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Abstract Background A considerable number of patients with moderate to severe atopic dermatitis (AD) are undertreated and have inadequate control of their symptoms leading to a hight patient dissatisfaction during their care. The VECUDA study composed of VECU and DA for french word lived and atopic dermatitis was conducted by anthropologists in cooperation with dermatologists, aimed to better understand the complexity of the care pathway and the physician‐patient relationship by questioning patients with moderate to severe AD. Objectives The aim was to identify patient's needs and to propose concrete ways of improving the doctor‐patient relationship by focusing on the narrative of their affects. Co‐designed easy‐to‐use tools were proposed by these patients. Methods The exploratory qualitative study involved 24 patients with moderate‐to‐severe AD. The study was conducted in two stages: a codesign phase with four patients, and a deepening phase with all patients (24), supported by a multidisciplinary scientific committee. During group interviews, conducted using creativity tools, patients' stories related to their experiences of the disease and its management were collected. Results By studying the patients' affect stories, researchers were able to identify the needs of patients who might be 1. emotional (better consideration of their experiences); 2. informational (more information about their disease and treatments); 3. participatory (being involved in their care: therapeutic alliance). Mechanisms of therapeutic dissatisfaction and satisfaction were mapped into vicious and virtuous circles. Patients also offered concrete and easy‐to‐use tools. We are presenting here the grid of questions these patients would like to be asked during their doctor's appointment: the Doctor‐Facing Questions Grid that these patients would like to be asked during a consultation. Conclusions By facilitating the identification of patients' needs/expectations, these tools would help guide the clinician's discussion and management in a few questions. The VECUDA study confirms the value of considering patients' perspective as a lever for improving the doctor‐patient relationship.

Abstract Background A considerable number of patients with moderate to severe atopic dermatitis (AD) are undertreated and have inadequate control of their symptoms leading to a hight patient dissatisfaction during their care. The VECUDA study, was conducted by anthropologists in cooperation with dermatologists, aimed to better understand the complexity of the care pathway and the physician‐patient relationship by questioning patients with moderate to severe AD. Objectives The aim was to identify patient's needs and to propose concrete ways of improving the doctor‐patient relationship by focusing on the narrative of their affects. Co‐designed easy‐to‐use tools were proposed by these patients. Methods The exploratory qualitative study involved 24 patients with moderate‐to‐severe AD. The study was conducted in two stages: a co‐design phase with 4 patients, and a deepening phase with all patients (24), supported by a multidisciplinary scientific committee. During group interviews, conducted using creativity tools, patients' stories related to their experiences of the disease and its management were collected. Results The VECUDA study, conducted by anthropologists in collaboration with dermatologists and focusing on the experiences of these patients and their journey, described mechanisms of dissatisfaction related to therapeutic management from the point of view of patients with moderate to severe atopic dermatitis. Factors that could generate dissatisfaction included the complexity of the care pathway. During this exploratory study emerged an unexpected patient figure, who had a “feeling of a being chosen” in access to a new treatment, the first biologic in the treatment of AD. We are interested here in the experience of the patient's care pathway. Conclusions The VECUDA study confirms the value of considering patients' perspective as a lever for improving the doctor‐patient relationship. The overall conclusion is based on the observation of a gap between patient expectations and treatment decisions made by some HCPs, which may lead to unsatisfactory scenarios. Analysing these data opens up a promising research avenue, showing that patients not only confer a therapeutic function to their care pathway, but also a symbolic value. The description of the complexity of the care pathway can be compared to a true “initiatory journey”. The symbolic value analysis given by patients to their care pathway when they are seeking a new treatment is an innovative approach that deserves to be further explored through qualitative and quantitative study.

Abstract Background Sickle cell disease (SCD) is an inherited chronic life-threatening disorder with increasing prevalence in Europe. People living with SCD in Europe mainly belong to vulnerable minorities, have a lower level of health education and suffer from isolation compared to those living with other chronic conditions. As a result, SCD patients are much less likely to partner in the design of research related to their condition and are limited in their ability to influence the research agenda. Aiming to increase the influence of patient voice in the development of SCD-related research, we set out to develop patient centered actions in the frame of International Scientific Conferences in collaboration with the ERN-EuroBloodNet, Oxford Blood Group, Annual Sickle Cell Disease and Thalassaemia Conference (ASCAT), the European Hematology Association and the British Society of Hematology. Results Two events were organized: a one-day research prioritization workshop and a series of education sessions based on topics chosen by SCD patients and their families. Methodology and outcomes were analyzed in terms of influence on scientific, medical and patient communities. Conclusion The ERN-EuroBloodNet workshops with patients at annual ASCAT conferences have provided an opportunity to enhance patient experience and empowerment in SCD in Europe, producing benefits for patients, caregivers, patient associations and health professionals. Future work should focus on delivering the research questions identified at this workshop and the opportunities to share information for patient education.

