| Summary: | The aim of this thesis was to investigate decision-making in the management of minor illness, in the context of symptoms associated with analgesic use. In 2002, a cross-sectional survey was mailed to a random sample of the Scottish population (n=3000) asking about their use of medicines, particularly over-the-counter (OTC) analgesics. In 2004, qualitative interviews with 24 respondents asked about how and why people manage symptoms of minor illness associated with analgesic use in particular ways. Finally, in 2005, another survey containing a discrete choice experiment was mailed to a further 652 respondents to the original survey, to establish preferences for self-care and different services that might be used to manage minor illnesses. The survey showed that analgesics were the most commonly used OTC medicines. Paracetamol was the most frequently used drug, headache the symptom most often treated, and community pharmacies were most people's usual source of analgesics (for reasons of convenience). Younger, female, better educated people, those required to pay prescription fees, and those not using prescribed analgesics were more likely to have used an OTC analgesic than their relevant counterparts. Up to 8% of the population appeared to be at risk from inappropriate use of OTC analgesics. Interviewees responded to symptoms associated with analgesic use by consulting health care professionals, practising self-care or doing nothing. Reasons for practising self-care included convenience, influence of others, avoidance of medical interventions, supplementation of medical treatments, and perceived appropriateness. Factors that influenced how people managed symptoms mapped well onto Andersen's Behavioural Model of Health Service Use. The DCE found that people preferred to manage flu-like symptoms using unsupported self-care and were willing to pay almost £23 to do so. When advice from a health care professional was required, community pharmacy or GP were the most preferred sources. Other types of management (practice nurse consultation, complementary therapist and NHS 24 advice) were preferred significantly less.
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