Patient Centered Medicine
Therapeutic patient education definition:
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. It’s principle purpose is to produce a therapeutic effect additional to that of all other interventions (pharmacological, physical therapy etc.)
Therapeutic patient education is designed to train patients in the skills of self-management or adapting treatment to their particular chronic disease and in coping processes and skills. It should also contribute to reducing the cost of long term care to patients and to society.
Why Patient Education?
New demands are being made on medicine today due to several factors:
– The first is the increase in the prevalence of chronic disease and this brings with it new objectives for the caregiver. We are less and less in a logic of curing a disease and more and more in a logic of controlling the progression of a disease and ensuring the patient has an optimal quality of life.
-The second factor is the low therapeutic adhesion observed in all chronic pathologies. The average global therapeutic adhesion is less than 50%. This accounts for many inefficient treatments or at least the low impact of topical treatment on the development of the disease. It also accounts for an increased socio-economic burden on the families concerned.
Among the possible solutions for increasing therapeutic adhesion, patient education is the most pertinent response.
Patient education places the patient at the centre of the care process by helping him/her to become more autonomous and develop the skills necessary to manage his/her life and disease.
There are three steps in the process of health promotion:
1.Primary prevention: hygiene and photo protection concern healthy individuals but are essential for diminishing risk of infection or cancer.
2.Early detection of disease (i.e. breast screening programs) for a high-risk population. Or congenital nevi follow-up in the prevention of melanoma.
3.Patient education comes last in the health promotion process. Education differs from disease prevention in the sense that it concerns the management of the disease and the quality of life of the patient.
Patient education is largely used in the management of chronic diseases such as asthma, diabetes and cardio-vascular disease. Numerous studies have demonstrated the crucial role of education programs in the adhesion, the impact of the treatments and the quality of life of the patients.
The quality of life of chronic skin disease patients is often affected, and sometimes more than in severe systemic diseases. Moreover, the fact that the patient needs to apply their own local treatment, on the correct area and at the right time, means that the patients need to acquire the necessary skills to treat themselves and evaluate their disease.
Finally, when considering patient education, the doctor should always remain at the centre of the process. Outsourcing patient education to education specialists is neither realistic nor desirable. The quality of the doctor-patient relationship is an integral part of the medical act in itself. This does not mean that the doctor must become an expert in patient education but he/she must integrate an educative approach into their consultation.