Core Values that Influence the Patient—Healthcare Professional Power Dynamic: Steering Interaction towards Partnership

Healthcare has long been marked by the authoritative-physician–passive-patient interaction, with patients seeking help and physicians seeking to restore patients back to health. However, lobalisation, social movements, and technological advancements are transforming the nature of this relationship. We aim to identify core values that influence the power dynamic betweenpatients and healthcare professionals, and determine how to steer these interactions towards partnership, a more suitable approach to current healthcare needs. Patients with physical chronic diseases (10 men, 18 women) and healthcare professionals (11 men, 12 women) were interviewed, sessions transcribed, and the framework method used to thematically analyse the data. Validation was done through analyst triangulation and member check recheck. Core values identified as influencing the patient-healthcare professional power dynamic include: (A) values that empower patients (acceptance of diagnosis and autonomy); (B) values unique to healthcare professionals (HCPs) (acknowledging patients experiential knowledge and including patients in the therapeutic process); and (C) shared capitals related to their interactions (communication, information sharing and exchange, collaboration, and mutual commitment). These interdependent core values can be considered prerequisites to the implementation of the patient-as-partner approach in healthcare. Partnership would imply a paradigm shift such that stakeholders systematically examine each other’s perspective, motivations, capabilities, and goals, and then adapt their interactions in this accord, for optimal outcome

The patients’ perspective on access to and use of Personal Health Records

We present the patients' perspective regarding the use of Personal Health Records, and give insights on patients' characteristics, such as socioeconomic and behavioural factors, that are associated with the access to and use of Personal Health Records. The findings come from the INTERREG APPS project that investigated preferences for and intention to use Personal Health Records in four cross-border regions, in Lorraine/France, Luxembourg, Rhineland-Palatinate and Saarland/Germany, and Wallonia/Belgium

Patient‐centered digital biomarkers for allergic respiratory diseases and asthma: The ARIA‐EAACI approach – ARIA‐EAACI Task Force Report

Biomarkers for the diagnosis, treatment and follow-up of patients with rhinitis and/ or asthma are urgently needed. Although some biologic biomarkers exist in specialist care for asthma, they cannot be largely used in primary care. There are no validated biomarkers in rhinitis or allergen immunotherapy (AIT) that can be used in clinical practice. The digital transformation of health and health care (including mHealth) places the patient at the center of the health system and is likely to optimize the practice of allergy. Allergic Rhinitis and its Impact on Asthma (ARIA) and EAACI (European Academy of Allergy and Clinical Immunology) developed a Task Force aimed at proposing patient-reported outcome measures (PROMs) as digital biomarkers that can be easily used for different purposes in rhinitis and asthma. It first defined control digital biomarkers that should make a bridge between clinical practice, randomized controlled trials, observational real-life studies and allergen challenges. Using the MASK-air app as a model, a daily electronic combined symptom-medication score for allergic diseases (CSMS) or for asthma (e-DASTHMA), combined with a monthly control questionnaire, was embedded in a strategy similar to the diabetes approach for disease control. To mimic real-life, it secondly proposed quality-of- life digital biomarkers including daily EQ-5D visual analogue scales and the bi-weekly RhinAsthma Patient Perspective (RAAP). The potential implications for the management of allergic respiratory diseases were proposed.info:eu-repo/semantics/publishedVersio

The ARIA-MASK-air® approach

Funding Information: The authors thank Ms Véronique Pretschner for submitting the paper. MASK‐air has been supported by Charité Universitätsmedizin Berlin, EU grants (EU Structural and Development Funds Languedoc Roussillon and Region PACA; POLLAR: EIT Health; Twinning: EIP on AHA; Twinning DHE: H2020; Catalyse: Horizon Europe) and educational grants from Mylan‐Viatris, ALK, GSK, Novartis, Stallergènes‐Greer and Uriach. None for the study. ® Publisher Copyright: © 2023 The Authors. Clinical and Translational Allergy published by John Wiley & Sons Ltd on behalf of European Academy of Allergy and Clinical Immunology.MASK-air®, a validated mHealth app (Medical Device regulation Class IIa) has enabled large observational implementation studies in over 58,000 people with allergic rhinitis and/or asthma. It can help to address unmet patient needs in rhinitis and asthma care. MASK-air® is a Good Practice of DG Santé on digitally-enabled, patient-centred care. It is also a candidate Good Practice of OECD (Organisation for Economic Co-operation and Development). MASK-air® data has enabled novel phenotype discovery and characterisation, as well as novel insights into the management of allergic rhinitis. MASK-air® data show that most rhinitis patients (i) are not adherent and do not follow guidelines, (ii) use as-needed treatment, (iii) do not take medication when they are well, (iv) increase their treatment based on symptoms and (v) do not use the recommended treatment. The data also show that control (symptoms, work productivity, educational performance) is not always improved by medications. A combined symptom-medication score (ARIA-EAACI-CSMS) has been validated for clinical practice and trials. The implications of the novel MASK-air® results should lead to change management in rhinitis and asthma.publishersversionpublishe

