- Therapeutic wandering: what is it?
- Therapeutic wandering: what is the difference with diagnostic wandering?
- Which patients are affected by therapeutic wandering?
- What are the causes of therapeutic wandering?
- What are the consequences of therapeutic wandering?
- What solutions to get out of therapeutic wandering?
Therapeutic wandering: what is it?
In France, 23 million patients suffer from chronic diseases according to health insurance. And among them, some face thetherapeutic wandering. It designates the period during which a patient will wander from treatment to treatment, as well as from doctor to doctor, until finally identifying the treatment that will allow him to live his life in the most normal way possible with the disease. This period can extend over months or even years.
Therapeutic wandering: what is the difference with diagnostic wandering?
I’diagnostic wandering, it is the period between the appearance of the first symptoms of a disease and the establishment of a diagnosis. It can be endless, especially for the three million French people affected by one of the approximately 6,000 to 8,000 rare diseases. Today, only one out of two people with a rare disease has a precise diagnosis, which takes an average of 5 years to be made for more than a quarter of people.
Its cousin, therapeutic wandering, begins, for its part, once the disease has been unmasked, the person responsible for the symptoms is identified, and lasts until the patient has found the treatment that suits him perfectly and that alleviates his symptoms.
Which patients are affected by therapeutic wandering?
Among others, people suffering from rare diseases, for a simple reason: 95% of them do not yet have a cure.
“This therapeutic wandering also affects a number of chronic diseases, as the psoriasisfor which many patients no longer consult, or stop following their treatment“, adds Benoît Brouard, founder of the startup Wefight.
What are the causes of therapeutic wandering?
The causes of therapeutic wandering can be multiple. To begin with, many diseases require specific expertise, beyond the skills of the attending physician. “In the case of psoriasis, for example, patients will consult their GP for years“, explains Sylvain Bonnet, CEO of Observia. Often, they navigate from treatment to treatment, without being fully satisfied with the results. Being directed from the start to the right specialist would save them precious time.
“Migraine is a good example: few migraine sufferers consult a neurologist. However, it is this specialist who is best able to find the right treatment“, underlines Benoît Brouard. Another problem, the waiting times which do not cease lengthening to obtain an appointment with a doctor. Once the treatment is found, it is still necessary to take it. “Half of the patients do not take the treatment prescribed by the doctor correctly and/or do not follow his recommendations“, laments Dr. Kamel Abdennbi, cardiologist.
This non-adherence to treatment, it is for example Zoé who cancels a follow-up appointment with her diabetologist, or Pierre who remains sedentary even though his cardiologist had recommended at least 30 minutes of walking a day. It is particularly common when patients do not feel sick, such as with high blood pressure or diabetes.
What are the consequences of therapeutic wandering?
It is a suffering for the sick and their loved ones, as much as a loss of opportunity. “Not treating yourself properly means taking the risk of an escalation“, warns Sylvain Bonnet. In cancer as in many other diseases, the earlier we treat, the more chances we have of getting out of it in good conditions. “Prevention is better than cure”the overused expression finds its full meaning here.
As for chronic illnesses,unchecked, they take up more and more space, until it becomes impossible to ignore them. Putting your illness under the rug is never a good idea. Untreated or poorly treated diabetes, for example, can lead to loss of vision, or amputation of a foot.“
Between 2012 and 2018, the cumulative sum of the increase in spending on chronic diseases reached 48.4 billion euros : reducing therapeutic wandering would also reduce expenditure related to chronic diseases.
What solutions to get out of therapeutic wandering?
“Finding the right specialist to solve your problem takes time and effort“, recognizes Sylvain Bonnet. “However, it is essential, the patient must become fully involved in his health“, insists Dr. Abdennbi. To improve compliance, Observia has developed SPUR, a tool based on a digital questionnaire, which can be done in the presence of the doctor. It identifies what prevents the patient from following his treatment properly. .
“Understanding that an asthmatic teenager is ashamed to take out his inhaler in front of his comrades then makes it possible to outline solutions“, details Dr. Abdennbi, who uses the tool with his patients.”Instead of giving everyone the same treatment, we personalize the approach. We find out what levers to use so that patients take their treatment better or modify their behavior more easily. Saying “Here’s your prescription, see you in 6 months”, it doesn’t work.“Today, you have to explain, listen, convince.
To provide an answer to this therapeutic wandering, the startup Wefight has also launched Vik apps, to inform about treatment options and facilitate access to patient care. About fifteen applications accessible on their phone or online allow patients to obtain reliable information outside of medical appointments, and thus not to find themselves isolated. On these applications, the information is verified by specialized health professionals and patient associations, to help patients and relatives better understand the disease.
Concretely the application:
- Answers questions from patients or their relatives via a chat accessible 24 hours a day, 7 days a week;
- Helps track symptoms;
- Reminds you of any medical appointments;
- Allows patients to fill out forms to self-monitor their disease and help research;
- Offers advice, articles and patient testimonials.
Our Experts:
- Dr Kamel Abdennbi, head of the cardiac rehabilitation department at the Léopold-Bellan hospital in Paris
- Benoit Brouard, former hospital pharmacist, founder of the startup Wefight
- Sylvain Bonnet, CEO of Observia
