Self-Care Needs a Clinical Safety Net: Integrating Community Pharmacists Into Primary Care

Self-care is an essential component of health and can increase autonomy, improve access to health information and treatment, and support more appropriate use of formal healthcare services. This editorial focuses on medicine-related self-care. For clarity, self-medication refers here to the selection and use of medicines without a prescription or direct clinician instruction, whereas pharmacist-supported self-care refers to structured pharmacist assessment, advice, safety-netting, and referral within the broader self-care pathway. However, the expansion of medicine-related self-care also creates an important clinical and policy challenge. When people are expected to recognize symptoms, select medicines, monitor response, and determine when further assessment is necessary without adequate professional support, diagnostic uncertainty, treatment risk, costs, and responsibility can shift from health systems to individuals. This concern is particularly relevant for people who rely on self-care because formal services are difficult to access or afford. Community pharmacists are well positioned to provide a clinical interface between individual self-care and formal healthcare because of their accessibility and expertise in medicines, but this role should complement rather than substitute for medical care. Accessibility alone, however, does not ensure safe, coordinated, or equitable care. Pharmacist-supported self-care should therefore be integrated into primary care pathways, operate within nationally defined scopes of practice, and be supported by minimum standards for structured assessment, identification of red flags, safety-netting, documentation, appropriate medicine use, referral, and continuity. Governance and financing should protect professional independence and ensure that assessment and referral are not conditional on purchasing a medicine. Evaluation should focus on safety, appropriateness, equity, affordability, patient experience, and clinical outcomes rather than consultation volume alone. Self-care can extend access and strengthen individual agency, but care may begin outside conventional clinical settings without health-system responsibility ending there.