What is therapeutic education?

Common and increasing, asthma is responsible for 2,000 deaths each year. To improve care and reduce this terrible balance, the development of therapeutic education is essential. It should soon be more accessible and even reimbursed.

The benefits of therapeutic education in asthma

The Bachelot law or the law "Hospital Patients, Health and Territory" voted in June 2009 emphasizes the importance of therapeutic education. What does the term cover? How effective is it, especially in asthma? The answers of Dr. Marc Sapène, pneumologist and President of the association Asthme and Allergies, and Marie-Pierre Rinn, asthmatic and president of the touraine branch of this association

Very positive results: "Everything has changed"

Defined in 1998 by the World Health Organization 1, patient therapeutic education (PTE) encompasses a set of means enabling people with a mostly chronic disease to better live with their pathology on a daily basis And its treatment and to be more autonomous.

Asthma: towards a prescription of therapeutic education

These means must be implemented by the health professionals, the associations, the entourage, in a continuous and individualized way. This process can be achieved through different consultations, workshops or appointments in specific centers, such as for asthma, diabetes, cancer or soon for mental illness.
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In all cases, therapeutic education places the patient back at the heart of the device, making him a player in his health.

As Dr. Marc Sapène, president of the Asthma and Allergies 2 association, "was initially skeptical, doctors were very convinced of the usefulness of these sessions of therapeutic education of the patient". Henceforth, the usefulness of ETP is fully recognized and essential in the management of asthma and other pathologies.

For this pneumologist, this program must begin with an evaluation of the severity of the asthma but also by an "educational diagnosis": who is the patient? His job? His background? How does he see his illness? Etc. This step is essential for individualization of support.

The main structure for therapeutic education for asthmatics, schools of asthma are now present in most French departments (interactive map on ). They allow patients, especially if their illness is poorly controlled, to

Therapeutic education is very useful, whatever the age at which it begins. It is even recommended in toddlers, as highlighted by the recent recommendations of the High Authority of Health on asthma of children under 36 months.

The results of the ETP are often spectacular, often leading to a decrease in crises, symptoms, school or work absenteeism, hospitalizations, calls to emergency services, and improved life expectancy. Every day.

For Marie-Pierre Rinn, asthmatic, "everything has changed" since a ETP was advised to him to the School of asthma of Tours 2. While she really had difficulty to manage her asthma on a daily basis, she was Often hospitalized although denying the disease ("I do asthma attacks but I am not asthmatic"), she has benefited undeniably from therapeutic education, going from 3 or 4 annual hospitalizations to none for 4 years. She learned to "manage the most difficult times", "better accepted her illness". Thanks to this experience, Ms Rinn has become president of the Asthma & Allergies association's Tourangelle wing, to help other asthma patients in her region.

"The ETP has given me a renewal of vitality, I have a much improved daily life, almost normal, I can now see the future more serenely" she confided enthusiastically.

Today, ETP is recognized and inscribed in French law, through the law HPST, known as law Bachelot, voted last spring after many vicissitudes. The decrees of this law, in the course of writing, should make it accessible directly by prescription of the doctor. This new feature would pave the way for social security reimbursement and wider use.

The financing of intra- or extra-hospital structures is partly provided by the State. Pharmaceutical companies, on the other hand, will not be able to do FTEs but can instead fund programs, tools, as do European foundations, associations or programs.

The Regional Hospital Agencies, also in the process of being established as a result of the HPST Act, are expected to coordinate these regional ETP approaches in order to organize the provision of care according to the number of patients Need.

These new steps are important steps towards more comprehensive and personalized care for millions of patients with asthma and other chronic diseases.

1 - Therapeutic Patient Education. Continuing Education Programs for Health Care Providers in the Field of Prevention of Chronic Diseases. WHO Europe, 1998, downloadable online; 2 - Therapeutic education: why and how to involve the asthmatic patient more in his care. Press conference of the GSK laboratories, with the participation of Dr. Marc Sapène, President of Asthme & Allergies, and Marie-Pierre Rinn, President of Asthme & Allergies Tours, September 24, 2009 3 - Asthma is a useful tool for the follow-up of the asthmatic patient, allowing a better involvement of the patient in its management, as well as a better adherence to the treatment. An online version is available on the Capital Souffle website, also published by GSK. 4 - Asthma of children under 36 months: diagnosis, management and treatment outside acute episodes. Recommendations of the High Authority of Health, March 2009, available online

Better understanding of their disease Knowing the actions of each treatment Taking their background treatment regularly Mastering the proper technique of inhalation medication Monitoring their asthma by measuring the peak flow of peak flow and keeping a diary Follow-up Assess and monitor the level of asthma control, for example through the Asthma Control Test 3. Know the preventive measures to adopt: environmental management (eg avoidance of allergens) Preventive treatment Recognize aggravation and know how to respond appropriately Identify factors or circumstances that trigger seizures to better avoid them Troubleshoot everyday difficulties related to the disease Perform regular physical activity, even moderate