Therapeutic patient education (TPE): A field of research and practice for psychosocial health intervention

Dear Editor,

In psychology, therapeutic patient education (TPE) is a patient-centered intervention that develops psychosocial skills for the management of chronic diseases providing quality of life and adherence to treatment. This approach considers the values, needs and coping strategies by patients in designing strategies for psychological intervention. It also aims to make patients actors in their own health to reduce future complications.¹

TPE is not a set of “tips” for health promotion and disease prevention, but is a strategy that has been developed over the last 30 years to better treat chronic diseases, based on a set of well-organized activities in education and learning programs where the psychosocial support component is considered as a fundamental part of treatment from a bio-psycho-social perspective to improve the health status of chronic patients and their families.² The specific objectives of therapeutic education are the acquisition and mobilization of personal and interpersonal, cognitive, and physical coping skills, and the maintenance of self-care skills to modifying the undesirable effects of chronic disease on patients’ health.

TPE has been effective in the treatment of chronic diseases such as type I diabetes, where patients achieve better metabolic control. In patients with asthma, TPE has had a direct impact on improved performance in daily life. However, studies demonstrating the effectiveness of TPE are still rare and the scientific literature is still scarce.³

While the practice of TPE is effective to improve quality of life, it is very important to focus research on patients’ lifestyles and health practices relative to the appearance of chronic diseases.⁴ For this reason, it is suggested that promoting the development of patients’ psychosocial skills as part of TPE plays a fundamental role in the prevention, relapse, and subsequent progression of the disease. This process aids adaptation to chronic illness and contributes to changes in habits and lifestyles.

In the field of medicine, psychosocial skills are rarely evaluated and are mainly understood from a biomedical concept. Research should focus on developing a bio-psycho-social approach to interventions in this area.⁵ Therefore, it is important to include patients in their own therapeutic process, they should be seen as an “active subject” in the care process, in which they are able to develop, propose and implement new self-care strategies.

The psychosocial approach to health enables the creation of therapeutic education programs based on tools that can be adapted to patients’ belief systems and behavior. This approach considers the patients experience of their illness as an important key factor for diagnostic and interventional work on health problems in the social contexts in which the illness manifests itself.³

Many therapeutic education interventions are influenced by socio-cognitive models in health psychology. Within cognitive theories, value is placed on beliefs, preconceptions, and shared representations, as these are ultimately responsible for health behaviors.⁴

A substantial body of research shows that the practice of therapeutic education has proven highly efficient in developing psychosocial skills for disease management, leading in the long term to a greater adherence to treatment not only at the psychotherapeutic level but also at the clinical level.⁵ This type of approach enables psychologist to understand the individual and collective meanings that influence the way patients behave and manage their condition, which becomes essential when establishing diagnosis and designing treatment.

Although little research has been conducted to understand the impact and effectiveness of TPE, it is now a commonly used tool in chronic disease management. Further studies are needed to assess the effectiveness in other types of disease, as well as in prevention and the development of new intervention approaches.

Funding

This research did not receive any specific grant from funding agencies in the public commercial, or not-for-profit sectors.

Competing interest

The authors report no financial or other relationship relevant to the subject of this article.