Information and therapeutic education of diabetic patients in French hospitals: the OBSIDIA survey.
OBJECTIVE
Although several studies have evaluated the efficacy of therapeutic education (TE) programmes in patients with diabetes and demonstrated the benefits of such interventions, operational aspects are rarely described. For this reason, this national survey was conducted to investigate TE in France, and to identify its obstacles and needs.


METHODS
A preliminary qualitative phase was extended to include a quantitative survey through face-to-face interviews, followed by a web-based self-administered questionnaire sent out to every healthcare professional dealing with diabetic patients.


RESULTS
From the expanded web-based survey, 272 questionnaires were analyzed (39% from academic hospitals, 54% from general hospitals and 7% from private clinics); 85% of these sites provided TE for inpatients. Overall, TE was offered to 66% of patients (84% new patients) and was individualized in 55% of cases, and involved 9.4 healthcare professionals on average, with physicians, nurses and dietitians making up the core team. The TE offered encompassed a wide range of diabetes topics. However, of every 10 healthcare professionals, only 35% received specific training, while 45% received coaching from their colleagues and 10% received no training at all. Evaluation of TE was carried out in 60% of teams by questionnaires or interviews.


CONCLUSIONS
TE is well implemented in French hospitals, but lacks homogeneity and standardization. Training is inadequate from both qualitative and quantitative points of view, and evaluation of TE procedures needs to be developed. There is also a need for more funding and dedicated qualified staff, a lack of which is partly due to the fact that TE is not a recognized medical activity in hospitals.
Service des maladies endocriniennes et métaboliques, Cochin Hospital, 27 rue du Faubourg-Saint-Jacques, Paris cedex 14, France. helen.mosnier-pudar@cch.aphp.fr
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H
Mosnier-Pudar
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G
Hochberg
G
G
Reach
D
D
Simon
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S
Halimi
D003920:Diabetes Mellitus / Q000628:therapy*; D005602:France; D019538:Health Care Surveys; D016304:Hospitals, Private; D006779:Hospitals, Public; D006801:Humans; D020407:Internet; D008505:Medical Staff, Hospital; D009741:Nursing Staff, Hospital; D010353:Patient Education as Topic / Q000458:organization & administration / Q000706:statistics & numerical data*