University for patients

Тhe nature of the program “University for patients”

The “University for patients” program is a long-term initiative of the National Patients’ Organization (NPO). It is the largest training program for patients which aims to develop certain skills in patients and help them manage their chronic disease in a better way. The training modules of the University target patients, healthcare specialists and volunteers in the healthcare system.

The model of the “University for patients” program was first developed by the Spanish Patients’ Forum, funded by the Catalan government and it has been replicated by the NPO since 2012.

Each disease model is integrated into a separate specific Faculty which has its own principle of conduct.

Main goals of the program:

  • To empower patients to better manage their chronic diseases
  • To ensure equal opportunities for quality education for patients
  • To promote modernization and improvement of the quality of the healthcare system by providing information, training and outcomes research




  • Osteoarthritis

Osteoarthritis is characterized by degenerative changes occurring in articular cartilage and subsequent expansion of bone tissue. According to various studies, between 12-15% of the population suffers from osteoarthritis, while the percentage for people over the age of 70 jumps to 50-70%.

Principle of conduct of the training

The Faculty consisted of two parts: Conducting educational lectures for patients by a medical specialists - orthopedists and neurologists; as well as monitoring the appointed treatment of the patient by a NPO representative and a representative from the “Association of patients with rheumatoid arthritis”. The aim was to monitor and follow-up whether the patient adheres to the appointed treatment, whether there are any problems they have encountered and whether they are satisfied with the training. 

The focus of the training was to present the seriousness of the disease osteoarthritis –lack of proper treatment can lead to serious deformities; the therapy needs to cure the pain in the joints but also to protect the gastric mucosa; the importance of the adherence to the appointed therapy so as to prevent disease progression.

-  Acute coronary syndrome

Cardiovascular diseases are the major cause of premature death in Europe. They are an important factor for disability and lead to an increase in healthcare costs.

The training within the Faculty was organized by NPO, the “Heart” Association and cardiologists. It aimed to monitor the health condition of the patients that have had a cardiovascular accident, have been hospitalized and need an effective secondary prevention in order to diminish the risk of another accident or death.

The Faculty gave the opportunity for patients to inform them well about the disease as well as to continually monitor their health condition. The cardiovascular diseases need to be considered as a serious matter by patients. Patients should adhere to the prescribed therapy and learn how to react to particular circumstances.

The post-training monitoring process within the Acute coronary syndrome faculty continued 6 months.

  • Diabetes Type 2

Type 2 Diabetes is considered as one of the most serious socially-significant diseases worldwide. Recent data shows that in Bulgaria patients with diabetes are around 520 000 and around 300 000 among them do not know that they have this disease or they are in a pre-diabetes condition.

Therefore, NPO launched a project aiming to provide a training module and support for patients with Diabetes Type 2. The training consisted of individual training lectures with the patient by the medical specialists – endocrinologists and general practitioners; regular calls by the call center of NPO and a free glycosylated hemoglobin test.

The monitoring process of the health condition of the patient lasted 6 months and included controlling questions to the patients and a reminder for the free glycosylated hemoglobin test. This aims to monitor whether the patient adheres to the appointed treatment, whether there are any problems they have encountered and whether they are satisfied with the training.

Focus of the training:

  • The seriousness of Diabetes 2 (untimely or lack of proper treatment could lead to serious complications).
  • The importance of the adherence to the appointed therapy by the doctor
  • Possible complications due to a discontinued therapy

Over 60 medical specialists – endocrinologists and general practitioners from Bulgaria


       -   Oncology Faculty - Breast and Prostate cancer

The program consisted of seminar trainings for patients, conducted by an oncologist, nurse and trained representative from NPO. The training modules lasted 5 months and were held simultaneously in different oncological hospitals.

  • Arterial Hypertension

Arterial Hypertension (AH) is called the "silent killer" because it is often diagnosed late, as its initial symptoms are hard to be diagnosed. AH is a socially significant problem due to the high morbidity, disability and mortality it causes.

The campaign was supported by the Bulgarian Hypertension League, the World Hypertension League and the International Society of Hypertension, in particular in the preparation of print materials.

The program included individual training modules conducted by general practitioners and cardiologists; controlling calls to patients by the call center of NPO and a free follow-up talk with the patient during the 3rd month of the program with the aim to track the status and the need for changes in the therapy.

Around 70 medical specialists from different towns in Bulgaria (cardiologists and general practitioners) took part in the training program.

-     Chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) is the most common chronic disease among smokers over 45 years old and one of the leading causes of death. However, the disease remains unrecognized and its initial symptoms are considered normal - for example, the so-called 'Smokers’ cough ".

The program included individual training modules by pulmonologists; controlling calls to patients by the call center representative of NPO and a free follow-up talk and examination of the patient during the 1st and 6th month of the program. It aimed to track the status and the need for changes in the therapy, problems that have occurred and the patient’s opinion on the effect of the program. Patients were given a training booklet including information about the disease, treatment options and ways to be monitored and controlled.

The program involved 51 pulmonologists from different cities in Bulgaria.

-       Flu

The program included educational printed materials on the essence of Flu, its symptoms, risk groups, infections, etc. It included also awareness raising campaign on the importance of vaccine prophylactics. Timely vaccination reduces the susceptibility to the disease and prevent its spreading.

  • Rheumatic diseases

The training module is a result from a pilot survey conducted in 2012. The survey analysis concluded that 1/3 of the patients do not know their treatment, how it should be applied and how to take their drugs.

Main activities within the program:

  • Training modules for patients on how to submit their documents at the National Health Insurance Fund (NHIF)
  • Printed training materials with information on how to receive their reimbursed treatment, including a handbook “First steps – How to get my medication reimbursed by NHIF?” , brochures containing drug information
  • Free regular consultations with regional coordinators in different towns in Bulgaria
  • Post-training  follow-up with patients


  • The method “I quit smoking”


IQS is a patented system for smoking cessation, approved by the EU and USA. The device with reflex analysis of the electro impulses is globally recognized (the so called technology R.I.S.E). It gives good results and is quite popular in medical practice.


I Quit Smoking


Patients are asked to provide their personal data and smoking history which are inserted into a special software that determines the individual therapy. Then the smoker’s motivation is assessed through different physical and psychological tests. The therapist starts to stimulate the reflex points on the ear shells with a special tool. The stimulation of these specific reflex points leads to a loss of the urge to smoke.


  • Students on the go

This program targeted young people and students that are travelling abroad which leads to more social contacts, long time stays at crowded places (dormitories, libraries, clubs). This increases the risk of spreading meningococcus – a cause for the serious meningococcal disease.

Main activities:

  • Awareness campaign in universities and schools on the risks while travelling abroad, in particular the risks of invasive meningococcal diseases
  • Seminars among young people, where infectionists explained them the risks of Invasive meningococcal diseases, that are very dangerous and develop quite fast and could be fatal, if they are not diagnosed on time and managed properly.
  • Printed information materials

The program was developed with the support of Work, Travel and Education agencies.

  • Atrial fibrillation

The program will be achieved through implementation of an information campaign. It will include training modules conducted by medical specialists that will explain them how to measure their pulse as well as awareness raising campaign among the public and especially among risk groups.

The program will develop and provide printed materials on the issue and will educate patients to measure their pulse as the easiest, cheapest and highly effective way for an early diagnosis of atrial fibrillation. Patients will be informed about the basic steps in detecting the disease, its treatment and further monitoring.