[Patient education in pulmonary rehabilitation: results of an implementation study]

Patient education is considered to be a major feature of medical rehabilitation in chronic disorders. While the substantial advances in the proposition of patient education programmes in in-patient health-care remain unquestioned, there are some deficits in actually performing such programmes in clinical practice. Only few clinics adhere to the protocol and recommendations for patient education. Mostly there are deviations in the actual performance of asthma education, e. g., mixing of different education schemes or using self-developed material. The reasons why clinics hesitate to use evaluated patient education programmes is still unclear. One can assume that there are problems due to organisation, structure or staff. This project aimed at observing the process of implementation of a new asthma education programme in order to identify barriers and helpful factors for the implementation. We conducted the study in three rehabilitation centres that did not use evaluated asthma education programmes. In these clinics we implemented the new education programme. After identifying the structure of the clinic before and after the implementation, interviewing the trainers and other staff members, we could assess the specific resources and barriers. We then included these aspects into recommendations for implementation. The most important barriers we found were too few staff and problems in planning the time and rooms for the programme. There was a high level of acceptance among all staff members and patients. The entire programme causes costs of 97 euro per patient. The costs at the beginning of the implementation were higher than those for the routine use.