Therapeutic Patient Education Program Research Articles

“Breaking barriers: empowering African youth through implementation of a therapeutic patient education program for juvenile idiopathic arthritis”

IntroductionPatient education is crucial in managing chronic diseases like Juvenile Idiopathic Arthritis (JIA). Traditional methods such as videos and brochures often fail to maintain long-term knowledge retention. Therapeutic Patient Education (TPE) offers a more effective, patient-centered approach.ObjectivePAFLAR aimed to implement a TPE program with a “train the trainers” masterclass to ensure effective delivery and improve outcomes for children with JIA.MethodsPAFLAR's TPE program was designed through a focus group, involving a literature review and strategic planning for the implementation step. The program includes specialized training for healthcare professionals enhancing their abilities to deliver TPE workshops. Participants were selected based on volunteerism and commitment to the project. Evaluations were conducted through feedback assessment of both patients and participants.ResultsPAFLAR launched a TPE program in 2023, aimed at training healthcare providers to implement TPE effectively. This initiative included both in-person and virtual masterclasses, resulting in five workshops conducted in Kenya, Tunisia, and Nigeria. These workshops covered various aspects of JIA management, such as patient and family education, self-esteem, physical activity, treatment adherence, and pain management. Early results showed significant improvements in patients’ and parents’ understanding and management of JIA, with positive feedback indicating a need for further sessions.ConclusionPAFLAR has taken the initial step in implementing a TPE program for JIA across three countries, representing different regions of Africa. The TPE program offers a promising alternative to traditional patient education methods, significantly improving patient care, empowering healthcare providers, and advancing healthcare systems.

Assessment of adherence to antiretroviral therapy and its related factors among people living with HIV in the region of Beni-Mellal-Khenifra, Morocco.

BackgroundThe management of the human immunodeficiency virus (HIV) as a chronic infection involves an optimal adherence to antiretroviral therapy(ART), which is determined by several factors as currently mentioned in the literature. This study aimed to describe the adherence to antiretroviral therapy among people living with HIV (PLHIV)and its related factors in the region of Beni-Mellal-Khenifra. Materials and methodsA cross-sectional study was conducted on 160 PLHIV and attending the regional hospital of Beni-Mellal, Morocco between February and July 2022. Participants were collected using a non-probabilistic sampling. The adherence to ART was assessed using the simplified medication adherence questionnaire (SMAQ). The sociodemographic and clinical characteristics of the participants were collected through an interviewer-administered questionnaire and consultation of medical records. Binominal logistic regression was used to determine potential factors influencing the adherence to ART. Statistical significance was set at p<0.05. Resultsthe adherence rate to ART among PLHIV was of 73.1%. the data analysis revealed the associated factors to antiretroviral therapy to be: therapeutic patient education( OR=0.217; 95%CI[0.049-0.955]), treatment regimen(OR=0.155; 95%CI[0.026-0.923]), and viral load (OR=0.43; 95%CI= [0.007-0.284]). Conclusionthe health strategies should focus on therapeutic patient education programs, and encourage drug industry to minimize the complexity of ART regimens.

Assessment of a Therapeutic Education Program for Coronary Patients: Quasi-Experimental Study

Abstract Introduction Therapeutic education is a patient-centered, approach aimed at addressing the patient’s needs and resources. It is intended not only to help the patient understand their illness and treatment but also to empower them to become autonomous. So far, in Tunisia, we lack structures for therapeutic education specifically tailored for coronary patients. In this context, we implemented a Therapeutic Education Program (TEP) for coronary patients visiting the cardiology department at Sahloul University Hospital with the aim of assessing the impact of this program in the short, medium (3 months), and long term (12 months). Methods We conducted a quasi-experimental study on TEP for patients with coronary artery disease over one year at Sahloul University Hospital. Patients were divided into two groups, intervention, and control. Outcome measures included major cardiovascular events, improvement in knowledge, and biological indicators, with statistical analysis performed using SPSS in accordance with ethical considerations. Results The study included 129 patients, of whom 38 underwent a therapeutic education program. TEP demonstrated a significant improvement in knowledge about coronary artery disease, with program satisfaction rated ≥8 on a scale of 0 to 10.Our program also showed improvement in biological parameters, particularly lipid profiles, within the educated group before and after 3 months, such as LDL cholesterol levels (2.53 vs 1.88, P &amp;lt; 0.001), and compared to the control group (1.88 vs 2.9, P = 0.001).Moreover, it led to a significant reduction in long-term cardiovascular events compared to the control group (21.1% vs 59.3%, p &amp;lt; 0.001). Conclusions this study underscores the crucial importance of therapeutic education in enhancing the care and quality of life of coronary patients, highlighting its central role in a proactive, personalized approach to medical management. Key messages • The significance of therapeutic education in empowering patients to understand their condition and become self-reliant. • Need for Structured Programs specifically for coronary patients in Tunisia.

