Therapeutic Patient Education A new approach for chronic disease

Transcription

1 Therapeutic Patient Education A new approach for chronic disease Professor Alain Golay University Hospital Geneva, Switzerland Cliquez pour modifier le style des sous-titres du masque Alain.Golay@hcuge.ch

2 Aims of Therapeutic Patient Education To help the patient deal dealy as well as possible with his chronic disease Improve or maintain Quality of life Avoid or decrease Relapses Autonomy Complications Adherence to treatment

3 Patient Therapeutic Education Empowe rment Search success Use mistakes Reinforcement Roll resistance Work ambivalence Support Motivate The objectives The evaluation Renegociate Formative Evaluate Patie nt cente red Negociate Transmit Take into account Type of treatment Behavioural changes Psychosocial Educatio nal Knowledge models Skill Health believes Resources Needs Motivationa l Interviewin Share the decision Cognitive - behaviou ral

4 Objectives of Therapeutic Patient Education Get Knowledge Gain competence s on disease and treatment Understand the disease Accept the disease Manage the disease Find autonomy Change behaviour Help the patient to change Grow in life

5 Patient s double need Cognitive dimension To know To understand Emotional dimension To be listened to To be known To be understood To be helped Bensing 2006

6 TO LISTEN IS TO GIVE A HAND Listening is everybody s matter

7 A. Golay, JP Assal. Pat Ed Counsel 2001, 44:65 The Geneva school for Therapeutic Patient Education 30 years of Therapeutic Patient Education WHO collaborating centre since 1983 Educat ing the Patient Educati ng the Educat or patients, 5 day/hospitalization patients, 1 day/hospitalization More than hours were given 51 seminars of one week post-graduate training attended by over HCP coming from more than 60 countries Continuing education Diploma on Therapeutic Patient Education

8 Efficacy of Patient Education

9 Diabetes Asthma BPCO Hypertension Cardiology Efficacy of Patient Education Cliquez Obesitypour modifier 1 meta-analyses, le style des sous-titres 71 studies du masque 6 reviews Rhumatology Oncology Total 4 meta-analyses 3 reviews 3 meta-analyses 1 review 3 meta-analyses 2 reviews 3 meta-analyses 3 meta-analyses, 1 review 1 meta-analyse 4 meta-analyses 22 meta-analyses 13 reviews 60 studies 30 studies 80 studies 100 studies 63 studies 17 studies 177 studies 598 studies patients patients patients patients patients patients patients patients ± patients

10 Efficacy of Patient Education Percentage of studies Less good % No effect Improvement % % Lagger Pataky Golay PEC 2010

11 Diabetes Decrease in hospitalisations % Total 86 patients Before 4 years After 4 years 0 % Days of hospitalisatio ns Days of hospitalisation / patient Garcia Ortega C. et al. Rev Esp Salud Publica : 45-50

12 Asthma Decrease in hospitalisations P<0.001 Crises/patient Education P<0.001 Visit to emergency rooms Control P<0.001 Hospitalisation days (n=pt) - 80% Fireman & al. Pediatrics 1981; 68 : 341

13 Schizophrenia Decrease in hospitalisations With TPE Without TPE 6-60 Number of patients No relapse Short hospitalisation % Long hospitalisation Continuing hospitalisation Rund BR. Et al. Acta Psychiatr Scand :

14 Asthma Effets of TPE on days out of work Days out of work Days (/10) - 50 % Before After 67 employees follow-up during a year Muhlhauser & al. J Int Med :157

15 Back pain : return to work 50 patients in each group Education - cognitivo-behavioural physical activity (54 h. for 3 weeks) % % Education Control 0 Return to work Mayer et al. Spine 1985 ; 10 : 482

16 Conclusi on 1 spent for Therapeutic Patient Education saves 4 Cost-benefit analysis of patient education E. Bartlett

17 Summary Therapeutic Patient Education is a Humanist medicine Patient centered approach to help him deal daily with his chronic disease Approach which enables a better quality of life Efficient for therapeutic adherence and complications Efficient for medical costs

18 Thanks to all my collaborators