Chronic low-back pain is the third most common cause of disability recognized by the French social security system. The psycho-social origin of the disease complicates patient support, and professionals have to cope with increasingly long waiting lists. Therapeutic Patient Education (TPE) has been identified as a lever for improving the quality of life of patients suffering from rachis pain, based on a pedagogical and multidisciplinary approach to the disease and the care relationship. Sensitive to this public health issue, professionals and users of the healthcare system in the Lorient-Quimperlé health democracy area in Brittany (France) have coordinated their efforts to improve access to care for these patients and the quality of their support. This article describes the co-construction of an ETP program by three partner organizations: Cap Autonomie Santé ETP platform, Kervignac health center and Kerpape functional rehabilitation center. It describes the methodology developed by the ETP platform to organize their articulation and the results of this collaboration. The Persistentpain and Rachis program highlights the pooling of expertise, the decompartmentalization of institutions and the decentralization of skills on a territorial scale. The success of this project is closely linked to the implementation of a participative approach, to the involvement of a facilitating actor favoring the creation of a collaborative framework, and to the involvement of local health policy-makers with the other stakeholders. Through a collective response, actors in the Lorient-Quimperlé health territory have strengthened their power to act and contributed to the fight against Social Inequalities in Health. [ABSTRACT FROM AUTHOR]

Lung transplantation requires a complex therapeutic approach, exposing patients to potential iatrogenic and infectious complications. Within our institution, a Patient Education Program dedicated to lung transplant recipients has been authorized since 2013. Starting November 2020, pharmacy interns and pharmacy students have been actively involved with the implementation of follow-up educational workshops on treatments. To assess the impact of these workshops on patient knowledge, we conducted the EnPhaSE study (Entretien Pharmaceutique - Suivi et Education). This study, a single-center, non-interventional comparative before-and-after evaluation, consisted of two educational sessions held three months apart, where a knowledge assessment questionnaire was administered at the outset of each session. The results of this study demonstrate a positive impact on enhancing patient knowledge. The average knowledge score during the second session showed a significant increase (93 ± 12 versus 68 ± 26; p < 0.001). Additionally, participants expressed a high level of satisfaction with these educational workshops. This work contributes to enhancing the healthcare trajectory of lung transplant patients and underscores the beneficial impact of pharmaceutical educational workshops on improving patient understanding regarding their treatments. [ABSTRACT FROM AUTHOR]

Background: Sickle cell disease (SCD) is an inherited chronic life-threatening disorder with increasing prevalence in Europe. People living with SCD in Europe mainly belong to vulnerable minorities, have a lower level of health education and suffer from isolation compared to those living with other chronic conditions. As a result, SCD patients are much less likely to partner in the design of research related to their condition and are limited in their ability to influence the research agenda. Aiming to increase the influence of patient voice in the development of SCD-related research, we set out to develop patient centered actions in the frame of International Scientific Conferences in collaboration with the ERN-EuroBloodNet, Oxford Blood Group, Annual Sickle Cell Disease and Thalassaemia Conference (ASCAT), the European Hematology Association and the British Society of Hematology. Results: Two events were organized: a one-day research prioritization workshop and a series of education sessions based on topics chosen by SCD patients and their families. Methodology and outcomes were analyzed in terms of influence on scientific, medical and patient communities. Conclusion: The ERN-EuroBloodNet workshops with patients at annual ASCAT conferences have provided an opportunity to enhance patient experience and empowerment in SCD in Europe, producing benefits for patients, caregivers, patient associations and health professionals. Future work should focus on delivering the research questions identified at this workshop and the opportunities to share information for patient education. [ABSTRACT FROM AUTHOR]