Making Conscientious Decisions: Engaging in Venous Leg Ulcer Self-Management Following Nurse-Led Patient Education.

Venous leg ulcers (VLUs) provoke multiple symptoms and impact individuals and society as a whole. Their treatment and prevention strategies require individual's involvement in self-management strategies. Insufficient knowledge with regard to prevention, management, and treatment has been identified as a critical factor related to VLUs and their recurrence. Therapeutic patient education (TPE) proposed as part of a management strategy for this population provides unclear benefits regarding wounds healing or prevention of recurrence. The aim of the study was to develop a theory explaining how individuals with a VLU experience an individualized nurse-led TPE program regarding self-management strategies. The constructivist approach of Charmaz to the grounded theory method was used to develop the theory. A total of 26 individuals contributed to the co-construction of the theory through face-to-face or telephone semi-structured interviews. Data analysis and data collection occurs simultaneously with a comparative process to reveal the conceptual categories, apply theoretical sampling, and define theoretical saturation. The theory of "Conscientiously Engaging in Self-Management" was co-constructed with the participants encapsulating four categories: "Being influenced by my own story," "Being personally informed," "Making conscientious decisions to engage in self-adapted management strategies," and "Integrating a conscientious way of living." This theory highlights individuals' voices and stories toward their journey of VLU self-management taking contextual factors into consideration. This new theory offers new knowledge about implementation of self-management strategies for individuals living with a VLU and will inform clinical practice and contribute to the development of targeted interventions.

TVE in the management of rare diseases in hematology: raising the "Dephi" bar

Launched in 2022 at the Policlinique d'hématologie et d'immunologie (PHI) of the Centre hospitalier(CH) Saint-Louis, the therapeutic patient education (TPE) program for patients suffering from rare hematology pathologies is continuing to develop. It has led to the creation ofan TPE team. To date, two workshops are up and running, and a third is nearing completion.

Therapeutic patient education programs on diabetes in sub-Saharan Africa: A systematic review

Therapeutic patient education programs on diabetes in sub-Saharan Africa: A systematic review

Use of qualitative methods to optimize collaborative practices by highlighting differences in perceptions between professionals: an example of patient education

ABSTRACT Interprofessional working must be approached within health promotion interventions using systematic methods to identify areas of suboptimal collaboration. We designed a qualitative study with a purposive sample of seven French therapeutic patient education programs. Semi-structured individual interviews were conducted with 14 healthcare providers and seven clinician leaders (coordinators) involved in patient education. We used the same interview guide and thematic grid regardless of the professional’s profile to compare their perceptions on elements affecting outcome, participation and sustainability of programs. Healthcare providers and coordinators addressed non-convergent issues at both ends of a continuum from a micro-level nested in the program delivery to a macro-level corresponding to the structured implementation and sustainability of the program. Meso-level issues featured convergent perspectives. Our methodology could be used at the level of health services in a health system to provide a complete recovery of stakeholders’ perspectives (without “blind spots” from one stakeholder or another). In our study, we focused on patient education in the French health system and pointed out possible considerations to optimize the functioning of programs. Such considerations include specific training plan development, encouraging reflection on the content and use of initial assessment, leading sessions in pairs to save on work time, and communication on the ins and outs of organizational imperatives that require healthcare providers’ contributions.

Therapeutic patient education for severe mental disorders: A systematic review.

