Does patient education in chronic disease have therapeutic value?

Abstract

A pool of 320 articles on patient education were screened to select controlled experiments in chronic disease where the dependent variables included (a) compliance with therapeutic regimen, (b) physiological progress of patients or (c) long-range outcome. Thirty such articles were found; and the magnitude of experimental effects of patient education were calculated using an empirical form of integrating research findings known as meta-analysis. Summary of all experimental effects showed patient education most successful in altering compliance (average improvement = 0.67 sigma over control, p less than 0.05). However, average improvements in physiological progress (0.49 sigma) and health outcome (0.02 sigma) were also statistically significant (p less than 0.01 and p less than 0.05, respectively). Efforts to improve health by increasing patient knowledge alone were rarely successful. Behaviorally-oriented program, often with special attention to changing the environment in which patients care for themselves, were consistently more successful at improving the clinical course of chronic disease.