Recommendations
67.

Ensure that patient-education programmes:

  • are evidence-based
  • have specific aims and learning objectives
  • meet the needs of the patient (taking into account cultural, linguistic, cognitive and literacy considerations)
  • promote the patient’s ability to manage their own health if appropriate.
68.

Give the patient the opportunity to take part in evidence-based educational activities, including self-management programmes, that are available and meet the criteria listed in recommendation 67.

Relative values of different outcomes
Trade off between clinical benefits and harmsRecent NICE guidelines have made a number of recommendations about education programmes for specific conditions. The GDG considered that patient education programmes had an important role to play in certain conditions where they had been implemented following consideration of the evidence on effective and cost effective. However, it was noted that outcomes were likely to vary by specific intervention and specific condition (for example, people with more severe conditions may be more willing to make behavioural changes) and so this consideration was best retained within condition-specific guidelines.
The GDG considered that although the literature review found positive effect sizes for one-to one counselling, group education, written/audiovisual information, and counselling or group plus material on knowledge, the quality of the evidence was not good enough to recommend these be included in all education programmes, particularly as the clinical and cost-efficacy have been shown to vary depending on the disease area and associated risk in existing NICE guidelines.
The GDG agreed there was no evidence of clinical harm so patients should be given the opportunity to participate in educational programmes if they already exist and meet the criteria specified in the recommendation.
Economic considerationsEffective patient education programmes have the potential to improve patients’ health and reduce healthcare resource use. However, as noted above, consideration of the effectiveness and cost effectiveness of specific interventions was considered best retained within condition-specific guidelines. The recommendation made promoting use of evidence-based education programmes is not considered to have additional economic considerations.
Quality of evidenceIn the systematic review identified there was a problem with incomplete descriptions of interventions in individual studies, making it difficult to assess authors’ claims of what they were testing. The authors of individual studies rarely specified a reason for selecting a specific intervention or combination of interventions in their study. Many studies were conducted within special subgroups within the population which impacts our ability to generalise the findings to other target groups of patients.
Other considerationsThe GDG considered that even when appropriate evidence-based education programmes were available, patients did not always get access to them, so made a recommendation that where available, patients should be offered the opportunity to take part in education programmes.

From: 10, Enabling patients to actively participate in their care

Cover of Patient Experience in Adult NHS Services: Improving the Experience of Care for People Using Adult NHS Services
Patient Experience in Adult NHS Services: Improving the Experience of Care for People Using Adult NHS Services: Patient Experience in Generic Terms.
NICE Clinical Guidelines, No. 138.
National Clinical Guideline Centre (UK).
Copyright © 2012, National Clinical Guideline Centre.

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