Effectiveness Of Therapeutic Patient Education Research Articles

Evolution and effectiveness of therapeutic patient education for obesity and diabetes

Therapeutic patient education (TPE) aims to help patients acquire or maintain the skills they need to best manage their lives with a chronic disease. Through a scientometric analysis of the literature, we identified the most influential bibliographic data related to TPE research that have strengthened the field and increased its effectiveness. These were studies from the fields of education, philosophy, psychology, anthropology and medical sociology. We have conducted a meta-analysis that has demonstrated the effectiveness of TPE for the management of obesity and diabetes on biological and psychological parameters. It allowed patients to improve their knowledge, their therapeutic adherence and their sense of self-efficacy.

Effects of therapeutic education on self-efficacy, self-care activities and glycemic control of type 2 diabetic patients in a primary healthcare center in Lebanon.

Diabetes type 2 is a chronic hyperglycemia, its control depends on the patient's Self-efficacy and self-care activities. Therapeutic Patient Education (TPE) enhances the patient involvement and engagement in managing chronic diseases effectively by improving the health outcomes. It helps the patients developing competencies of self-care, coping with diabetes and controlling glycaemia. The objectives of this study are to assess the effects of TPE in type 2 Diabetic patients in Lebanon on their glycemic control, Diabetes Management Self-Efficacy Scale (DMSES) and their self-care activities (Summary of Diabetes Self-Care Activities SDSCA). A total of 100 diabetic patients (50 experimental, 50 control) were recruited from a primary care center according to inclusion and exclusion criteria. The experimental group followed the TPE by a multidisciplinary team. Glycemic control, DMSES and SDSCA were measured at baseline and after three months. The experimental group (EG) was followed up by phone calls every two weeks after the TPE. The results revealed that the experimental group showed significant improvement at the level of self-efficacy in managing their disease concerning general nutrition, specific nutrition, control of glycaemia, physical activity, weight control and medical control (α<0.01); the total score of DMSES had significantly increased from 5.02 to 8.28 in the EG (α<0.01) compared to the control group (CG) that has decreased from 4.91 to 4.85 (α<0.05). Moreover, regarding the SDSCA of the EG, the results highlighted that the activities related to general diet, specific diet, physical exercise, foot care, the measurement of glycaemia and the medication-taking had significantly improved (α<0.05), whereas the CG didn't improve his self-care activities (α>0.05). In addition, the glycemic control HbA1c had improved in the EG after the intervention compared to the CG. The findings of this study demonstrated that Therapeutic Patient Education is efficient in contributing to better glycemic control, better DMSES and SDSCA. Health professionals are best suited to help diabetic patients improve their self-efficacy in managing diabetes, controlling glycemia and improving their self-care.

A 5-dimension patient education program targeting type 2 diabetes remission

Introduction: Type 2 diabetes (T2D) reversal has been demonstrated in patients undergoing bariatric surgery or low caloric diets. Objective: To investigate the effects of therapeutic patient education alone on T2D reversal in early diagnosed patients. Methods: Seventeen T2D patients underwent a one-week therapeutic education program, followed by 12 months of 1 hour sessions every month, targeting diabetes reversal. This reversal was determined using the DiaRem score which integrates glycated hemoglobin levels and antidiabetic drug treatment. Patient’s conceptions, perceptions and motivation were assessed using a 5-dimensional psychopedagogic score. Results: After 1 year, the mean HbA1C fell from 7.2% (± 1.9) to 6.2% (± 0.8) (p &lt; 0.05), antidiabetic drug doses decreased by 25% (p &lt; 0.05), and the DiaRem score increased by 15% (p &lt; 0.01), indicating a reversal of the disease, not correlated to weight loss. At the end of the study, 15 out of 17 patients had excellent glycemic control (HbA1C &lt; 7.0%) and 4 patients had parameters compatible with partial diabetes remission. A significant improvement in glycemic control coupled with a lowering of antidiabetic drug treatment was observed. Conclusions: Following an initial therapeutic education program and regular consultation sessions thereafter, early diagnosed patients may reverse their type 2 diabetes.