Objective. To develop and validate a patient knowledge questionnaire regarding axial spondyloarthritis (axSpA). Methods. Knowledge considered essential for patients with axSpA was identified through Delphi rounds among rheumatologists, healthcare professionals (HCPs), and patients, then reformulated to develop the knowledge questionnaire. Cross-sectional validation was performed in 14 rheumatology departments to assess internal validity (Kuder-Richardson coefficient), external validity, acceptability, reproducibility (Lin concordance correlation coefficient), and sensitivity to change (knowledge score before vs after patient education sessions and effect size). Results. The Spondyloarthritis Knowledge Questionnaire (SPAKE) is a self-administered 42-item questionnaire with a 32-item short form, both scored 0 to 100, assessing knowledge of disease, comorbidities, pharmacological treatments, nonpharmacological treatments, self-care, and adaptive skills. In the validation study (130 patients; 67 [51.5%] male, mean age 43.5 [SD 12.9] yrs), the mean (SD) score of the long-form questionnaire was 71.6 (15.4), with higher scores (better knowledge) in nonpharmacological treatments and adaptive skills and lower scores in cardiovascular comorbidity and pharmacological treatments. Acceptability was good, with no missing data; the internal validity coefficient was 0.85. Reproducibility was good (0.81, 95% CI 0.72-0.89). SPAKE showed good sensitivity to change; scores were 69.2 (15.3) then 82.7 (14.0) after patient education sessions (Hedges effect size = 0.92, 95% CI 0.52-1.31). Conclusion. SPAKE is a knowledge questionnaire for patients with axSpA, developed with the involvement of HCPs and patients and reflecting current recommendations for the management of axSpA. SPAKE will be useful in assessing knowledge acquisition and self-management strategies in routine care and research. [ABSTRACT FROM AUTHOR]

Copyright of Sexologies is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

To develop and validate a questionnaire assessing patient knowledge in rheumatoid arthritis (RA). Knowledge considered essential for patients with RA was identified through a series of Delphi rounds among rheumatologists, health professionals (HPs), patients, and then reformulated to construct the knowledge questionnaire. Cross-sectional multicenter validation was performed in 12 rheumatology departments to assess internal validity (Kuder–Richardson coefficient), external validity, acceptability, reproducibility (Lin's concordance correlation coefficient) and sensitivity to change (difference in total score before and after patient education sessions). Associations between patient variables and knowledge levels were evaluated. RAKE (RA Knowledge questionnairE) is a self-administered 45-item questionnaire scored 0–100, with a 32-item short-form survey assessing knowledge of disease, comorbidity, pharmacological treatments, non-pharmacological treatments, self-care and adaptative skills. Of 130 patients included in the validation study, 108 were women. Acceptability was good with < 5% missing data. Internal validity coefficient was 0.90. Mean (standard deviation) long-form score was 72.8 ± 17.8, with lower scores in comorbidity and self-care and higher scores in adaptive skills. Reproducibility was good (0.86 [0.80; 0.92]). RAKE score was positively correlated with the patients' level of education and the HPs' opinion on the patients' knowledge. RAKE score showed good sensitivity to change: 66.8 ± 16.4 then 83.8 ± 12.7, representing a hedges effect size of 1.14 [95% CI 0.73; 1.55]. RAKE is an updated questionnaire assessing essential knowledge for patients with RA to enhance self-management according to current guidelines and the patients' perspective. RAKE can usefully inform patient education interventions, routine care and research. [ABSTRACT FROM AUTHOR]

Objective: Information and education are recommended for patients with inflammatory arthritis including rheumatoid arthritis (RA) and spondyloarthritis (SpA). However, there is no consensus on which knowledge is essential to enhance patients' self-management. The aim of this study was to determine such knowledge.Methods: Based on published knowledge questionnaires (KQs) collected by a systematic literature review, a list of items was elaborated, classified in domains and sub domains. A Delphi process was performed with rheumatologists, healthcare professionals and patients in 2014-2015, selecting the items considered useful.Results: Three published KQs were analysed: 2 for RA; 1 for SpA and 5 unpublished KQs were collected. In the KQs, 90 knowledge items were mentioned for RA and 67 for SpA. The 1st Delphi round enlarged the list to 322 items for RA and 265 items for SpA. The second round selected 69 and 59 knowledge items for RA and SpA respectively, of which 36 (52%) and 34 (57%) were not present or modified from the published KQs. Key domains included treatment strategies, managing cDMARDs and bDMARDs, managing symptomatic medications. Knowledge on non-pharmacological treatment concerned pain and fatigue, physical activity, adaptative skills to personal and professional environment, patient-HP communication and shared decision-making.Conclusion: The present study provides a corpus of knowledge considered essential for patients in the self-management of their arthritis. The selection of many items reflects recent emphasis on professional recommendations and the patients' perspective. Future work should lead to the development of new updated KQs for patients with inflammatory arthritis. [ABSTRACT FROM AUTHOR]

