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 educati on in Germany. The current legal background and its implications for patien t education are discussed. Based on examples from four selected areas (card iovascular diseases, diabetes mellitus, chronic pain, and asthma) the curre nt practice of patient education in Germany is summarized. While many well- structured programs exist that are based on state-of-the-art guidelines, th ere is a lack of high quality research that documents the long-term effecti veness and cost-effectiveness of such approaches. Structural problems and a n insufficient number of highly trained personnel result in the fact that m any patients do not have access to standardized programs. Persisting compli ance 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 educa tors are discussed. (C) 2001 Elsevier Science Ireland Ltd. All rights reser ved.