Effectiveness of therapeutic patient education interventions for chronic diseases: A systematic review and meta-analyses of randomized controlled trials

Abstract

BackgroundChronic disorders are highly prevalent and are a major contributor to death and disability worldwide. Evidence has shown that therapeutic patient education (TPE) interventions are effective in improving a range of biomedical and psychological outcomes for a variety of chronic disorders. This has been demonstrated in scores of randomized controlled and evidence-synthesis studies. However, no quantitative evidence has been published so far on the content and effective teaching strategies in TPE programs. The present systematic review and meta-analysis aim to bridge this gap by answering the who, what, and how of TPE programs.MethodsUsing a pretested search strategy, we searched the Web of Science, MEDLINE, CINAHL, PsycINFO, and the COCHRANE databases, from inception to August 2019. The search strategy was based on four comprehensive search concepts (patient education, chronic diseases, study design, and outcomes). After a careful screening for eligible studies, two reviewers extracted qualitative and quantitative data from the randomized controlled trials on the TPE interventions. We also developed a taxonomy of curriculum skills and intervention delivery techniques to aid the extraction of data in these domains.ResultsWe found that these interventions were effective in improving biological outcomes (SMD = 0.48; 95% CI: 0.38–0.57), adherence to the treatment regimen (SMD = 0.73; 95% CI: 0.46–1.002), knowledge (SMD = 1.22; 95% CI: 0.79–1.65), self-efficacy (SMD = 0.43; 95% CI: 0.30–0.56), and psychological health (SMD = −0.41; 95% CI: −0.53 to −0.29). This effectiveness was consistent across different delivery formats (individual, group, and electronic) and delivery agents (non-specialists vs. specialists).ConclusionThe flexibility in the choice of mode of delivery and curriculum development gives stakeholders an opportunity to scale up TPE interventions in healthcare settings.Systematic review registrationIdentifier: CRD42019141294.

Bridging gaps: A qualitative inquiry on improving paediatric rheumatology care among healthcare workers in Kenya.

“…So if I'm able to involve the lab technician and also if those ones are not available I can be able to expedite that to either the superiors or the management to provide the services or even allow to create more awareness in the rest of the facility. Optimizing chronic disease care requires involvement of patients and their families in their care as partners in the doctor-patient relationship (22). This was reiterated by our participants who stated the importance of patient education and highlighted it as one of the pillars of intervention (22).…”

“…Optimizing chronic disease care requires involvement of patients and their families in their care as partners in the doctor-patient relationship (22). This was reiterated by our participants who stated the importance of patient education and highlighted it as one of the pillars of intervention (22). Patient empowerment can be de ned as having knowledge and being motivated to in uence one's health (23).…”

“…Therapeutic patient education delivered by healthcare professionals can empower patients to engage in informed participation in clinical decision-making, and effectively manage their conditions (22). Several patient education interventions have been shown, in clinical trials, to improve medical outcomes, selfe cacy, and satisfaction with treatment among patients with chronic conditions (22).…”

“…Therapeutic patient education delivered by healthcare professionals can empower patients to engage in informed participation in clinical decision-making, and effectively manage their conditions (22). Several patient education interventions have been shown, in clinical trials, to improve medical outcomes, selfe cacy, and satisfaction with treatment among patients with chronic conditions (22). Nonetheless, patient education alone is often insu cient for generating and maintaining behaviour change, as health decisions are typically driven by multiple factors, not merely lack of knowledge (24).…”

Lived experience of people with painful hallux valgus: A descriptive qualitative study

“…Through therapeutic patient education, health professionals can enhance a patient's health literacy to help them access, appraise and apply health information in order to improve their health‐related quality of life (Wittink & Oosterhaven, 2018). For many chronic diseases, therapeutic patient education, delivered via individual, group and electronic approaches, has been found to improve adherence to treatment regimens, self‐efficacy and psychological health (Correia et al., 2023).…”