Instruments used to assess the impact of patient education in chronic diseases: a scoping review

Background

Patient education (PE) is a structured process aiming to equip people with chronic diseases with the skills and confidence to self-manage effectively. Despite widespread implementation, evaluating PE impact remains methodologically fragmented: tools are often disease-specific or restricted to focused outcomes. Whether generic instruments adequately capture PE-targeted competencies remains unmapped. This scoping review aims to identify generic instruments used to assess the impact of PE, characterize their outcome domains, and identify measurement gaps.

Methods

Following JBI guidelines, PubMed, Embase, PsycINFO, and Cochrane were searched. Title/abstract screening was assisted by ASReview (an active learning-based tool) calibrated by four reviewers. Studies were eligible if they used a generic instrument in a chronic disease population. Identified instruments were mapped against a 10-domain heuristic taxonomy informed by WHO competency frameworks and Lorig’s self-management model, using binary coding with explicit decision rules.

Results

Of 9,985 records screened, 256 full-text articles were assessed; 77 studies from 26 countries were included, yielding 51 instruments across 13 chronic condition groups. Median domain coverage was 1 (IQR: .1.0–2.5). Coverage focused on mental health (53%), social functioning (33%), and HRQoL (25%), while symptom management (10%), problem-solving (8%), and self-monitoring (6%) were rarely represented. Only the Health Education Impact Questionnaire (n = 15) and the Partners in Health Scale (n = 3) reached 7/10 domains.

Conclusions

This mapping reveals a potential misalignment between generic instruments and established self-management competency domains. No instrument achieved full coverage. Whether disease-specific instruments compensate for these gaps warrants further investigation. These findings may support the development of standardized evaluation frameworks enabling equitable benchmarking across chronic conditions.

Key messages

• This scoping review provides a cross-condition mapping of generic instruments used to evaluate patient education, highlighting that most cover fewer than 2 of 10 self-management competency domains.

• Generic instruments mainly assess mental health and HRQoL, while problem-solving and self-monitoring are covered by fewer than 1 in 10 instruments used in PE evaluation.