This systematic review aimed to review therapeutic patient education (TPE) programmes in managing psychiatric disorders, considering the diversity in delivering agents, intervention formats, targeted skills, and therapeutic outcomes. Comprehensive database searches, including Web of Science, PubMed, and COCHRANE, were conducted from September 2019 to January 2023, yielding 514 unique records, with 33 making it through rigorous evaluation for full-text review. Eleven studies met the inclusion criteria, focusing on various psychiatric disorders such as depression, bipolar disorder, psychosis, and multiple serious mental illnesses. A total of 38 studies were included from our previous review to supplement the current database search. TPE programmes exhibited diversity in delivering agents and intervention formats, with a notable presence of multidisciplinary teams and various professionals. The interventions prioritized coping strategies and disease management techniques, though the extent varied based on the disorder. Effectiveness was heterogeneous across studies; some interventions showed significant benefits in areas such as symptom management, coping, and functional improvement, while others reported no significant outcomes. The findings underscore the potential of TPE in psychiatric care, revealing its multifaceted nature and varied impact. TPE not only addresses deficits but also leverages patients' existing strengths and capabilities. Despite the reported benefits, a portion of the interventions lacked statistical significance, indicating the necessity for continuous refinement and evaluation.

Investigation of the therapeutic education effect on glycemic control and quality of life of children and adolescents with type-1 diabetes mellitus: A non-randomized controlled study.

Type-1 diabetes mellitus (T1DM) is one of the most dreaded chronic diseases, especially in children or youth. To help patients and their families effectively manage their disease, structured therapeutic patient education (TPE) is essential. The purpose of this non-randomized before and after controlled study was to assess TPE program effects. In total, 200 T1DM children and adolescents, aged 8-18 years, selected from two pediatric departments, were equally assigned to the intervention and control groups. The primary endpoints were differences between groups at 3 months follow-up in measured HbA1c and health-related quality of life (QoL) assessed by a validated questionnaire. At 3 months follow-up of a TPE intervention for T1DM children and adolescents, although there was no significant change in HbA1c for both groups, a significant improvement was observed in the maximum pre- and postprandial blood glucose levels (r: ~0.3; variation rates: -10,47% and -3,85%, respectively) in the intervention group, whereas there was a significant increase in the maximum and minimum of preprandial blood glucose levels in the control group (r: ~0.3, variation rates: 14.29% and 25%, respectively). Global and dimensional QoL mean scores variation rates showed a significant difference between groups, with an improvement in the intervention group (r ≥ 0.7, Cohen's > 0.8) and a decrease in the control group (r ≥ 0.7). These results support the hypotheses of difference between the study groups in favor of better glycemic control and QoL for the intervention group.

Effectiveness of integrated education and relaxation program on migraine-related disability: a randomized controlled trial

BackgroundMigraine is one of the most disabling disorders worldwide. Globally, in 2019, headache disorders were the cause of 46.6 million years of disability, with migraine accounting for 88.2% of these. The value of integrative strategies in migraine management has been raised due to the recurrent and provoked nature of migraine. So, the current study aimed to evaluate the effectiveness of implementing a therapeutic patient education and relaxation training program versus usual pharmacological treatment alone on the frequency, severity, and duration of migraine attacks as the primary outcome and migraine-related disability and quality of life as the secondary outcome. A randomized controlled trial was conducted at the specialized headache clinic of a tertiary referral center. Sixty patients were randomly assigned to intervention or control groups. Participants in the intervention arm received the education and relaxation training program and were instructed to perform daily relaxation exercises in addition to their routine pharmacological treatment, whereas the control group only received their routine treatments. Follow-up was done after 1 and 3 months using a headache diary and a migraine-specific quality of life questionnaire (MSQ).ResultAfter implementation of the program, there was a significant reduction in migraine attack severity in the intervention group compared to the control group, and they also had significantly fewer migraine headache days/month and duration of migraine attacks compared to patients in the control group. Statistically significant improvement in the role-function restrictive, role-function preventive, and emotional function domains of MSQ.ConclusionAn integrated migraine management program has a significant effect on reducing the burden of migraine attacks and improving the daily activities of migraine sufferers.

Effects of therapeutic patient education program on glycemic control and quality of life among children and adolescents with type 1 diabetes mellitus in Fez city, Morocco.

