MT Cardio


The role of therapeutic education in the management of chronic disease: example of diabetes and possible application to cardiovascular diseases Volume 2, issue 1, Janvier-Février

Service de diabétologie, université René-Descartes Paris 5, AP-HP, Hôtel-Dieu, 1 place du Parvis Notre-Dame, 75181 Paris Cedex 04

Education for diabetic patients is necessary, useful, and consequently unavoidable. Therapeutic education places the patient at the center of the educational process, with his opinions, ideas, feelings, health beliefs, his environment… as well as his medical status. With this educational process, one tries to help patients to organize their own treatment, in order to prevent complications and to maintain or enhance their quality of life. Thus, it becomes another therapeutic tool along side all the others. Educational diagnosis is the first step of this process : it means collection of patient information related to bio-clinical, educational and psychosocial data. Recently, in the Diabetes Unit of Hôtel-Dieu Hospital, in Paris, a self-learning ambulatory program for type 1 patients has been implemented; it is a model for therapeutic education that we have imported and adapted which was invented by Howorka in 1990 and developed by Grimm and Berger in Switzerland. More recently, we created a program devoted to type 2 diabetic patients, following the same model. This educational method can be transposed to other chronic diseases and in particular in the cardiovascular prevention field, whether the patient is diabetic or not. A major obstacle remains: the payment and reimbursement of this activity by our health authorities.