The expert patient: towards a novel definition

Experience of illness and knowledge of disease make the expert patient an empowered partner for health professionals http://ow.ly/x8vbjChronic diseases have become a major burden in many developed countries.Physicians and policy makers manage patients and set clinical as well as research goals.In recent years, however, it has become progressively apparent that, as the patients are the ones living with the disease, their views and wishes should be considered, and healthcare should be more patient-centred.Many guidelines stress the importance of patient education, especially now that patients have easy access to information through the internet, mass media, educational activities in hospitals, communities and patient groups.Those living with common conditions such as chronic obstructive pulmonary disease (COPD) and asthma, and even rare pulmonary disorders, progressively acquire both experience and knowledge of their condition.The importance of patient involvement not only in their own management but also in health policy planning and decision-making is now being emphasised in Europe.Task forces are beginning to include patients in their expert panels when setting guidelines.Patient education and self-management of chronic illnesses/diseases Illness and disease are not synonymous Medical anthropologists use the terms ''illness'' and ''disease'' to describe the different views of health held by patients and doctors, respectively [1].''Illness'' not only includes the experiences of ill health but also the meaning given to these experiences, which are influenced by the patient's social and cultural background, including ''folk'' models of illness [1,2].''Disease'' is an abnormality in the function and/or structure of the body's organs and systems.Diseases can occur in the absence of illnesses (e.g.asymptomatic arterial hypertension).In brief, patients suffer illnesses, and physicians diagnose and treat their diseases [1,3,4]. Patient education and self-managementPatient education consists of healthcare professionals teaching patients about their disease and offering therapeutic instruction, particularly information about drugs, adaptation of their dosage and side-effects.Patient education is the first step on the way to self-management.Patient self-management [5] is the individual's ability to control their symptoms, treatment, the physical and psychological consequences of their condition, and the lifestyle or behaviour associated with chronic conditions [6].The objective of self-management is to control the condition with clear strategies to achieve desired outcomes [5].Interventions may be delivered by a variety of health professionals, including physicians, nurses, psychologists, educators, etc.In asthma, most interventions target some aspect of behaviour, particularly compliance with prophylactic treatment [5].