252 Recognition of pulmonary exacerbation (PEX) in adult patients with CF: An educational process to overcome barriers
Objectives PEX are the main cause of lung function worsening. Early recognition of PEX by patients should improve the management of the disease. The objective was to design an educational process to achieve a shared vision of PEX signs between patients and professionals and an action plan for the management of a PEX. Methods This work was conducted by the national multidisciplinary group in charge of therapeutic patient education, including patients and parents. The different steps were:
				 1. To classify an extensive list of clinical signs of a PEX in the three categories – signs at baseline, moderate and severe signs – and propose an educational session framework for patients in order to assess their knowledge of PEX signs, the actions to be undertaken and review timeliness of actions 2. To test the educational framework with a panel of patients 3. To adjust and finalize the educational process Results The educational framework was tested by caregivers in 18 patients aged from 17 to 41 during a dedicated time (average 45 min) during clinic visits in 6 CF centres. PEX signs awareness was satisfactory but the severity of exacerbation was often underestimated. Actions were known but management was delayed because of barriers related to the consequences of intravenous antibiotherapy or lack of motivation. Patients were usually satisfied by the educative session (score: 7/10). Conclusion Despite patients are aware of their personal forewarning PEX signs, some barriers may prevent them from appropriate management. Therapeutic patient education may be a process to check problem solving. Baseline improvement is a major challenge and motivation for adults with CF.