Type 1 diabetes mellitus (T1DM) is a chronic disease, mainly observed in children or youth, with a significantly increased incidence in young children. Structured therapeutic patient education (TPE) is a must to help them manage their disease effectively and lead a healthy lifestyle. This study aimed to assess the effects of a structured TPE program on glycemic markers and quality of life (QOL) of T1DM children and adolescents in Fez city, Morocco. It is a quasi-experimental study. One hundred T1DM children and adolescents, aged 8-18, participated in a TPE intervention at the pediatric department in a hospital center in Fez, Morocco. Glycemic markers were measured and QOL was assessed by a validated questionnaire. Parametric and nonparametric tests were used and statistical significance determined by P < 0.05. At 3 months' follow-up, both global and dimensional QOL mean scores improved significantly (P ≤ 0.0001), whereas glycosylated hemoglobin (HbA1c) decreased (10.28% vs. 10.62%), tough with no statistical significance (P = 0.160). Furthermore, a significant improvement was observed in the maximum preprandial (2, 11 g/L [1.51-2.58] vs. 2, 37 g/L [1.81-3.21], P = 0.001) and postprandial blood glucose levels (2, 50 g/L [1.90-3.27] vs. 2, 95 g/L [2.07-3.99], P = 0.001) after 3 months; with no significant change in their minimum. Although this TPE intervention was more effective in improving patients' QOL than their HbA1c, it is worth striving to implement regular TPE programs for T1DM pediatric patients and adjust them to achieve a better patients' glycemic markers levels.

Impact of therapeutic education on the evolution of social representations of medication in patients with Parkinson's disease: A quantitative and qualitative study (ETPARK REMED)

BackgroundAmong the workshops of our therapeutic patient education (TPE) program, the medication workshop (TPEM workshop) is very frequently proposed to patients in view of the difficulties they encounter related to the complexity of managing antiparkinsonian treatment. Patients’ appropriation of their medications could depend on their social representations. ObjectivesTo evaluate the effect of our TPEM workshop on the social representations PD patients have of their medications and to compare it with that of another therapeutic intervention such as a talking group defined as the control group. MethodsThis single-center, prospective, randomized, parallel-group study investigated the social representations of medication through a questionnaire on knowledge about antiparkinsonian medications, a questionnaire on beliefs about medication (BMQ), and a word association task. ResultsIn the TPEM group (n=16), the workshop induced significant effects over time on the knowledge questionnaire (P=0.01), BMQ specific necessity and concerns scores (P=0.04 and 0.01, respectively), necessity-concerns differential (P=0.04), and BMQ general harm (P=0.04). No significant difference was found in the talking group (n=6). Comparison of the two groups showed a significant difference of the BMQ general harm with a decrease in belief in the harmfulness of the medications in the workshop group (P=0.03). The results of the verbal association task showed a modification in the content and structure of the social representations of medication in the TPEM group. DiscussionThe TPEM workshop helped reduce initial negative aspects of medication representations. Improved knowledge of their medication allowed patients to feel more competent and legitimate in communicating with caregivers, modifying their beliefs about medications. Indeed, the medication was perceived as less restrictive, care becoming central as shown by the emergence of the medical team in the social representations of the medication. ConclusionAll the results show a specific beneficial effect of the TPEM workshop through an evolution of the social representations of medications, which became more positive in our PD patients.

Un programme d’éducation thérapeutique pour l’initiation et le suivi d’un traitement par clozapine

Clozapine is the reference treatment for resistant schizophrenia. Although its efficacy has been widely demonstrated in numerous studies, it remains largely under-prescribed in its main indication. Therapeutic patient education (TPE) programs focused on clozapine could, on the one hand, promote the prescription of this drug and, on the other, encourage patients to adhere to the treatment schedule by improving their knowledge of its effectiveness. This article presents the TPE program entitled “Living with clozapine” developed to support the initiation and follow-up of patients being treated with clozapine.

