Nos objectifs étaient de caractériser les pratiques éducatives quotidiennes des psychiatres hospitaliers publics et les programmes d’éducation thérapeutique du patient (ETP) mis en place. Nous avons réalisé une enquête en ligne auprès des psychiatres des établissements publics hospitaliers d’Aquitaine. Le taux de participation était de 36 %. La plupart des psychiatres (85 % et plus) éduquaient « toujours » ou « souvent » leurs patients concernant le nom, l’étiologie, les symptômes de la maladie, le traitement et la prévention de la rechute et des complications. Ils étaient un peu moins d’un quart à proposer « toujours » ou « souvent » à leurs patients de suivre un programme d’ETP structuré. Les autres soignants étaient peu associés à cette démarche éducative. Douze programmes d’ETP ont été décrits par leurs coordonnateurs respectifs. Ces derniers étaient majoritairement des praticiens avec moins de dix années d’ancienneté. Les programmes s’adressaient essentiellement à des patients souffrant de trouble bipolaire ou de schizophrénie. La moitié des programmes était distribuée par les laboratoires pharmaceutiques. Notre étude montre une forte implication des psychiatres dans l’éducation thérapeutique quotidienne de leurs patients qui contraste avec des programmes structurés peu nombreux.

The aims of this study were to assess the characteristics of therapeutic education practice in French public psychiatric hospitals and to describe the ongoing patient education programs.

We conducted an online survey. Adult and child psychiatrists (n=264) of Aquitaine’s public hospitals (n=9) were asked to describe their daily educational practice using an internet questionnaire. Coordinators of patient education programs were invited to complete a specific questionnaire describing these programs.

Of the 264 psychiatrists contacted, 95 participated in the only survey (participation rate 36%), 85.7% were adult psychiatrists and 14.3% child psychiatrists. Most psychiatrists (85% or more) “always or often” educated their patients on the disease (name, etiology, symptoms), its treatment and the prevention of relapses and complications. Other mental health professionals, such as nurses, were rarely involved in this educational process. Less than a quarter of the psychiatrists “always or often” invited their patients to participate in a structured patient education program. Twelve education programs were described by their coordinators (13.6% of the participants). Compared to non-coordinators, coordinators had graduated significantly more frequently less than 10years before (92% vs. 49%) but did not differ regarding other characteristics. Bipolar disorder (n=4) and schizophrenia (n=7) were the most frequent indications of these programs. Half of the programs were distributed by pharmaceutical companies. Almost half (45%) of the programs were opened to patient’s carers and relatives. Increase in knowledge and competence were evaluated in 73% of the programs, and satisfaction in 64% of the programs. These findings have to be interpretated in the light of a possible selection bias favouring the participation of practitioners supporting or actively implicated in patient education, contributing to inflated estimates of the real frequency of educational practice in public psychiatric hospitals.

On the one hand, our study shows a strong involvement of psychiatrists in patient therapeutic education in daily practice. On the other hand, very few structured programs were ongoing, mostly concerning bipolar disorder and schizophrenia, i.e. disorders for which evidence of efficiency of patient education has been demonstrated. These findings suggest that implementation of further patient education programs should be encouraged and that formation of further professionals is a priority.