5.1.3. Therapeutic patient education

The WHO produced a document in 1998 on therapeutic patient education (Report of a WHO Working Group on Therapeutic Patient Education. Continuing education programmes for healthcare providers in the field of chronic disease prevention).

The management of chronic diseases requires the development of a particular partnership between the patient and his health care professional in order to achieve awareness, knowledge, confidence and skills which could help the patient to have a major role in the management of his/her disease. This approach is called “guided self management” and there is proof it can help to reduce asthma morbidity in both adults and children. The educational aspect should constitute the basis of the interactions between patients and physicians and a good communication is essential for an adequate compliance and adherence.

Therapeutic patient education should enable patients to acquire and maintain abilities that allow them to optimally manage their lives despite their disease. It is, therefore, a continuous process, integrated in health care. Moreover, it is patient-centered and includes organized awareness, information, self-care learning and psychosocial support for what concerns the disease, prescribed treatment, care, hospital and other health care settings, organizational information, and behaviour related to health and illness. Therapeutic patient education has been designed to help patients and their families understand the disease and the treatment, cooperate with health care providers, live healthily, and maintain or improve their quality of life. There are a growing number of centres that practice therapeutic patient education, hoping therefore to improve patients’ autonomy and self-management. Moreover, nowadays there is an important drive for long-term accompaniment of patients where the various characteristics – i.e. personal, family, professional, social, economic, etc. -, have to be taken into account in the long-term follow-up. Medical schools are lagging behind this global need. Therapeutic patient education is a systemic, patient-centered learning process, provided by health care providers trained in the education of patients that takes into account:

·          the patient’s adaptation processes (coping with the disease, locus of control, health beliefs, and socio-cultural perceptions);

·          subjective and objective needs of patients, whether expressed or not. This is an integral part of treatment and care.

Therapeutic patient education is about the patient’s daily life and psychosocial environment, and also involves the patient’s family and his/her closest friends. This is a continuous process, which has to be adapted to the course of the disease, to the patient and to his/her daily life. It is part of the long-term care of the patient and has to be structured, organized and systematically provided to each patient using different means. We are talking of a multi-professional, inter-professional and inter-sectoral methods, also including the making of networks as well as an evaluation of the learning process and its effects. Health care providers tend to talk to patients about their disease rather than train them in the daily management of their condition. Therapeutic patient education is designed, therefore, to train patients in the skills of self-managing or adapting the treatment to their particular chronic disease as well as in coping processes and skills. It should also contribute to reducing the cost of long-term care for patients and our society. Therapeutic patient education is essential for an efficient self-management and high quality of care for all long-term diseases or conditions, although acutely ill patients should not be excluded from its benefits. Therapeutic patient education is education managed by health care providers trained in the education of patients, and designed to enable a patient (or a group of patients and families) to manage the treatment of their condition and prevent avoidable complications, while maintaining or improving quality of life. Its main purpose is to produce a therapeutic effect additional to that of all other interventions such as pharmacological and physical therapy .