The Spa Resort, an ideal place for patient education. Examples in Venous and Lymphatic disorders”

Abstract

The health of patients with chronic diseases cannot be improved substantially on the long run by the treatment of their lesions or even of their disease alone. They need in addition a patient-based approach, involving their ability to participate in the management of their disease. Therapeutic education falls within the scope of patient-based treatment approach. Its purpose is to help the patient with chronic disease to achieve the changes in lifestyle and health related behaviors required by his health condition and to cope with the everyday limitations he encounters. This is carried out through structured programs involving both group workshops and faceto-face interviews conducted by specially trained health professionals, aiming at improving his knowledge, skills and motivation. Although at first restricted to diabetes mellitus and asthma, the field of therapeutic education of the patient now widened to almost any chronic disease, and spa resorts have proven to provide a suitable setting for the development of such therapeutic education programs, because of the large number of patients present at the same site with the same disease, the motivation and availability of the patient during his stay in the Spa resort, but also to a positive interaction between the physical experience of the balneotherapeutic sessions and the education process. In France, balneology is a popular treatment for patients with chronic venous and lymphatic insufficiencies with close to 100 000 patients treated each year. With the logistic help of the Francaise pour la Recherche Thermale, we were able to develop the Veinothermes program dedicated to patients with advanced venous insufficiency (with skin trophic changes) and the 'Thermœdeme program for patients with lymphedema. Both programs were accredited by the French public health system, and we were able to show their ability to improve the patients' health related behaviors and compliance to their treatment at 3 and 9 months, with parallel improvement of their quality of life. In the case of venous insufficiency, a randomized controlled trial evaluation the combination of balneology and therapeutic education showed a long-lasting (12 months), large and significant improvement of patients symptoms, quality of life and health status. Another RCT is presently starting regarding lymphedema. The presentation will summarize the data of these four studies. Works supported by grants from the Association Francaise pour la Recherche Thermale.