Follow-up of patients with chronic obstructive arterial disease, some months after their rehabilitation: Assessment of a therapeutic education program

This study aims to assess, in the long term, the effects of TPE in VR, and to observe the transformation of certain lifestyle habits of patients. We convened 68 patients (51 men and 17 women) 6 months and 1 year after VR treatment during which these patients participated in an TPE program. We assessed: knowledge by questionnaire, walking range, weight and body composition by impedimetric techniques. We found that patients improved their knowledge at the end of rehabilitation 45.8 (±7.6) of good responses on average, compared to 36.2 (±8.6) at the beginning of rehabilitation and these results are consolidated 6 months after 43.4 (±7.5) and 1 year after 44.1 (±8.1). We also found that walking distances during treadmill testing and outdoor walking improved at the end of rehabilitation and were maintained at six months and one year. Finally, weight, fat mass and lean mass decreased slightly compared to the end of rehabilitation. Only 7 patients out of 22 gave up smoking. An education program concerning risk factor management during vascular rehabilitation enables patients to acquire knowledge that can be used to maintain new lifestyle habits and stabilize their health status.

Therapeutic patient education in children with moderate to severe atopic dermatitis: A multicenter randomized controlled trial in China.

Therapeutic patient education is a continuous, systematic, patient-centered learning process to help patients and their families acquire and maintain the skills they need to manage their lives with a chronic disease. It has been proven effective in increasing treatment adherence and improving quality of life for patients with atopic dermatitis (AD) in Western countries. We introduce the first multicenter, randomized controlled clinical trial of therapeutic patient education in Chinese children with AD. To evaluate the effects of therapeutic patient education on the severity of AD, quality of life, and understanding and successful use of emollients in Chinese children with eczema. We recruited 580 children, ages 2-14 years, with moderate to severe AD from six hospitals in China. Participants were randomized (1:1) to an intervention (n = 293) or control (n = 249) group. In addition to the severity of AD, data on quality of life and a questionnaire on family and patient knowledge of emollients were evaluated at the 6-month follow-up. On study completion, we found that the intervention group showed a significantly greater reduction in mean SCORing Atopic Dermatitis (P < .001) and Infant's Dermatology Life Quality Index (P = .030) scores than the control group. In addition, knowledge about the use of emollients improved significantly in the intervention group. There was no significant difference between groups in Children's Dermatology Life Quality Index scores. The first randomized controlled trial of a therapeutic patient education program in China had positive long-term effects on decreasing eczema severity and improvement of quality of life in children 2-4 years of age with AD, as well as in promoting greater understanding of the use of emollients.

French healthcare professionals' perceived barriers to and motivation for therapeutic patient education: A qualitative study.

Therapeutic patient education is effective for various patient outcomes; however, healthcare professionals sometimes lack the motivation to carry out patient education. Surprisingly, this issue has rarely been addressed in research. Therefore, this study explores healthcare professionals' perceived barriers to and motivation for therapeutic patient education. Healthcare professionals, mainly nurses, working in different French hospitals were interviewed. Thematic content analysis was performed. Findings included a lack of skills, knowledge, and disillusionment of the effectiveness of therapeutic patient education were features of a demotivated attitude. In contrast, a positive attitude was observed when therapeutic patient education met a need to work differently and more effectively. A key factor motivating professionals was the integration of therapeutic patient education in routine care within a multidisciplinary team. To keep healthcare professionals motivated, managers should ensure that therapeutic patient education is implemented in accordance with its core principles: a patient-centered approach within a trained multidisciplinary team. In the latter case, therapeutic patient education is viewed as an efficient and rewarding way to work with patients, which significantly motivates healthcare professionals.

The effectiveness of therapeutic patient education on adherence to oral anti-cancer medicines in adult cancer patients in ambulatory care settings: a systematic review.

