John Libbey Eurotext

Hépato-Gastro & Oncologie Digestive


Therapeutic Education and Hepatitis: A new patient's ecology, “The Care Pathway”. An example with the network REVHEPAT Volume 24, issue 2, Février 2017


  • Figure 1
  • Figure 2
1 Réseau ville hôpital hépatites REVHEPAT,
pavillon Abrami, 100 Bd du Gal Leclerc,
92110 Clichy,
2 Hôpital Beaujon,
service d’hépatologie,
Clichy, France
3 Hôpital Beaujon,
Pharmacie, Clichy,
* Tirés à part

The management of patients with chronic liver disease has evolved rapidly over the last 10 years, particularly for chronic hepatitis C, taking into account the emergence of antiviral treatments, their difficult initial tolerance and high virological efficacy. However, scientific progress should not obscure the patient himself. His or her management must be part of a “care pathway” organized to take care of him in his entirety : “Patient ecology”. It must also be carried out over time : before treatment (screening, management of appointments, detecting comorbidities, access to treatment), during treatment (adherence, quality of life, medical, psychological and social support) and after treatment (risk of new contamination, persistent worsening of fibrosis factors, screening for complications and hepatocellular carcinoma). In this context, the team of the city hospital network REVHEPAT presents his experience of “care pathway”, developed for over 15 years, in collaboration with the Pharmacy and the Hepatology department of Beaujon Hospital APHP (Clichy, France). Besides the development of the city hospital relationships to strengthen screening, treatment course is based on : a “fast track outpatient's access”, in place since 2001, receiving nearly 450/500 patients a year, allowing easier access to care and treatments, promoting the therapeutic alliance and the management of comorbidities. This treatment course, conducted by a multidisciplinary team, in association with the patients, is supported by an “Outpatient Therapeutic Education Program” which has, since 2011, accompanied 560 patients (213 in 2015), through Individual Consultations (989 in 2015) and/or Collective Workshops (69 meetings in 2015) and developing their capacity for autonomy, towards a cure and better quality of life to come.