A structured therapeutic education program for patients with type 1 diabetes

Type 1 diabetes is a chronic disease that represents a global health problem that its incidence is constantly increasing, hence the need for an effective management approach to control the disease and its complications. The main objective of this work is to share the experience of our service in the therapeutic education of the type 1 diabetic patient, from a study spread over 16 months involving 142 patients, including a 1st phase during the collection of data was made during patient hospitalization for therapeutic education, and a 2nd phase during which an evaluation was made after 6 months of intervention. The average age of our patients was 17 years. Among our recruited patients, 54% were able to benefit from the educational program for the initiation of functional insulin therapy. The evaluation after the educational intervention at 6 months was carried out in 78, 8% of our patients, having objectified a significant glycemic evolution by a 1.7% drop in HbA1c and an increase in the percentage of adherence to lifestyle and dietary measures and the practice of regular self-monitoring of the glycaemia as well as an improvement in the mean of the overall treatment satisfaction score was noted after the educational intervention. Our results underline the importance of therapeutic education in the management of diabetic patients, the main objective of which is to improve their quality of life, which was highlighted by the patient testimonial sessions and their entourage, which remain a novelty of the educational program called "Type One.. Number One" ,whose objective is to serve to motivation for type 1 diabetics, their entourage and also the medical team.

Assessing health literacy in transplant patients to better tailor the content of their therapeutic education: an observational study

ObjectivesEvaluate health literacy in transplant patients to better tailor the content of their continuing therapeutic education.MethodsA 20-item questionnaire divided into five themes (sport/recreation, dietary measures, hygiene measures, recognition of the...

French guidelines for the etiological workup of eosinophilia and the management of hypereosinophilic syndromes

Eosinophilic-related clinical manifestations are protean and the underlying conditions underpinning eosinophilia are highly diverse. The etiological workup of unexplained eosinophilia/hypereosinophilia can be challenging, and can lead sometimes to extensive, inappropriate, costly and/or invasive investigations. To date, guidelines for the etiological workup and management of eosinophilia are mainly issued by hematologists, and thus mostly cover the scope of clonal hypereosinophilic syndromes (HES). Here, thanks to an extensive literature review, and thanks to the joint work of a large panel of experts involving physicians from both adult and pediatric medicine and from various subspecialties (as well as a representative of a patients’ association representative), we provide recommendations for both the step-by step diagnostic workup of eosinophilia (whether unexplained or within specific contexts) as well as the management and follow-up of the full spectrum of eosinophilic disorders (including clonal, reactive, lymphocytic and idiopathic HES, as well as single-organ diseases). Didactic prescription summaries intended to facilitate the prescription of eosinophil-targeted drugs are also provided, as are practical diagnostic and therapeutic algorithms. Lastly, this set of recommendations also includes a summary intended for general practitioners, as well as an overview of the therapeutic patient education program set up by the French reference center for HES. Further updates will be mandatory as new validated information emerges.

Glyquemic controle and quality of life of children and adolescents with Type 1 diabetes mellitus - Therapeutic patient education program effects.

Glyquemic controle and quality of life of children and adolescents with Type 1 diabetes mellitus - Therapeutic patient education program effects.

Evaluation of sleep and therapeutic education needs of military with PTSD

Sleep disorders in post-traumatic stress disorder (PTSD) are both diagnostic (nocturnal reliving) and prognostic. Poor sleep worsens the daytime symptomatology of PTSD and makes it resistant to treatment. However, no specific treatment is codified in France to treat these sleep disorders although sleep therapies (cognitive behavioural therapy for insomnia, psychoeducation and relaxation) have proven for years to be effective in treating insomnia. Therapeutic sessions can be part of a therapeutic patient education program, which is a model for the management of chronic pathologies. It allows for an improvement in a patient's quality of life and enhanced medication compliance. We therefore carried out an inventory of sleep disorders of patients with PTSD. First, we collected data by means of sleep diaries concerning the population's sleep disorders at home. Then we assessed the population's expectations and needs regarding its management of sleep, thanks to a semi-qualitative interview. The data from sleep diaries, which was consistent with the literature, showed that our patients suffered from severe sleep disorders that strongly impact their daily lives, with 87% of patients having an increased sleep onset latency, and 88% having nightmares. We observed a strong demand from patients for specific support for these symptoms, 91% expressing an interest in a TPE program targeting sleep disorders. Thanks to the data collected, the emerging themes for a future therapeutic patient education program targeting sleep disorders of soldiers with PTSD are: sleep hygiene; management of nocturnal awakenings, including nightmares; and psychotropic drugs.