The aim of this single center prospective controlled study in volunteers with obesity and overweight was to evaluate the effect of a patient therapeutic education program (PTE group) combined with spa therapy on weight, physical activity, eating habits and quality of life versus spa therapy alone (control group). The main endpoint was weight change at 5 months after the end of the program. The PTE group of 151 subjects with obesity or overweight followed a 3-week program combining patient education with spa therapy and 189 attended a course of spa therapy alone. At 5 months significant loss was observed in the PTE group compared to controls (−2.69 kg vs −1.24 kg, p = 0.008), a relative weight loss of −2.8% vs −1.3%. At 11 months after spa therapy, only the PTE group maintained a weight loss in addition to the weight loss obtained during spa therapy. The control group returned to the weight they had at the end of spa therapy. In both groups, a significant increase in physical activity was observed at 5 (p < 0.001) and 11 months (p < 0.001) with a significant better improvement in the PTE group. In addition, while in both groups some quality of life parameters and dietary choices were improved, the improvement (more fruit, vegetables, fish and water) was significantly higher in the PTE group, at both 5 and 11 months after spa therapy. In conclusion, while spa therapy alone initiated positive changes in weight loss, physical activity and some quality of life parameters, the PTE program enhanced this effect. [ABSTRACT FROM AUTHOR]

Introduction: The use of the arts as a method of changing behaviour in care is topical. This systematic literature review aims to understand the effects of theatrical interventions on health behaviour change. Methods: The research strategy consisted of indexing articles on theatrical interventions for chronic diseases in seven bibliographic databases (Medline, Cochrane, Cairn, Eric, Eric, Isidore, Base santé Psy and CINAHL) using a combination of keywords. The quality of the articles included was assessed through the double expertise, and a self-assessment of the systematic review was carried out in accordance with the principles described in the AMSTAR 2 grid. Results: 619 articles were identified from all databases, 23 of which were selected. These were intervention studies published in English between 1988 and 2017 on chronic diseases. Qualitative results reveal that the use of theatre generates positive effects on improvement: knowledge, skills, caregiver-patient-family interaction, recall, self-awareness, quality of life and social deficits. Conclusion: Theatre remains a promising strategy for therapeutic patient education and can be encouraged to promote behaviour change. [ABSTRACT FROM AUTHOR]

Résumé But de l'étude En prévention primaire des maladies cardiovasculaires, l'éducation thérapeutique du patient aide à la mise en place d'une hygiène de vie protectrice, dans un contexte sociétal où les facteurs de risque abondent. Patients et méthodes L'éducation thérapeutique du patient propose aux personnes désireuses de préserver leur santé cardiovasculaire un programme comportant actuellement six thèmes d'ateliers. Lors de l'inscription, elles s'entretiennent avec l'éducateur pour compléter, de façon spécifique à chaque thème, un diagnostic éducatif qui permet de connaître les dimensions clinique, socioprofessionnelle, cognitive et psychoaffective. Une évaluation de chaque atelier est demandée aux participants, sous forme de questions ouvertes et fermées. Résultats Les 2225 participants sont essentiellement de sexe féminin (79 %), relativement âgés (63,9 ans pour les femmes et 66,3 ans pour les hommes) et le plus souvent retraités (65 %). L'analyse des diagnostics éducatifs note la grande fréquence des facteurs de risque classique ; la bonne connaissance des facteurs les favorisant contrastant avec les faibles moyens mis en œuvre dans la vie quotidienne pour en réduire l'impact ; la conviction de la grande majorité (68 %) d'avoir une alimentation équilibrée ; la très grande implication des patients dans la prise en charge de leur santé, avec un locus externe discret impliquant le médecin généraliste, l'entourage immédiat et la société. Les notes des évaluations sont le plus souvent maximales. Conclusion L'éducation thérapeutique des patients suscite un vif intérêt du public, permet une approche personnalisée qui optimise l'apprentissage, augmente les connaissances, facilite la mise en place de nouvelles pratiques protectrices. Abstract Background As primary prevention against cardiovascular diseases, Patient Therapeutic Education helps to develop a protective lifestyle within a socioeconomic context where risk factors abound. Patients and methods Patient Therapeutic Education offers those eager to protect their cardiovascular health a program of six workshops. Upon enrolment, a Program aide conducts an educational diagnosis with the patient, specific to each workshop theme, so that he might understand the clinical, socio-professional, cognitive and psycho-affective dimensions. An evaluation of each workshop is requested from participants in the form of open and closed questions. Results The study comprised 2225 people, majority women (79%), relatively old (age 63.9 for women, 66.3 for men), most often retired (65%). An analysis of the educational diagnosis notes a great frequency of classic risk factors; a good knowledge of the factors favoring them contrasting with the weak means implemented in everyday life to reduce their impact; the great majority of participants (68%) believe they have a well balanced diet; patients are greatly involved in their own health, with a slight external locus involving the general practitioner, the immediate entourage and society. The notes of the evaluation are usually maximum. Conclusion Patient Therapeutic Education arouses strong interest in the public, allows a personalized approach that optimizes learning, increases knowledge and facilitates the use of new protective practices. [ABSTRACT FROM AUTHOR]

