Implications of structural deficits for patient education in Germany

Several changes in health politics and legal settings in recent years have affected the structure and practice of health promotion and patient education in Germany. The current legal background and its implications for patient education are discussed. Based on examples from four selected areas (cardiovascular diseases, diabetes mellitus, chronic pain, and asthma) the current practice of patient education in Germany is summarized. While many well-structured programs exist that are based on state-of-the-art guidelines, there is a lack of high quality research that documents the long-term effectiveness and cost-effectiveness of such approaches. Structural problems and an insufficient number of highly trained personnel result in the fact that many patients do not have access to standardized programs. Persisting compliance problems indicate that there is still room for improvement of patient education interventions. As important for the future, necessary changes in the legal settings and possible implications for the education of the educators are discussed.