Article

OBJECTIVE: To assess the impact of therapeutic education programmes for Coronary
Artery Disease (CAD) and Chronic Heart Failure (CHF),
as well as patients'
expectations and education needs, tips to improve adherence to lifestyle
modifications, and education materials. METHOD: We conducted a systematic review
of the literature from 1966 to 2010 on Medline and the Cochrane Library databases
using following key words: "counselling", "self-care", "self-management",
"patient education" and "chronic heart failure", "CAD", "coronary heart disease",
"myocardial infarction", "acute coronary syndrome". Clinical trials and
randomized clinical trials, as well as literature reviews and practical
guidelines, published in English and French were analysed. RESULTS: Therapeutic
patient education (TPE) is part of the non-pharmacological management of
cardiovascular diseases, allowing patients to move from an acute event to the
effective self-management of a chronic disease. Large studies clearly showed the
efficacy of TPE programmes in changing cardiac patients' lifestyle. Favourable
effects have been proved concerning morbidity and cost-effectiveness even though
there is less evidence for mortality reduction. Numerous types of intervention
have been studied, but there are no recommendations about standardized rules and
methods to deliver information and education, or to evaluate the results of TPE.
The main limit of TPE is the lack of results for adherence to long-term lifestyle
modifications. CONCLUSION: The efficacy of TE in cardiovascular diseases could be
improved by optimal collaboration between acute cardiac units and cardiac
rehabilitation units. The use of standardized rules and methods to deliver
information and education and to assess their effects could reinforce this
collaboration. Networks for medical and paramedical TPE follow-up in tertiary
prevention could be organized to improve long-term results.
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Langue : ANGLAIS