A history of patient education by health professionals in Europe and North America: From authority to shared decision making education

Objective: This paper describes the development of patient education from the 1960s until now and identifies future challenges to improve patient education. Results: Patient education developed from the health care professional deciding what the patient needed to know to a shared decision making design where physician and patient are equally influential on the decision making process. The development of patient education is described for primary and secondary health care, as well as the impact of biomedical advances, an ageing population and cultural diversity on patient education. Some of the challenges for future patient education are identified: training health professionals as well as patients, involvement of the patient's social environment and application of e-Health techniques to patient education. Conclusion: Patient education has made several developmental changes, has spread to different settings in health care and has now finally established itself as a valuable part of health care for patients. Nevertheless, both patients and health professionals still need to be provided with skills to optimize patient education. A good science-practice fit for future interventions to facilitate patient education is paramount. Practice implication: Lessons from the past of patient education are important for the growth and future development of patient education.