or misuse of medicines results in wastage of scarce resources and widespread health hazards. There may be concern that self-care could aggravate these risks, but information and education and appropriate consultation with health care professionals can help to manage this.

WHO recommendations for rational use…