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AB0806 Patient education, a full component of patient care in france : impact of the new regulations – results of a national survey
  1. L. Euller Ziegler1
  1. 1Rheumatology, CHU L’Archet 1 - University of Nice Medical School, Nice, France

Abstract

Background In 2009, patient education was recognised as a full component of care for patients with chronic diseases by the French Law HPST (“hospital, patients, health, territories”). As per January 2011, physicians and health professionals teams were allowed to run patient education only after having received a formal agreement from their territorial health agency (ARS), under precise conditions, published at the national level. A yearly report to the ARS became mandatory. The French society of rheumatology created a working group for patient education, devoted to its optimisation at the national level.

Objectives To make an inventory of the agreements for patient education in rheumatology and to collect the main points of the teams’ first year activity report, at the national level.

Methods We run a national survey via the website of the French Society of Rheumatology, using two questionnaires, early 2011 (patient education programs and agreements) and early 2012 (evaluation of the 1st year of working according to the new rules).

Results 56 answers were collected (all from hospital rheumatology teams), gathering 70 agreements out of 91 requests. The approved programs were targeted on inflammatory joint disorders (25), RA (18), SA (9), osteoporosis (5), low back pain (5), chronic pain (2), rare diseases (6).

The experience of the first year of working under the new Law was coherent with the previsions of the patient education teams in 22 cases out of 32 answers. The main reported difficulties (27 answers) were : lack of staff (16), of financial resources (8), recruitment (2), patient motivation (2), lack of recognition (1).… 15 teams (out of 28 answers) were likely to submit new requests for agreement, for osteoporosis (9), low back pain (2), other (RA, SA, lupus, gout, OA, chronic pain, orthopaedic surgery…).

The response rate to our survey was correct (about 70% of all the patient education programs in rheumatology agreed at the national level - synthesis by the ARS). The agreement rate in rheumatology was similar to the global national one (all chronic diseases). The patient education programs in Rheumatology stand at the 6th raw for agreements, after diabetes, cardio-vascular diseases, respiratory disorders, obesity, renal insufficiency. Globally (all chronic diseases) the main reasons for not being agreed were: lack of conformity with the regulatory pre-requisite, patient education “action” instead of “programme”, projects devoted mainly to the caregivers…

Conclusions According to the new Law “HPST”, patient education became a full part of patient care in chronic diseases. This survey confirms the dynamism of Rheumatology in the field of patient education, with a fair agreement rate at the national level to run various educational programs. After the first year of working accordingly with the new rules, the difficulties mentioned by the patient education teams in Rheumatology were mainly linked with some lack of staff and lack of financial resources, without negative impact on the construction of new projects, targeted notably on under represented diseases (including osteoporosis). This survey provides additional data to strengthen further developments of patient education in Rheumatology.

Disclosure of Interest None Declared

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