[Guide for therapeutic education program in psoriasis]

Introduction: Psoriasis is a chronic inflammatory skin disease which can cause significant impairment of quality of life, absenteeism at work and significant psychological distress. This justifies the elaboration of a multidisciplinary education program for patients. The objective of this work was to develop the content of a therapeutic education program in psoriasis, which may serve as a basis for teams wishing to develop psoriasis therapeutic education in their community.

Patients and methods: A group of 15 health professionals (dermatologists, dermatology nurses, and psychologist) and four psoriasis patients representatives of the psoriasis patient association (Association pour la lutte contre le psoriasis) participated in the development of this program. Health professionals all had an experience in therapeutic patient education in psoriasis through prior participation in a multicenter open pilot study, evaluating a therapeutic education program in psoriasis. Based on the previous experience, preparatory work in subteams was initiated to prepare draft objectives and content of the program. A two-day meeting was then organized to discuss in depth content of the therapeutic education program and elaborate recommendations. The meeting structure combined subteam work and plenary sessions. The following program was elaborated: two individual sessions and three group sessions. The groups have worked for two days, according to a predefined pattern: interview guide of educational diagnostic, content of collective workshops and knowledge questionnaire. All these documents were validated in plenary session. The methodology used for the development of this program followed the recommendations of the HAS in the field of chronic disease.

Results: In the end, were retained three collective workshops, preceded by a consultation of individual educational diagnosis and knowledge questionnaire followed by an evaluation session at the end of the program. The interview guide for educational diagnosis and the knowledge basis questionnaire have been defined. Three themes of group workshops were defined: (1) understanding the disease, (2) understanding the mechanism of onset of disease and treatments available, (3) how to live with psoriasis in everyday life. For each workshop, were defined learning objectives, skills to acquire and how to get there.

Discussion: We describe here a framework of educational therapy program in psoriasis comprising educational objectives, skills to acquire, basic disease knowledge, suitable for patients with psoriasis. The content was tailored to patient language and knowledge based on feedback from participating patients. The list of skills may be adapted to patient's individual needs. This program serves primarily as a working basis for the caregiver, to standardize practices in terms of therapeutic education in psoriasis in France.