Not all heroes wear capes, and not all healthcare comes in a pill. Some treatments come in the form of pills and injections, others in the form of physiotherapy or even psychotherapy. Both forms are reimbursed, although the majority of people still doubt the benefits of the latter. However, educating and training a patient can also be a form of care to be administered in a healthcare context; and may even lead to a healthier lifestyle than having 2 sessions of physiotherapy a week for a month… Therapeutic patient education (TPE), as defined by the World Health Organization in 1998 refers to a set of activities aimed to teach and train the patient to better cope with chronic diseases. The relevance is clear: it should aid the patient to combat the chronicity of the disease and its consequences, including lifelong treatment and comorbidities. Its feasibility is however much less obvious: it’s perceived as more work for healthcare professionals who are already overworked. And though it is currently poorly supported by healthcare systems, it still merits more attention.

TPE is a means to ensure appropriate disease management, which is crucial in a chronic disease. People with the flu will not benefit from TPE, whereas patients who need lifelong treatment will benefit from understanding the chronicity of diseases and their own contribution to a better health. For instance, the importance of treatment adherence. Several studies have shown that actual compliance amongst patients with chronic conditions is often suboptimal, leading to inadequate disease management and, dare we say, waste of resources. Although not all drugs are expensive, one of the most costly matters in healthcare is waste. Incomplete or lack of compliance is responsible for more than 700 billion USD per year. But being nonadherent is not always a concious choice of the patient and may result from poor time management, forgetfulness or not even understanding the dangers of nonadherence. These items cannot always be addressed appropriately during a consultation. Actually, including TPE in a single visit together with diagnosis and treatment may even lead to overexposure to information and overwhelm the patient. Giving instructions on how to take a medicine is one thing, tailoring advice to incorporate the treatment as a routine into the patient’s daily life is another thing and requires in-depth interaction. Such interactions may be addressed through a multidisciplinary team, depending on the patient’s issue(s), and can be supported by a variety of tools such as webinars, leaflets and workshops.

TPE will not solve all problems at once, but is a means to tailor medicine to the patient’s non-medicinal needs. A means for personalized medicine if you will. In an era that is buzzing with such a catchy term, governmental bodies should better support implementation of TPE in routine care. Finding the best interventions and integrating these in care pathways for patients may actually lead to healthier patients, and thus citizens. With the growing pressure of our ageing population with an unhealthy Western lifestyle, such investments today are timely and crucial for tomorrow’s challenges. Not all heroes wear capes and fly throug the sky; some educate and train patients to make healthier life choices.

About the author:
Lynda Grine completed her Master in Biochemistry and Biotechnology in 2010 at the Ghent
University. Right aftewards, she pursued a PhD at the Flemish Institute of Biotechnology
(VIB) with an IWT-grant. Today, she’s doctor-assistant at the Ghent University, an FWO-
project manager and senior researcher at UZ Gent. In 2018, she successfully attained the
‘Translational Medicine’ certificate at the ULB. Next to her daytime job, Lynda remains
passionate about science and wants to let the world know about scientific innovation, today’s
challenges and tomorrow’s opportunities.