Fédération de médecine physique et réadaptation, hôpital Carémeau, université de Montpellier-Nîmes, France.
Ann Phys Rehabil Med. 2011 Jul;54(5):319-35. doi: 10.1016/j.rehab.2011.06.001. Epub 2011 Jul 1.
Therapeutic patient education (TPE) is a continuous medical care process whose role in lower back pain (LBP) has yet to be well defined.
To evaluate the role and impact of TPE in the medical and surgical management of LBP.
A non-systematic literature review.
Few formal TPE programmes have been rigorously evaluated in the context of LBP. In most cases, TPE tools have been combined with other interventional measures that vary according to the conceptual models used - thus limiting the extent to which the effect of TPE alone can be judged. Information that complies with the guidelines modifies knowledge and inappropriate beliefs. Whether formalized or not, TPE appears to modify (i) the physical disability and pain related to LBP and (ii) the patient's choice of therapy (e.g. surgery). The impact appears to be more marked in the (sub)acute phases.
National and international guidelines suggest that TPE based on a biopsychosocial model has a positive impact on the patients' behaviour and treatment compliance. The cost/benefit ratio appears to be favourable.
Therapeutic patient education appears to reduce the negative consequences of fear-avoidance behaviour and thus promotes treatment compliance in LBP patients, from the acute phase onwards.
治疗性患者教育（TPE）是一个持续的医疗护理过程，其在腰痛（LBP）中的作用尚未得到很好的定义。
评估 TPE 在 LBP 的医疗和手术管理中的作用和影响。
非系统性文献回顾。
在 LBP 背景下，很少有严格评估的正式 TPE 计划。在大多数情况下，TPE 工具与其他干预措施相结合，这些干预措施因使用的概念模型而异 - 因此限制了单独判断 TPE 效果的程度。符合指南的信息可以改变知识和不适当的信念。无论是否正式，TPE 似乎都可以改变（i）与 LBP 相关的身体残疾和疼痛，以及（ii）患者的治疗选择（例如手术）。这种影响在（亚）急性期更为明显。
国家和国际指南表明，基于生物心理社会模型的 TPE 对患者的行为和治疗依从性有积极影响。成本/效益比似乎是有利的。
治疗性患者教育似乎可以减少恐惧回避行为的负面影响，从而促进 LBP 患者的治疗依从性，从急性期开始。
