Cyril Crozet

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

OBJECTIVE The 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. METHOD Studies 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. RESULTS The 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. CONCLUSION A 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.

Analysis of the 2004-2007 literature on therapeutic patient education in diabetes: results and trends

The purpose of this study is to identify the recent characteristics and the developments of therapeutic education in diabetes through an analysis of the international articles published from 2004 to 2007. Studies were selected from several databases: Medline, Embase, Eric, Cochrane central database, using the following keywords: diabetes, patient education, self management, programs. Two authors independently reviewed each study and selected the data using the same categories of analysis. Articles consistently related to patient education in diabetes (80 among 118) were included. The selected articles have been published in 43 scientific journals. The majority of them concern TPE for adult patients with type 2 diabetes. TPE is delivered in several structures and education to groups of patients represents the most widespread educational strategy mostly provided by a multiprofessional team. A total of 70% of the studies show the effectiveness of TPE based on bioclinical, educational, psychosocial, economical criteria. The problem of barriers to TPE concerns 21% of the studies we have analysed and most of the authors propose the implementation of specifically-designed TPE programs as strategy to overcome them. A large number of studies still assess the positive effects of TPE. Nowadays the problems of accessibility to TPE and the barriers to this practice have become a major issue for research.