A Community-Based Therapeutic Education Programme for People with Alcohol Use Disorder in France: A Qualitative Study (ETHER)

Abstract

Therapeutic patient education (TPE) aims to help people with chronic disease strengthen their empowerment and psychosocial skills to better manage their condition. Although TPE has great potential for addiction medicine, studies on its benefits for reducing alcohol-related harms and increasing empowerment are sparse. We conducted a qualitative study of people with alcohol use disorder (AUD) who participated in the community-based TPE programme Choizitaconso to assess their perceptions and experiences of it. Semi-structured interviews were conducted with 16 participants who had completed the TPE programme at least six months previously. The interviews were transcribed and analysed using a sequential thematic analysis. We identified four general themes: (1) the context of participation: the TPE programme could be a strategy to facilitate engagement in AUD care; (2) representations and experiences: the programme helped to “normalize” participants’ relationship with alcohol use by increasing empowerment; (3) TPE strengths: improved knowledge about alcohol use, self-image, weight loss, self-stigma reduction; (4) TPE limitations: difficulty putting learning into practice after the programme ended. The Choizitaconso programme met participants’ health and psychosocial expectations, strengthening their empowerment and reducing self-stigma, thereby facilitating engagement in AUD care.

A novel community‐based therapeutic education program for reducing alcohol‐related harms and stigma in people with alcohol use disorders: A quasi‐experimental study (ETHER study)

“…And this idea … I don't like the word "control," to have the freedom to take it or not, […] I could do it without feeling guilty'. [38] The TPE program did not lead to a decrease in alcohol consumption and was not superior to other treatments in improving alcohol-related harms. The larger reduction in the number of alcohol-related harms observed in the comparison group 14 weeks after Choizitaconso program ended may be due to a higher (although non statistically significant) baseline level of both alcohol consumption and the number of alcoholrelated harms.…”

“…‘Because guilt damages your self‐esteem, that's it: “yes, I'm a nothing so I drink.” And this idea … I don't like the word “control,” to have the freedom to take it or not, […] I could do it without feeling guilty’. [38]…”

“…The study protocol has been extensively described elsewhere [37]. ETHER comprises a quantitative study, whose results are presented in the present paper, and a qualitative study, whose results have been published elsewhere [38]. For convenience, in the present paper, the term ETHER hereafter refers exclusively to the quantitative component of the study.…”

A retrospective observational study to assess the cirrhosis risk in alcoholic patients

“…Cirrhosis isn't curable, but it's treatable. Doctors have two main goals in treating this disease: to stop the damage to your liver and prevent complications [19]. Alcohol abuse, hepatitis, and fatty liver disease are some of the main causes [20].…”