Consumer Health

Positive health outcomes undeniably represent the greatest contribution of self-care. The practice of responsible self-care also results in a more efficient use of resources and a significant reduction in health care expenditure. It plays an important role in improving the competitiveness of European economies by providing incentives for growth in a highly innovative, knowledge-based industry.¹

“Self-medication empowers patients to treat or prevent short-term or chronic illnesses which they consider not requiring the consultation of a physician or which may be treated by the people after an initial medical diagnosis”. European Commission Communication on Safe, innovative and accessible medicines.¹

Self-care has a number of potential benefits including:

• increased access to effective treatment
• reduced number of visits to physicians (thereby alleviating pressure on health care services)
• increased productivity of the population
• increased patient autonomy
• reduced costs to third-party payers, such as government or insurance companies²

The evidence shows that responsible, appropriate self-medication with non-prescription products can provide significant economic benefits for patients, employers, and health care systems worldwide.²

• more than 50% of adults have suffered from headache within the last year
• 60% suffer from tension-type headache
• the prevalence of migraine is 15%
• the prevalence of chronic headache is about 4%
• the prevalence of possible medication overuse headache is 1-2%
• cluster headache has a lifetime prevalence of 0.2-0.3%.⁵

Most headaches are more prevalent in women, and somewhat less prevalent in children and youth.

Some studies indicate that the prevalence of headache has increased in the last decades in Europe.⁵

The third edition of the International Classification of Headache Disorders (ICHD-3) is hierarchical and allows diagnosis in different clinical settings, diagnosing at the first or second level in general practice and at the third, fourth, or fifth level in neurological practice or in headache centres.⁴

The International Headache Society has two broad categories for headache disorders:

• the first is based on symptoms (called primary headache disorders) and includes migraine, tension-type headache and cluster headaches²
• the second is based on their causes (called secondary headache disorders). This includes headaches associated with a head and/or neck injury, stroke, substance misuse and/or their withdrawal (including alcohol), infection, disorders of the cranium, eyes, nose, sinuses or teeth.³

There is a difference between a headache and a migraine headache. Headaches are not usually accompanied by the other symptoms associated with migraine. However, it is quite likely that if you have migraine you will also experience other headaches.² In general terms, migraine attacks are experienced as a headache of at least moderate severity usually on one side of the head and occurring with other symptoms such as nausea, vomiting, sensitivity to light and noise (although some people experience migraine without headache).²

Not only is headache painful, it is also disabling. In the Global Burden of Disease Study, updated in 2013, migraine on its own was found to be the sixth highest cause worldwide of years lost due to disability. Headache disorders collectively were third highest. Repeated headache attacks, and often the constant fear of the next one, damage family life, social life and employment. The long-term effort of coping with a chronic headache disorder may also predispose the individual to other illnesses. For example, anxiety and depression are significantly more common in people with migraine than in healthy individuals.⁶

Headache disorders are prominent health-related drivers of immense economic losses for the EU.³ This has immediate implications for health care policy. Health care for headache can be both improved and cost saving.⁷

The vulva is the first line of defence to protect the genital tract from infections.¹

Vulvar skin differs from other skin sites in:

• hydration
• friction
• permeability
• visually discernible irritation
• higher susceptibility to topical agents compared to forearm skin because of its increased hydration, occlusion, and frictional properties.¹

Supported by international guidelines, daily gentle cleansing of the vulva is an important aspect of feminine hygiene and overall intimate health. Women should be encouraged to choose a carefully formulated and clinically tested external wash that provides targeted antimicrobial and other health benefits without negatively affecting the natural vulvovaginal microbiota.¹

The normal vaginal flora, acidic vaginal pH, and vaginal discharge are all components of the innate defence mechanisms that protect against vulvovaginal infections. Resident bacteria help maintain an acidic pH and compete with exogenous pathogens to adhere to the vaginal mucosa.¹ The importance of vaginal lactic acid needs to be emphasized as it correlates with vaginal health, inhibits the growth of bacteria associated with bacterial vaginosis and possibly plays a role in the local immune defence.¹

Many factors such as:

• immune deficiency
• hormonal changes
• stress
• use of a vaginal douche or soap to clean the vagina

may upset the normal flora and cause infections.¹

The vulva is susceptible to dermatitis and other dermatological conditions, particularly when the barrier function of the skin is compromised by factors that constitute the normal vulvar environment, namely, moisture (urine, vaginal discharge), enzymes (stool residue), friction, and heat. ¹

Signs and symptoms of vulvovaginal disorders are common (e.g. pruritus, pain and discomfort, changes in skin colour and texture) and can have a significant impact on the quality of life. ¹ An extensive review confirmed that molecular vaginal microbiota dominated by Lactobacilli corresponded to a healthy vaginal microenvironment and that bacterial vaginosis should be described as a polybacterial dysbiosis (microbial imbalance) where the Lactobacillus load decreases and the diversity and bacterial load of other anaerobic bacteria increases. Dysbiosis has been consistently associated with increased risk of human immunodeficiency virus (HIV), human papilloma virus (HPV), herpes simplex virus-type 2 (HSV-2), and Trichomonas vaginalis infection.¹

Upper respiratory tract infections (URTIs) are the most common infections in the population. They are the leading cause of people missing work or school and, thus, have important social implications.

The term “upper respiratory tract” covers several mutually connected anatomical structures: nose, paranasal sinuses, middle ear, pharynx, larynx, and the proximal part of trachea.²

Most acute URTIs are caused by viruses, especially rhinovirus, coronavirus, adenovirus, parainfluenza virus, respiratory syncytial virus, and enterovirus. They are responsible for more than 80% of all common colds.²

• rhinitis (inflammation of the nasal mucosa)
• rhinosinusitis or sinusitis (inflammation of the nares and paranasal sinuses)
• nasopharyngitis (rhinopharyngitis or the common cold)
• pharyngitis (inflammation of the pharynx, hypopharynx, uvula, and tonsils)
• epiglottitis (inflammation of the superior portion of the larynx and supraglottic area)
• laryngitis (inflammation of the larynx)
• laryngotracheitis (inflammation of the larynx, trachea, and subglottic area)
• tracheitis (inflammation of the trachea and subglottic area).²

In most cases, these diseases are self-limiting and can be managed at home.² However, some may cause severe complications.²

Patients with URTIs typically present with:

• runny nose
• sneezing
• congestion
• clear-to-mucopurulent nasal discharge
• an altered sense of smell
• postnasal drip with cough
• low-grade fever²

A fever of moderate-to-high grade suggests a secondary bacterial infection.¹

Fever is a normal physiological response to illness that facilitates and accelerates recovery.¹ Although fevers are often a presenting symptom of a self-limiting viral infection, they are also associated with serious bacterial infections, such as meningitis and pneumonia, and other non-infective illnesses.¹ However, in children, timely identification of those at risk of serious illness allows rapid referral and appropriate management.¹ Antipyretics should be used to make the child more comfortable and not used routinely with the sole aim of reducing the temperature.²