Évaluation des effets du programme d’éducation thérapeutique Bipolis® sur le parcours de santé des participants entre mars 2009 et juillet 2017

ObjectivesBipolis® is a therapeutic patient education program for people with bipolar disorders from healthcare institutions in the Occitania region, designed and implemented by Dr Barbara Combes. This program is based on the SARA® method (Ambulatory Recovery Assistance Internship), four independent and complementary sub-programs. This innovative therapeutic and pedagogical approach incorporates therapeutic knowledge in four areas of activity (Appropriation of the disease, Relapse, Sociality, Hygiene of Life) and invests the working postures of the patient and the specific professional ETP caregiver. It adopts original ETP techniques in “common axes of strength” in each SARA ® sub-program to understand psychic functioning, address states of stability and instability, and the fundamental problems of psychiatric pathology. A Free Enrolment Modality was used depending on the patient's desire to learn skills, self-care strategies and adaptive strategies. We explored its impact on the recurrences of bipolar disorder, the degree of patient's satisfaction and the perceived quality of life. MethodsOur work constitutes a retrospective survey of cohort exposed versus non-exposed research, whose target population is patients with bipolar disorder who participated in Bipolis® between March 2009 and July 2017, with whom we have compared a sample of controls based on gender, age, and the year of the beginning of follow-up at the counselling center who did not participate in the Bipolis® program (non-exposed group). Our study consisted of analyzing the data contained in the patients’ medical files and conducting a telephone questionnaire. We included 55 patients in the exposed group and 50 in the non-exposed. The primary endpoint is the number of psychiatric hospitalizations occurring at 2 years and at 5 years following the index date. The index date (T0) is the end date of participation in the 4 SARA® sub-programs of Bipolis® for the exposed patients. ResultsOur study established a significant link between Bipolis® and the number of hospitalizations at either 2 or 5 years following the end of the program. In effect, at 2 years after the program (involuntary admission in psychiatric care at the request of a third party) we observed an 80 % decrease in ASPDT hospitalizations. In the 5 years following the end of the program, we noted that the implementation of the Bipolis® program is associated with an overall decrease in hospitalizations (all categories combined) and more precisely a drop of 41.17% in voluntary hospitalizations. As for the results regarding the impact of Bipolis® on destabilizations treated on an outpatient basis, we find, however, that within 2 years, they are fewer in number but the differences are not significantly conclusive. Whereas at the 5-year mark following the end of the program, there is a 34.62% decrease in destabilizations for those patients in outpatient care. We can therefore hypothesize that, surprisingly, Bipolis® seems to provide better protection from outpatient relapse at 5 years, than at 2 years. Several hypotheses can be suggested : in the first place, 31% of the Bipolis® patients we included participated in at least one other SARA® program and therefore did more than 4 SARA® programs, or at least one SARA®, after their T0 when they personally felt the need for reinforcement. The results of the questionnaire show that Bipolis® improves the patients’ perception of their mental and physical health. 93.1% of patients found that Bipolis® helped them in understanding and accepting treatment, and 85.7% of the patients were able to identify complementary non-medicinal strategies and to distinguish between them and chemical treatments. Bipolis® allows patients to feel less limited in carrying out domestic tasks, establishing social links, participating in leisure activities or setting up projects. It also reduces the difficulties experienced by patients in the workplace. ConclusionBipolis® reduces the severity of hospitalizations: in fact, 2 years after the end of the program, there is an 80% reduction in ASPDT hospitalizations in the exposed group compared to the non-exposed Bipolis® group. In the long term, this same program reduces the number of hospitalizations at 5 years following the end of the program and particularly for voluntary hospitalizations. Outpatient destabilizations are also reduced over the same period. This program is also associated with an improvement in the patients’ quality of life.

A therapeutic education program for patients with multiple sclerosis

The MOTIV-SEP therapeutic education program for people with multiple sclerosis integrates the cognitive, emotional, behavioral and social components of therapeutic compliance. These components allow for an approach centered on the individual, in order to help him or her better support the important stage of starting treatment, but also to anticipate and reduce the obstacles to compliance.