Adherence to oral cancer medicines is a challenge for adult patients with cancer. Education specifically tailored for an individual patient with cancer may improve adherence. Therapeutic patient education when utilized effectively may maximize health outcomes and positively affect the quality of life of adult patients with cancer. Currently, there are no published systematic reviews specific to the effectiveness of therapeutic patient education on improvement of oral anti-cancer medicines adherence in patients with cancer. To synthesize the best available evidence on the effectiveness of therapeutic patient education on adherence to oral anti-cancer medicines in adult cancer patients 18 years and older in an ambulatory care setting. Types of participants: This review considered studies involving adults of any ethnicity, race or gender, aged 18 years or older who were diagnosed with any form of cancer, receiving oral anti-cancer medicines in an ambulatory care setting. Types of intervention(s): This review considered studies on the use of therapeutic patient education as the additional intervention to routine patient education for promoting oral anti-cancer medicine adherence in adult patients with cancer in an ambulatory care setting. Routine patient education was considered as a comparator. Types of outcomes: The outcome considered was adherence to prescribed oral anti-cancer medicines. Types of studies: This review considered experimental and observational studies. The literature search included published and unpublished studies in the English Language from 1953 through August 2014. A search of PubMed, CINAHL, Excerpta Medica Database, Academic Search Premier, Cochrane Library, PsycINFO, and Health Source: Nursing/Academic Edition was conducted using identified keywords and indexed terms across all included databases. A search for grey literature and electronic hand searching of relevant journals was also performed. Two reviewers independently evaluated the included studies for methodological quality utilizing standardized critical appraisal instruments from the Joanna Briggs Institute. Standardized data extraction tools were used by two reviewers independently as per the Joanna Briggs Institute for data extraction. Due to clinical and methodological heterogeneity between the included studies, statistical meta-analysis was not feasible. The results are presented in a narrative form. Two studies were included in this review, one randomized controlled trial and one cohort study. Both studies had small sample sizes and were moderate and low quality. The clinical significance of therapeutic patient education interventions and the relationship between behavior changes and health outcome changes remain unclear. The randomized clinical trial found a benefit in medication adherence rates in the tailored education intervention group compared to the standard education group at two and four months. Adherence rates measured by self-report (91.3% and 95.1%) and pharmacy refill rates (80% and 73.7%) were superior for the intervention group; however pharmacy refill rates were lower than self-reports of adherence. Tailored educational interventions were only beneficial on pharmacy refill rates (p=.0048) for promoting adherence at the two-month time interval. The cohort study found the intensified pharmaceutical educational intervention group demonstrated enhanced overall medication adherence then the standard education group (97.9% vs. 90.5%, p=0.069). The intervention group also showed a higher mean daily adherence to medication (96. 8% vs. 87.2%, p=0.029). The relative risk of the intervention group deviating from the medication intake interval of 12 hours was 0.51(95%CI, 0.46-0.56) compared to the control group (p<0.05, Chi-square test).The two studies showed no statistically significant differences, only modest to low evidence that therapeutic educational interventions support the clinical outcome of oral anti-cancer medicine adherence. There is a paucity of research evidence on the effectiveness of therapeutic patient educational interventions for improving patient adherence to oral cancer medicines. The effect of therapeutic patient educational interventions on oral anti-cancer medicine adherence has yet to be determined. Therapeutic patient educational interventions remain questionable, differing in format and educational strategies. A specific standardized methodology and evaluation approach to therapeutic patient education may reduce symptomatology, prevent side effects, maximize health outcomes and positively affect the quality of life and survival of adult patients with cancer. There is limited evidence that therapeutic patient educational interventions improve oral anti-cancer medicine adherence in adult patients with cancer in ambulatory care settings. A growing number of patients with cancer are being prescribed oral anti-cancer medicines; a better understanding of how therapeutic patient education strategies are effectively implemented may promote patient self-motivation and oral anti-cancer medicine adherence. This review recommends the development of a specific standardized methodology and evaluation approach to therapeutic patient education that may empower patients to increase their adherence to self-managed medication and achieve positive health outcomes Clinical trials with larger sample sizes, standardization of content, comparing specific adherence education or tailored education interventions are needed.

The effectiveness of therapeutic patient education on adherence to oral anti-cancer medicines in adult cancer patients in ambulatory care settings: a systematic review

The effectiveness of therapeutic patient education on adherence to oral anti-cancer medicines in adult cancer patients in ambulatory care settings: a systematic review

Effectiveness of therapeutic patient education for adults with migraine. A systematic review and meta-analysis of randomized controlled trials.

