Modern Health Observation

Frequent and increasing, asthma is responsible for 2 000 deaths each year. To improve care and reduce the terrible toll the development of therapeutic education is essential. It should soon be more accessible or refunded.

Bachelot law or statute “Hospital Patients, Health and Territory” passed in June 2009 stresses the importance of therapeutic education. What does that mean? What is its efficiency, particularly in asthma? Answers from Dr. Marc Sapene, pulmonologist and president of the Asthma and Allergy Association, and Marie-Pierre Rinn, asthmatic and Chair of the antenna Tours of this association.

What is educational therapy?

Defined in 1998 by the World Intellectual Health the Therapeutic Patient Education (TPE) covers all means for people with an illness, often chronic, better live every day with their pathology and treatment and be more independent.

These means must be implemented by health professionals, associations, environment, continuously and individually. This process can be achieved by various consultations, workshops or appointments in specific centers, as there is for asthma, diabetes, cancer or soon to mental illness.

In all cases, the education therapy puts the patient at the heart of the device, making the player’s health.

The benefits of therapeutic education in asthma

As noted by Dr. Marc Sapene association president and Asthma Allergies “skeptical at first, doctors were very quickly convinced of the usefulness of these sessions therapeutic patient education. Now, the usefulness of the ETP is completely recognized and indispensable in the management of asthma and other diseases.”

For lung, the program should begin by evaluating the severity of asthma but also by an “educational diagnosis” is the patient? His job? His background? How does he see his illness? etc.. This step is essential for individualized care.

Main structure involved in education for asthma therapy, schools of asthma are now present in most French departments . They enable patients, especially if their disease is poorly controlled, by:

• Better understand their illness;
• Know the actions of each treatment;
• Take their DMARD regularly;
• Mastering proper technique of medication to be inhaled;
• Monitor their asthma by measuring peak expiratory flow or “peak flow” and keep a log tracking
• Assess and monitor the level of asthma control, for example through the Test Control asthma;
• Knowledge of preventive measures to be adopted: Environmental Design (eviction of allergens for example), taking a preventive treatment;
• Recognize aggravation and knowledge to respond appropriately;
• Identify the factors or circumstances triggering crises better avoided;
• Solving everyday problems related to the disease;
• Perform regular physical activity, even moderate.

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

Very positive results: “Everything has changed”

The results of the TPEs are often spectacular, often causing a decrease in seizures, symptoms, absenteeism from school or work, hospitalizations, calls to emergency services, and improved the lives of every day.

For Marie-Pierre Rinn, asthmatic, “everything changed” since that ETP has been recommended to the school’s asthma Tours. So it was really difficult to manage their asthma every day, was often hospitalized while denying the disease ( “I am an asthma attack but I’m not asthmatic), it fired one undeniable benefit of the therapeutic education from 3 or 4 in any annual hospitalizations for 4 years. She learned how to handle the most difficult periods, “a” more accepted her illness. With this experience, Mrs. Rinn became chair of the wing Tours of Asthma & Allergy Association, to help other patients with asthma in their region.

“TPE has given me a renewed vitality, I have a life much improved, near-normal. I can now see the future calmly” says she enthuses.

Asthma: Towards a prescription for therapeutic education

Today, the TPE is recognized and enshrined in French law, through law HPST, Bachelot said Act, passed last spring after many vicissitudes. The decrees of this law being written, should make it directly available by prescription from a doctor. This new pave the way for reimbursement by Social Security and wider use.

The funding structures within or outside the hospital is partly provided by the state. Pharmaceutical companies, meanwhile, cannot make but can TPEs by cons finance programs, tools, as well as foundations, associations or European programs.

Agencies Regional Hospital, also being created following the law HPST should help coordinate the efforts of ETPs in the region to organize the provision of care based on the number of patients who need.

These new stages are all important steps towards support more comprehensive and more customized for millions of patients suffering from asthma, but also other chronic diseases.