Éducation thérapeutique des patients diabétiques de type 2 en cabinet de médecine générale à Marseille : pratiques, limites et modalités de recours aux programmes d'ETP

Abstract : Diabetes is a chronic disease whose increasing incidence reflects in France social inequalities. Ten years ago, therapeutic education (TE) was included in the medical care by the HPST law, which reformed the Hospital and relating to Patients, Health and Territories. Our work was carried out from a cross-sectional descriptive survey, through an anonymous questionnaire sent by mail and self-administered to 211 general practitioners (GP). The objective of this study was to review the practices in therapeutic education of patients with type 2 diabetes (T2D) in general practice. Our study shows that general practitioners are increasingly involved in the therapeutic education of their type 2 diabetic patients, although the lack of time still being the main obstacle. They do not yet use enough the structured programs of therapeutic education, that they mainly solicit for the type 2 diabetic patients in therapeutic failure. Therapeutic education training does not have a significant impact on the general practitioners practice of ET, but it favours the implementation of ET sessions at the GP’s office and the knowledge of their territory’s therapeutic education offer, increasing their use of ET structured programs. Furthermore, doctors working in precarious areas are better trained in therapeutic education, they are more concerned with the psychosocial support and quality of life of their type 2 diabetic patients, which they more easily address to TE structured programs. It testifies to their increased awareness of the issues of isolation, coordination of care and psychosocial support. Ten years after the HPST law, the link between general practitioners, primary care providers and TE structured programs is still insufficient. ET training should be promoted and required. Other studies should research about the therapeutic education needs of the most disadvantaged socio-cultural groups, in order to explore how to adapt therapeutic education to different cultures and levels of health literacy.
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Submitted on : Monday, February 25, 2019 - 5:48:03 PM
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Cécile Dard. Éducation thérapeutique des patients diabétiques de type 2 en cabinet de médecine générale à Marseille : pratiques, limites et modalités de recours aux programmes d'ETP. Sciences du Vivant [q-bio]. 2018. ⟨dumas-02048779⟩

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