Therapeutic education unit for heart failure: setting-up and difficulties. Initial evaluation of the I-CARE programme

Abstract

Background: Education programmes are required in chronic diseases. The insuffisance cardiaque : éducation thérapeutique (I-CARE) programme was developed in France to promote the setting-up of therapeutic education units for chronic heart failure.

Aim: To evaluate the setting-up of such units, assessing the influence of training on the creation and organization of the unit, the problems encountered and the contribution of the dedicated educational tools.

Methods: We submitted a questionnaire to the first 136 trained centres. The questionnaire was divided into two sections: one section dealing with educational practices and the other with the advantages and disadvantages of the tools provided.

Results: The participation rate reached 69.1%. Seventy-four centres (78.7%) declared themselves to be active in therapeutic education. Unit educational activities determined an educational diagnosis (89.2% of the centres) and provided education by means of collective workshops (73.0%) or one-to-one teaching sessions (75.7%). A complete education programme for a patient consisted of a median of four sessions (25th-75th percentile, 2-5 sessions) and lasted for a median of 6 h (25th-75th percentile, 4-10 h). The education team was multidisciplinary and usually included a nurse (93.2%), a dietician (78.4%), a cardiologist (71.6%) and a physiotherapist (40.5%). Heart failure educational tools were used only in part in most centres (89.2%). All advantages and disadvantages were recorded.

Conclusion: This first evaluation of the setting-up of therapeutic education units in the I-CARE programme has yielded promising results, despite expected difficulties. The effects of therapeutic education on the behaviour of heart failure patients remain to be determined.