Un appel aux recommandations pour l’enseignement de l’ETP en formation initiale des professionnels de santé : regards croisés entre exploration de la littérature et avis des acteurs européens de l’ETP

Introduction: Teaching of therapeutic patient education (TPE) in initial training (IT) is developing without any guidelines defining good practices. The starting point of such a work of recommendations is the study of the recent situation. This study describes FI training practices. Method: A scoping review was conducted from January to May 2019 on 4 databases (Pubmed, ERIC, Cinahl and Psycinfo). Results were categorized and supplemented with the viewpoints of TPE actors solicited during the 7th Congress of the European Therapeutic Education Society (SETE) in May 2019. Results: Twenty-four articles were selected and 40 TPE actors were questioned. Results show an important heterogeneity of learning objectives and contents, often reduced to a few contributory elements of an educational approach. Active learning methods are most often mobilized, particularly role-playing. Some training courses supplement teaching with internship. Evaluation focuses mainly on satisfaction and skills acquired by the students but does not explore the transfer capacities of the students. Discussion: Results indicate the need to define learning trajectories in the field of IT TPE. Recommendations are needed to stabilize the core foundations of this curriculum. This work should be based on broad consultation with experts in TPE and its teaching. In view of the lack of evidence, a consensus research method is to be preferred.Introduction : L’enseignement de l’éducation thérapeutique du patient (ETP) en formation initiale (FI) se développe sans que des recommandations claires aient été définies. Le point de départ d’un travail de recommandations consiste en l’étude de l’existant. Cette étude décrit les pratiques de formation en FI. Méthode : Une revue de portée a été menée de janvier à mai 2019 sur 4 bases de données (Pubmed, ERIC, Cinahl et Psycinfo). Les résultats ont été catégorisés et complétés par le point de vue d’acteurs de l’ETP sollicités lors du 7 e congrès de la Société d’Education Thérapeutique Européenne (SETE) en mai 2019. Résultats : Vingt-quatre articles ont été retenus et 40 acteurs de l’ETP ont été questionnés. Les résultats montrent une grande hétérogénéité des objectifs et contenus d’apprentissage, souvent réduits à quelques éléments contributifs d’une approche éducative. Les méthodes actives d’apprentissage sont le plus souvent mobilisées, notamment les jeux de rôle. Certaines formations complètent l’enseignement par un stage. L’évaluation porte principalement sur la satisfaction et compétences acquises par les étudiants mais explore peu les capacités de transfert des étudiants. Discussion : Les résultats indiquent la nécessité de définir de véritables parcours d’apprentissage en matière de FI ETP. Des recommandations sont nécessaires pour stabiliser les bases universelles de ce curriculum. Ce travail devrait s’appuyer sur une large consultation des experts de l’ETP et de son enseignement. Au vu de l’insuffisance de preuves, une méthode de recherche par consensus est à privilégier

Un appel aux recommandations pour l’enseignement de l’ETP en formation initiale des professionnels de santé : regards croisés entre exploration de la littérature et avis des acteurs européens de l’ETP

Introduction : L’enseignement de l’éducation thérapeutique du patient (ETP) en formation initiale (FI) se développe sans que des recommandations claires aient été définies. Le point de départ d’un travail de recommandations consiste en l’étude de l’existant. Cette étude décrit les pratiques de formation en FI. Méthode : Une revue de portée a été menée de janvier à mai 2019 sur 4 bases de données (Pubmed, ERIC, Cinahl et Psycinfo). Les résultats ont été catégorisés et complétés par le point de vue d’acteurs de l’ETP sollicités lors du 7e congrès de la Société d’Education Thérapeutique Européenne (SETE) en mai 2019. Résultats : Vingt-quatre articles ont été retenus et 40 acteurs de l’ETP ont été questionnés. Les résultats montrent une grande hétérogénéité des objectifs et contenus d’apprentissage, souvent réduits à quelques éléments contributifs d’une approche éducative. Les méthodes actives d’apprentissage sont le plus souvent mobilisées, notamment les jeux de rôle. Certaines formations complètent l’enseignement par un stage. L’évaluation porte principalement sur la satisfaction et compétences acquises par les étudiants mais explore peu les capacités de transfert des étudiants. Discussion : Les résultats indiquent la nécessité de définir de véritables parcours d’apprentissage en matière de FI ETP. Des recommandations sont nécessaires pour stabiliser les bases universelles de ce curriculum. Ce travail devrait s’appuyer sur une large consultation des experts de l’ETP et de son enseignement. Au vu de l’insuffisance de preuves, une méthode de recherche par consensus est à privilégier

