Predicting patient uptake of Therapeutic Patient Education using the health belief model.

Abstract

Despite the well-documented benefits of Therapeutic Patient Education (TPE), patient uptake remains low. This study examined whether patients' health beliefs, as described by the Health Belief Model (HBM), predict TPE participation. In this prospective cohort study, 351 adult patients from a French university hospital were followed for six months after being offered TPE for various chronic diseases. At baseline, they completed questionnaires assessing their perceptions of the benefits of and barriers to TPE, disease threat, control over their condition, and the empathy displayed by the healthcare professional (HCP) who recommended TPE. Contextual variables were also recorded. Logistic regressions were used. High perceived benefits significantly predicted TPE participation among patients who perceived high barriers (OR = 3.66, 95% CI [1.72-7.78]). Patients were also more likely to participate if TPE was proposed during a change in the treatment of their disease (OR = 2.91, 95% CI [1.32-6.42]). Finally, their baseline intention to participate (rated from 0 to 100) was predictive of uptake (OR for a 10-unit increase = 1.33, 95% CI [1.17-1.51]). Conversely, neither the perceived threat nor control over the disease predicted uptake. HCP empathy, time since diagnosis, and the type of professional recommending TPE had no significant impact. The HBM displayed some explanatory power in relation to TPE uptake, with perceived benefits and barriers playing a key role. Emphasizing the benefits of TPE while addressing barriers may boost participation, and a change in treatment could serve as a meaningful opportunity to engage patients in TPE. Conversely, highlighting the potential worsening of the disease may be ineffective. Finally, HCPs could tailor their communication strategies based on patients' expressed intention.