a new guide for policy-makers and health professionals to support self-management of chronic conditions

WHO Regional Office for Europe has published a new “how-to” guide for policy-makers, health professionals, and education and training bodies on therapeutic patient education (TPE). The guide covers commissioning, designing and delivering TPE services and training programmes for health professionals. It also looks at the evidence and theory underpinning patient education, outlines key components for delivering a high-quality service and identifies implementation opportunities and barriers. 

Supporting self-management

The prevalence of noncommunicable diseases (NCDs) or chronic diseases is increasing in Europe. NCDs now account for 90% of deaths in the WHO European Region, yet most health systems were developed to treat and care for people with acute conditions. Health care services are still lagging behind in terms of responding to the particular needs of those living with chronic conditions, including diabetes, cardiovascular disease (hypertension and heart failure) and respiratory diseases (asthma and chronic obstructive pulmonary disease). 

Policy-makers and health-care managers are working to better organize health services to reflect and cater to the needs of these patients, for example by strengthening integrated primary health-care services. Important work is also needed to increase people’s knowledge, skills and confidence to manage their own conditions on a day-to-day basis, outside of health-care settings. Patients spend on average 2 hours per year with their health professional and the rest of the time they need to take care of their health themselves. Supporting patients to self-manage their condition is crucial to improving outcomes and reducing anxiety and complications. 

Closing the gulf between patients and health professionals

Research shows that patient education plays an important role in the management of chronic NCDs at both population and individual levels. Dr Jill Farrington, WHO/Europe’s Regional Medical Officer for Cardiovascular Diseases and Diabetes, explains: 

“Many patients may be just given a leaflet and sent home. They can end up relying on informal online chatrooms as their only support. TPE is an evidence-based, structured learning process where a trained health professional supports the patient to gain competencies for their condition through a person-centred approach and techniques such as skills training and self-monitoring. With the support of carers and families, this approach can help people to manage their chronic conditions throughout their lives, adapting to changes in their circumstances and in their conditions.”

Challenges in scaling up

Countries across the WHO European Region are at various stages of incorporating TPE into the core curricula of health professional training. In order to facilitate the roll-out and scaling up of such training courses for health professionals, measures that policy-makers can take include:

• revising workforce regulations to enable health professionals to work on patient education as a team, expanding job roles and responsibilities; 
• including TPE in health-care provider commissioning specifications;
• revising educational strategies and introducing accredited educational programmes in patient education for different health and allied professionals; and
• mandating TPE training for health professionals, including in undergraduate nurse and medical school curricula.

These actions alone will not ensure successful implementation of TPE at population level. It is known that people from lower socioeconomic groups have lower levels of health literacy; it is therefore critical to ensure this group and all underserved groups have access, means and capacity to use health information. Political commitment is needed to address known barriers to patient education among those with the greatest health-care needs. 

From theory to practice

Marking the launch of this new guide, Dr Gauden Galea, WHO/Europe Strategic Advisor to the Regional Director, Special Initiative on NCDs and Innovation, highlighted the important role of TPE in the context of broader health system transformation for NCDs management.

“[TPE] needs to be an integral part of professional health-care training. It may require certain policy changes and investment to provide programmes. This investment, however, can deliver multiple positive results for patients and professionals as relationships grow stronger and people are better equipped with the knowledge, skills and confidence to manage their condition and ask questions when they need help.” 

The new step-by-step guide is written primarily for policy-makers who commission services, senior health professionals, and professional health-care bodies responsible for workforce training and education.

“Therapeutic patient education: an introductory guide” will be launched during an online webinar event at 09:00–11:00 CET on Wednesday 15 November 2023. You are invited to register for this event at the link below. 

The new publication will be accessible on the WHO/Europe website from 15 November.