Therapeutic Patient Education in Atopic Dermatitis: Worldwide Experiences
Jean-Francois Stalder, M.D.,* Claire Bernier, M.D.,* Alan Ball, B.A.,* Linda De Raeve, M.D.,† Uwe Gieler, M.D.,‡ Mette Deleuran, M.D.,§ Danielle Marcoux, M.D., Lawrence F. Eichenfield, M.D.,** Peter Lio, M.D.,†† Sue Lewis-Jones, M.D.,‡‡ Carlo Gelmetti, M.D.,§§ Roberto Takaoka, M.D., Christine Chiaverini, M.D.,***Laurent Misery, M.D.,††† Se´bastien Barbarot, M.D.,* and for the Oriented Patient-Education Network in Dermatology (OPENED)
*Department of Dermatology, Nantes University Hospital, Nantes, France, †Department of Dermatology UZ Brussels, Vrije Universiteit Brussel, Brussels, Belgium, ‡Department of Psychosomatic Medicine-Psychodermatology, University of Giessen, Giessen, Germany, §Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark, Department of Dermatology, St. Justine University Hospital, Montreal, Canada, **Department of Dermatology, Rady Children’s Hospital, San Diego, California, ††Department of Dermatology, Children’s Memorial Hospital, Chicago, Illinois, ‡‡Department of Dermatology, Ninewells Hospital and Medical School, Dundee, Scotland, §§Department of Anesthesia, Intensive Care and Dermatological Sciences, Fondazione Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy, Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil, ***Department of Dermatology, Archet Hospital, Nice, France, †††Department of Dermatology, University Hospital, Brest, France
Therapeutic patient education (TPE) has proven effective in increasing treatment adherence and improving quality of life (QoL) for patients with numerous chronic diseases, especially atopic dermatitis (AD). This study was undertaken to identify worldwide TPE experiences in AD treatment. Experts from 23 hospitals, located in 11 countries, responded to a questionnaire on 10 major items. Patients in TPE programs were mainly children and adolescents with moderate to severe AD or markedly affected QoL. Individual and collective approaches were used.
Depending on the center, the number of sessions varied from one to six (corresponding to 2 to 12 hours of education), and 20 to 200 patients were followed each year. Each center’s education team comprised multidisciplinary professionals (e.g., doctors, nurses, psychologists). Evaluations were based on clinical assessment, QoL, a satisfaction index, or some combination of the three. When funding was obtained, it came from regional health authorities (France), insurance companies (Germany), donations (United States), or pharmaceutical firms (Japan, Italy). The role of patient associations was always highlighted, but their involvement in the TPE process varied from one country to another. Despite the nonexhaustive approach, our findings demonstrate the increasing interest in TPE for managing individuals with AD. In spite of the cultural and financial differences between countries, there is a consensus among experts to integrate education into the treatment of eczema.