Background: Maps conceptual, initially developed in American universities to aid in learning purposes, are also used in therapeutic patient education in areas other than mental health. Objectives: Evaluate the feasibility of the realization of concept maps by stabilized adult patients suffering from schizophrenia, analyze their content and potential usefulness as part of educational activities. Methods: In our study, 20 volonteer patients were included in a 1h interview to realize a concept map on the theme "me and my treatments". Two methods of construction of the conceptual map have been tested. The media used for the interviews were a recorder, a logbook, an interview guide, and leaves in A3 format for mapping. Results: Concept maps can be produced by patients with schizophrenia, regardless of the degree of cognitive impairment, in respect of conditions such as a good experience of the investigator and the right moment to interview patients. The analysis of the content of the conceptual maps showed a wealth of the stated concepts and relationships underlying them. These concepts fit into the area of the knowledge of patients about their experiences with the disease, their seeking and their beliefs. The richness of the mentioned concepts suggests that this method would be useful in patient education. Conclusion: This study shows the feasibility of concept maps in the field of mental health and opens potentially interesting educational perspectives. [ABSTRACT FROM AUTHOR]

Copyright of Douleur et Analgésie is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Douleur et Analgésie is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Résumé But de l’étude L’amélioration de l’hygiène de vie est utile en prévention des maladies cardiovasculaires mais les limites de sa réalisation pratique dans la population générale ont vite été atteintes. L’éducation thérapeutique du patient peut aider à les dépasser. Patients et méthodes Nous proposons en prévention primaire un programme personnalisé comportant une ou plusieurs séances individuelles et collectives ayant pour objectifs d’aider les participants à cheminer vers une hygiène de vie plus protectrice. Cela inclut une meilleure éducation sur 6 facteurs de risque (tabac, sédentarité, surcharge pondérale, hypertension artérielle, hypercholestérolémie, diabète) et la recommandation de quelques habitudes alimentaires ; une est limitée : charcuterie ; d’autres sont privilégiées : consommations de poissons, légumes verts, céréales complètes et légumineuses, fruits. Des scores ont été attribués aux 6 paramètres de facteurs de risque et aux 5 items d’habitudes alimentaires. Ils sont recueillis au moment du recueil du diagnostic éducatif et un an plus tard, permettant ainsi des comparaisons temporelles. Résultats À propos des 291 premières personnes ayant suivi ce programme, nous observons à un an une amélioration significative de la pratique d’une activité physique d’endurance et de la consommation des poissons, des légumes verts, des fruits, des céréales complètes et légumineuses. Conclusion L’hygiène de vie est globalement améliorée, certains paramètres plus que d’autres. Faciliter l’accès de l’éducation thérapeutique du patient au plus grand nombre est une voie à développer et à évaluer. Goal of the study Lifestyle improvement is useful in the prevention of cardiovascular disease, but its practical implementation in the general population is limited. Patient therapeutic education can help go beyond these limits. Patients and methods In primary prevention, we propose a personalized program including one or several individual and collective sessions to help the participants towards a healthier lifestyle. This includes better education about six risk factors (tobacco, sedentary lifestyle, overweight, high blood pressure, high cholesterol, diabetes) as well as advice on better eating habits. The first recommendation is to limit processed meats, the other recommendations advise more fish, green vegetables, whole grains and beans, and fruits. Scores are attributed to six risk factors and five eating habits. These scores are given at the time of the first session and again a year later, thus permitting time comparisons. Results For the first 291 participants in the program, we observed at one year a significant improvement in physical activities of endurance and in the consumption of the recommended food groups (fish, green vegetables, fruits, whole grains and beans). Conclusion The patient's lifestyle has improved as a whole, certain parameters more than others. Assessed patient therapeutic education should be offered to a larger number of people. [ABSTRACT FROM AUTHOR]

