Asthma to a recognition by the guardianship of therapeutic education

Therapeutic education is officially recognized as a tool for the management of asthma, said the Directorate General of Health (DGS) at the Francophone Day "Asthma and Education" organized in Paris by the Asthma Association & Allergies.Créée for its usefulness and efficiency

"Reflections were made" between the Ministry of Health, the General Inspectorate of Social Affairs (IGAS), health insurance, the High Authority for Health (HAS) and health professionals on the importance of education therapy in asthma and how to develop it, said Carole Cretin, head of chronic diseases, children and aging in the DGS.

It has been shown that this approach proves useful and effective in chronic diseases, she recalled, noting that the HAS eg recognized therapeutic education in its recommendations on diabetes in the context of the reform of the support long-term illnesses (ALD). It is the same for severe cases of asthma and chronic obstructive pulmonary disease (COPD).

The discussions are based on an inventory of "asthma schools" existed in 2005-2006 in France, which was requested by the DGS and is provided by external evaluators, with a steering committee with representatives from health professionals, families, the National Institute for Prevention and Health Education (INPE) and health insurance.

Carole Cretin presented before more than a hundred participants, proposals for the DGS to improve patient education in asthma.

It is first to develop a specification of structures that perform an activity of therapeutic education, with all the partners, based on the charter schools asthma developed by the association . These structures should provide a common core of chronic diseases and specific conditions to respiratory diseases.

This requires defining the tasks of this patient education, determine the critical active file for a structure to be sustainable and achieve its target and the base minimum training of trainers, using educational methods recognized by health professionals and HAS and finally organize the evaluation and reporting of information, especially for the medical economics, said Carole Cretin.

The labeled structures would then responsible for designing and organizing patient education with other partners: private practice, emergency and school.

To better organize the provision of care, the DGS proposes to label structures to make them more visible to both institutions, health professionals and patients. We must also consider pooling resources.

Establish appropriate funding

It is important to ensure the sustainability of therapeutic education structures to advocate for the establishment of a suitable financing within the pricing activity (T2A) or by setting up an "educational package ".

DGS would like to develop with INPE an observatory of therapeutic education and research activities. It is important to assess the educational activities and whether they are effective and reproduce, said Carole Cretin.

Finally, it will raise awareness of patient education and the structures that offer to health professionals, the general public and patients.

Roland Cash National Center Hospital expertise (NECH), one of the external evaluators of the investigation, said that there were four levels of intervention. We must first educate the public through campaigns made by the ministry of health insurance and / or health care facilities, and direct asthma by physicians, pharmacists and emergency services, which could require specific compensation.

Then the education phase itself should involve education facilities in the city or even hospital group practices, and requires specific funding. Finally, the follow-up phase and capacity could be provided by the attending physician, pharmacist or the structure of education itself, via telephone follow-up or possibly in an act of consultation, the expert added.