Un appel aux recommandations pour l’enseignement de l’ETP en formation initiale des professionnels de santé : regards croisés entre exploration de la littérature et avis des acteurs européens de l’ETP

Introduction: Teaching of therapeutic patient education (TPE) in initial training (IT) is developing without any guidelines defining good practices. The starting point of such a work of recommendations is the study of the recent situation. This study describes FI training practices. Method: A scoping review was conducted from January to May 2019 on 4 databases (Pubmed, ERIC, Cinahl and Psycinfo). Results were categorized and supplemented with the viewpoints of TPE actors solicited during the 7th Congress of the European Therapeutic Education Society (SETE) in May 2019. Results: Twenty-four articles were selected and 40 TPE actors were questioned. Results show an important heterogeneity of learning objectives and contents, often reduced to a few contributory elements of an educational approach. Active learning methods are most often mobilized, particularly role-playing. Some training courses supplement teaching with internship. Evaluation focuses mainly on satisfaction and skills acquired by the students but does not explore the transfer capacities of the students. Discussion: Results indicate the need to define learning trajectories in the field of IT TPE. Recommendations are needed to stabilize the core foundations of this curriculum. This work should be based on broad consultation with experts in TPE and its teaching. In view of the lack of evidence, a consensus research method is to be preferred.Introduction : L’enseignement de l’éducation thérapeutique du patient (ETP) en formation initiale (FI) se développe sans que des recommandations claires aient été définies. Le point de départ d’un travail de recommandations consiste en l’étude de l’existant. Cette étude décrit les pratiques de formation en FI. Méthode : Une revue de portée a été menée de janvier à mai 2019 sur 4 bases de données (Pubmed, ERIC, Cinahl et Psycinfo). Les résultats ont été catégorisés et complétés par le point de vue d’acteurs de l’ETP sollicités lors du 7 e congrès de la Société d’Education Thérapeutique Européenne (SETE) en mai 2019. Résultats : Vingt-quatre articles ont été retenus et 40 acteurs de l’ETP ont été questionnés. Les résultats montrent une grande hétérogénéité des objectifs et contenus d’apprentissage, souvent réduits à quelques éléments contributifs d’une approche éducative. Les méthodes actives d’apprentissage sont le plus souvent mobilisées, notamment les jeux de rôle. Certaines formations complètent l’enseignement par un stage. L’évaluation porte principalement sur la satisfaction et compétences acquises par les étudiants mais explore peu les capacités de transfert des étudiants. Discussion : Les résultats indiquent la nécessité de définir de véritables parcours d’apprentissage en matière de FI ETP. Des recommandations sont nécessaires pour stabiliser les bases universelles de ce curriculum. Ce travail devrait s’appuyer sur une large consultation des experts de l’ETP et de son enseignement. Au vu de l’insuffisance de preuves, une méthode de recherche par consensus est à privilégier

The use of patient‐reported outcome measures by healthcare professionals in specialized asthma management centers in French‐speaking Belgium: A mixed‐methods study

Abstract Introduction Recently, the literature has promoted the use of patient‐reported outcome measures (PROMs) in clinical practice as a means to foster patient engagement. However, conditions necessary to support the use of PROMs to encourage asthma patient engagement are not clearly defined. Therefore, we sought (1) to explore the current and ideal use of PROMs by healthcare professionals (HP) in specialized asthma management centers in French‐speaking Belgium and (2) to understand under which conditions the use of PROMs contributes to patient engagement. Methods We undertook a mixed‐methods study with both anonymous online survey and in‐person qualitative semi‐structured interviews conducted with HPs to understand their perspectives on the routine use of PROMs. HPs were recruited from 16 asthma centers (French‐speaking Belgium) identified via the Belgian Respiratory Society. Results Of the 170 HPs identified from the 16 participating centers, 51 (30%) responded to the survey (n = 51) and 11 completed semi‐structured interviews. 53% (27/51) of the surveyed HPs reported using PROMs primarily for asthma monitoring and clinical research while all reported that PROMs should primarily be used in practice to facilitate communication with the patient and to address neglected aspects of the care relationship such as the psychosocial aspects of the disease. The qualitative interviews revealed avenues for moving from a medical‐centered and utilitarian use of PROMs to a use serving patient engagement. This would require HPs to go beyond their current representation of PROMs, to use instruments offering a more holistic image of the patient, to incorporate PROMs into a digital tool and to integrate PROMs in a patient education process. Conclusion The main findings of this study suggest relevant avenues for using PROMs in ways that support patient engagement

Patient partenaire : de la pratique à la recherche.

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