Copyright of Lettre de Medecine Physique et de Readaptation is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Résumé: L’éducation thérapeutique du patient (ETP) est maintenant reconnue et recommandée dans la prise en charge des rhumatismes inflammatoires chroniques. Des preuves existent pour faire ces recommandations même si les effets sont modestes avec les critères évalués et semblent ne pas toujours persister dans le temps. Certaines techniques d’interventions pourraient s’avérer plus intéressantes sur certains critères de jugements : des techniques basées sur les théories d’autorégulation pourraient avoir des effets plus importants sur la dépression ou les changements de comportement tels que la pratique d’activité physique par exemple. La quasi-totalité des données de la littérature sur l’ETP dans les rhumatismes inflammatoires concerne la polyarthrite rhumatoïde. Les critères améliorés dans la polyarthrite sont les connaissances de la maladie et du traitement et la pratique d’activité physique, ainsi que le coping ou les mesures d’auto-efficacité. L’amélioration des autres critères évalués est faible même si elle est parfois statistiquement significative. À noter que les mesures de satisfaction sont toujours élevées. Les méthodes d’analyse mixte des résultats, associant évaluation quantitative et qualitative, sont encore très peu utilisées mais sont indispensables dans ce type d’intervention complexe. Par ailleurs, la méthodologie de l’évaluation des interventions complexes telles que l’ETP doit être adaptée et ne pas se limiter aux essais contrôlés randomisés. Il ne faut pas oublier que l’intérêt actuel pour l’ETP est aussi dû à une évolution de la relation soignant-soigné et au concept de soin (de care) qui se définit plus comme « avoir le souci de l’autre et l’accompagner dans sa vulnérabilité » que « d’accomplir une part technique de soignant ». [Copyright &y& Elsevier]

Copyright of Actualités Pharmaceutiques is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Therapeutic education is not a recent idea. It arouses renewed interest thanks to the article 84 of French law no. 2009-879 from July 21, 2009 reforming the hospital and concerning patients, health and territory. This article inserts in the public health code no less than five articles devoting patient therapeutic education. Nevertheless, the conditions imposed by the legislator raise questions, which should be outstripped in favor of a widespread implementation of integrated care pathways in which therapeutic education is enclosed. In France, internists should be involved in the development of new programs of therapeutic education in the field of rare diseases, especially systemic autoimmune diseases. A pilot project for systemic lupus erythematosus is ongoing, before an expected geographic extension through referent centers, as well as the progressive development of additional programs aiming all rare diseases. Content, funding and evaluation are key points that remain to be defined. [Copyright &y& Elsevier]

Introduction: Within the framework for the long-term educational follow-up of patients with chronic disease, the methods used to identify patient educational needs are not well described. Objective: Investigate the educational advantages of using concept mapping to make decisions about the educational follow-up of patients with cardiovascular risk factors in a specific educational structure. Method: Elaboration of a concept map and negotiation of an educational contract during an interview with 16 patients. Results: Two-thirds of the needs expressed by the patients after the concept map are new compared with the expectations expressed before concept mapping. The needs of 11 patients are fully or partially similar compared with those identified by the caregiver. For 13 patients, all the needs expressed by the patients are connected with a knowledge field found in their concept map. For 14 patients, the negotiated educational contracts take into account needs expressed by the patients. Conclusion: The study shows that concept mapping might help to identify patients' educational needs as well as to negotiate a therapeutic educational contract. It allows this follow-up to meet the patient's needs and the caregiver's educational objectives. [ABSTRACT FROM AUTHOR]