Interviews - Uwe Gieler


Germany

ABOUT YOUR OWN STRUCTURE :


  1. Puce First of all, do you have an individual and/or collective approach ?

A collective approach with national consensus


  1. Puce What type of patient comes to the Atopic school?

All kind of patients, we divided them into 4 age-groups:

1.parents of atopic dermatitis children from 0 -7 years

2.children with their parents from 8 – 12 years

3.children from 13 – 18 years

4.adults older than 18 years


  1. Puce How many children have today integrated the patient education programme in your department ?

We have in our Atopic Dermatitis school academy (Hessen/Germany) about 200 patients a year in the school program


  1. Puce How many members of staff participate in this programme, what training do they receive and where do they train ?

The staff which participate in the programme are always 3 specialists: a dermatologist/paediatrician; a psychologist or psychotherapist and a nutrition specialist.

In our academy we have about 20 Atopic Dermatitis trainers, they are educated in train-the-trainer workshops and have supervision and a one afternoon workshop twice a year.


  1. Puce Do private dermatologists participate in the Atopic school ?

This depends on the activity of the private dermatologists, nowadays we don’t have strictly ‘private’ dermatologists but we have dermatologists who are working in private practices.


  1. Puce How is the link established between the Atopic school and the dermatologists and pediatricians in private practice ?

They are normal member of the atopic school academy as trainers.


  1. Puce Is your Atopic school attached to a network of care givers (pharmacists, nurses, state medical programs…) ?

Yes, our trainers at the academy are all members of the German GADIS project, a nationwide academy for the treatment of Atopic Dermatitis through education.


  1. PuceDo you have contact with other patient education teams, particularly those teams working with Asthma or Food Allergies ?

Yes, we have contact with the Asthma education program and there is an annual congress in Germany together with the Asthma trainers. There are only some special programs for Food Allergies and no nationwide program for that.


  1. Puce How is your Atopic school funded 

The program is funded by insurance companies. They sponsored the previous study and, since 2007, fund the Atopic Dermatitis school program for Atopic Dermatitis children from 0–18 years. The adults are not always funded but about 50% get funds for the school from their insurance companies as well. Otherwise the patients have to pay from their own pocket.

Collective approach;


  1. Puce How many participants are there in the collective workshops and who are they (children, parents, other adults…) ?

See answer above, the groups are 5–8(10) patients in the mentioned age-groups


  1. Puce Who are the educational staff for this programme (doctors, nurses, psychologists..) ?

The Atopic Dermatitis school trainer-team are always one doctor (dermatologist/paediatrician), psychologist or psychotherapist and a nutrition specialist, and sometimes additional nurses for the topical treatment.


  1. Puce What are the principal aims of these workshops ?

The principal aims of these workshops are mainly to empower patients, help them find their personal strategy to deal with the treatment, help them learn management skills to cope better with the disease and decrease anxiety and negative coping behaviour.


  1. Puce Do you use educational support tools and if so can you describe them ?

In Germany all trainers work with a manual with educational support tools, which are completed by individual skills if necessary. The Atopic Dermatitis program is run by a scheduled time-table of support.



PATIENT EDUCATION IN YOUR COUNTRY :


  1. Puce What role, if any, do parent associations/patient support groups, play in the Atopic schools ?

The patients in the atopic dermatitis schools are all informed about parent and patient self help groups and some information from these groups are given to the patients. There are close contacts with some groups who are willing to cooperate with the medical staff of the schools.


  1. Puce What role, if any, do schools play in managing chronic skin disease ?

The atopic dermatitis school program plays a major role in the management of this chronic skin disease. At the moment no disease management programs exists but there is an ongoing project to establish a management program for atopic dermatitis. Guidelines for atopic dermatitis are established in discussion with dermatologists and paediatricians with regard to evidence based medicine.


  1. Puce Do you have schemes like the PAI (in France this is an individualised adaptation project linking parents, children and teachers) ?

No, in Germany there is a lack of such networks, a prevention program does exist where teachers and the government cooperate but only for allergies.


  1. Puce Besides Atopic schools, is patient education developed for other pathologies in your country, and if yes, which pathologies are concerned ?

A meta-analysis from a department in Würzburg/Germany summarized all education programs in Germany and counted more than 1000 education programs for diseases in different specialities. The most common ones are Diabetes, Asthma, Atopic Dermatitis and Rheumatologic Disorders.


  1. Puce Do you have official patient education recommendations/guidelines in your country ?

Yes we have a education manual and guidelines for atopic dermatitis at the level 2 of the EBM.


  1. Puce How many active education departments exist today in your country ?

There are 10 so called academies of atopic dermatitis education in Germany, each of them look after several teams running education programs.


Thank you Uwe Gieler

Prof. Uwe Gieler


Prof. at the Clinic for Psychosomatics and Psychotherapy at the University

Hospital Giessen and Marburg

Ludwigstraße 76; D 35392 Gießen ; Germany.