Our aim was to systematically review and meta-analyze the effectiveness of therapeutic patient education for migraine. A literature search of multiple electronic databases (MEDLINE, EMBASE, PEDro, CINAHL, and PsychINFO) was conducted to identify randomized control trials (RCTs) published in the English and Spanish languages up to and including May 2013. Two reviewers independently selected the studies, conducted the quality assessment (Delphi list), and extracted the results. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses method was used throughout the systematic review and meta-analysis. Standardized mean difference (SMD) and 95% confidence intervals (CIs) were calculated for relevant outcome measures (headache frequency, headache disability, self-efficacy, depressive symptoms, and quality of life) and pooled in a meta-analysis using the random effects model. Fourteen RCTs were included in the systematic review. Only nine studies were included in the meta-analysis. The median quality score was 6.14 ± 1.29 (range: 5-9). There was strong-moderate evidence for intermediate-term effectiveness of therapeutic patient education on headache frequency (five studies: N = 940, SMD = -0.24, 95% CI of -0.48 to -0.01, P = 0.03), headache disability (four studies: N = 799, SMD = -1.02, 95% CI of -1.95 to -0.08, P = 0.03), and quality of life (three studies: N = 674, SMD = 0.36, 95% CI of 0.05-0.67, P = 0.02). There was no evidence for either short-term or intermediate-term effectiveness of therapeutic patient education on self-efficacy or depressive symptoms. This systematic review revealed strong-moderate evidence for intermediate-term effectiveness of therapeutic patient education for migraine. Further high-quality RCTs are required for conclusive determination of its effectiveness.

The effectiveness of therapeutic patient education on adherence to oral anti-cancer medicines in adult cancer patients 18 years and older in an ambulatory care setting: a systematic review protocol

Review question In adult cancer patients, 18 years and older, what is the effectiveness of therapeutic patient education on adherence to oral anti-cancer medicines in an ambulatory care setting? Inclusion criteria Types of participants This review will consider studies that include all adult patients aged 18 and older, of any gender and ethnicity and diagnosed with any form of cancer, receiving oral anti-cancer medicines in an ambulatory care setting. Adult patients with cancer receiving intravenous or non-oral chemotherapy will be excluded from this review. Types of intervention(s) This review will consider studies that evaluate the use of therapeutic patient education as the additional intervention to routine patient education to promote oral anti-cancer medicine adherence in adult cancer patients in an ambulatory care setting. Therapeutic patient education is a coordinated set of educational activities proposed by a healthcare team that involve other professionals and family members. Therapeutic patient education can empower patients and family members to manage life with a chronic disease, based on a set of integrated and organized actions, including psychosocial support, designed to make patients and family members more autonomous by acquiring knowledge and skills to make them agents of their own change, thus improving their wellbeing and quality of life. Comparator Interventions will be compared with routine patient education. Routine patient education is defined as a process health care professionals regularly follow and utilize to communicate information to the patient that may alter one’s health behaviors or improve health status. Types of outcomes The primary outcome of this review is adherence to prescribed oral anti-cancer medicines. The definition of adherence encompasses the extent to which a person’s behavior when taking medication, following a diet, and/or accomplishing lifestyle changes follows or agrees with recommendations made by healthcare professionals. Adherence will be measured using validated and reliable tools that assess medication adherence including, the Medication Adherence Questionnaire the Morisky Medication Assessment Scale, the Medication Adherence Self-Efficacy Scale, the Medication Adherence Report Scale, the Beliefs about Medicine Questionnaire ,and the Brief Illness Perception Questionnaire Studies with objective methods for measuring medication adherence will also be considered in this review TRUNCATED AT 350 WORDS

Validación de un cuestionario de conocimientos sobre la hipertensión

IntroductionHypertension is a chronic disorder and is the main cause of cardiovascular disease. Educational interventions designed to increase knowledge may help hypertensive patients to change unhealthy lifestyles and optimize treatment adherence, thus facilitating better blood pressure control. Consequently, a reliable tool is required to evaluate the effectiveness of these interventions. ObjectiveTo validate a hypertension knowledge questionnaire in Spanish to assess patients’ knowledge and understanding of this disorder. Material and methods1) Adaptation of an existing questionnaire. 2) Focus groups to unify criteria and consultation with experts. 3) Pilot test to evaluate comprehension of the questionnaire. 4) Reliability through internal consistency (Cronbach's alpha) and sensitivity to change (McNemar test). ResultsA final questionnaire was developed in 9 blocks, which included knowledge of hypertension, associated risk factors, risks of hypertension, diet, exercise, and medication. Sixty patients participated: 30 were from primary care centers and the remaining 30 were from specialized centers. The mean age of the participants was 60 years, and 57% (n=34) were women. Cronbach's alpha was 0.799. ConclusionThe questionnaire developed in this study is a reliable and easily applied tool to assess knowledge about hypertension in hypertensive patients. This questionnaire is especially useful to evaluate the effectiveness of therapeutic patient education.

Patient education for neck pain

Neck disorders are common, disabling, and costly. The effectiveness of patient education strategies is unclear. To assess the short- to long-term effects of therapeutic patient education (TPE) strategies on pain, function, disability, quality of life, global perceived effect, patient satisfaction, knowledge transfer, or behaviour change in adults with neck pain associated with whiplash or non-specific and specific mechanical neck pain with or without radiculopathy or cervicogenic headache. We searched computerised bibliographic databases (inception to 11 July 2010). Eligible studies were randomised controlled trials (RCT) investigating the effectiveness of TPE for acute to chronic neck pain. Paired independent review authors conducted selection, data abstraction, and 'Risk of bias' assessment. We calculated risk ratio (RR) and standardised mean differences (SMD). Heterogeneity was assessed; no studies were pooled. Of the 15 selected trials, three were rated low risk of bias. Three TPE themes emerged.Advice focusing on activation: There is moderate quality evidence (one trial, 348 participants) that an educational video of advice focusing on activation was more beneficial for acute whiplash-related pain when compared with no treatment at intermediate-term [RR 0.79 (95% confidence interval (CI) 0.59 to 1.06)] but not long-term follow-up [0.89 (95% CI, 0.65 to 1.21)]. There is low quality evidence (one trial, 102 participants) that a whiplash pamphlet on advice focusing on activation is less beneficial for pain reduction, or no different in improving function and global perceived improvement from generic information given out in emergency care (control) for acute whiplash at short- or intermediate-term follow-up. Low to very low quality evidence (nine trials using diverse educational approaches) showed either no evidence of benefit or difference for varied outcomes.Advice focusing on pain & stress coping skills and workplace ergonomics: Very low quality evidence (three trials, 243 participants) favoured other treatment or showed no difference spanning numerous follow-up periods and disorder subtypes. Low quality evidence (one trial, 192 participants) favoured specific exercise training for chronic neck pain at short-term follow-up.Self-care strategies: Very low quality evidence (one trial, 58 participants) indicated that self-care strategies did not relieve pain for acute to chronic neck pain at short-term follow-up. With the exception of one trial, this review has not shown effectiveness for educational interventions, including advice to activate, advice on stress-coping skills, workplace ergonomics and self-care strategies. Future research should befounded on sound adult learning theory and learning skill acquisition.

Characteristics and development of therapeutic patient education in rheumatoid arthritis: Analysis of the 2003–2008 literature

ObjectiveThe aim of this study is to point out the recent characteristics and developments of therapeutic patient education (TPE) in rheumatoid arthritis through an analysis of the international articles published from 2003 to 2008. MethodStudies were selected from major databases, using the following keywords: rheumatoid arthritis, patient education, self-management, programs. Three authors independently reviewed each study and selected the data using the patient education research categories (PERC). Articles consistently related to patient education in rheumatoid arthritis (37 among 109) were included. ResultsThe selected articles have been published in 23 scientific journals. The majority of them concern TPE for adult patients with rheumatoid arthritis. TPE is delivered in several structures and group education represents the most widespread educational strategy mainly provided by a multiprofessional team. There are two types of programs: educational, aiming to make the patient competent in the daily management of his disease and psycho-educational ones, aiming to improve coping and to decrease stress, anxiety and depression. Twenty-eight studies show the effectiveness of TPE on the basis of bio-clinical, educational, psychosocial, economical criteria, but the majority of these positive results are observed in short-term. Barriers to TPE are linked to cultural and socio-economic factors. ConclusionA large number of studies still assess the positive effects of TPE. Nowadays, the problems of short-term efficacy of TPE and the cultural and social barriers to this practice have become a major issue for research.