Chronic diseases are frequent and potentially severe. Type II diabetes, asthma and heart failure affect 3.3 million, 4 million and 1 million people respectively in France. They are sources of avoidable mortality as well as disabilities leading to a loss of years of full health life (DALYS). Cumulatively, they were responsible for the loss of more than 1 million DALYS in 2019 in France. National and international recommendations also include TVE in the management of these three diseases.

This severity can be reduced by better management underpinned by therapeutic education. By improving their knowledge of the disease, it allows a better adherence of patients to the care project, the achievement of clinical and biological objectives, a decrease in the number of emergency room visits and unscheduled hospitalizations, and an improvement in the quality of life during the course of three frequent chronic diseases such as type 2 diabetes, asthma and heart failure.

However, participation in a therapeutic education program remains highly variable depending on many parameters. Lack of information seems to play a major role in this context.

In the Ile de France region, the density of available TEP programs is high, particularly in Paris. The three chronic diseases that are managed by an advanced practice nurse with a PCS mention have the largest number of TVE programs in Paris: type 2 diabetes (32, and 6 for diabetic foot), asthma and heart failure.

In an urban area with a good supply of TVE facilities, how can investigators explain the lack of integration of these facilities into the care pathway? Among the diverse patient population consulting an emergency department suffering from type II diabetes, asthma or heart failure, investigators wish to determine the proportion of patients who have not been offered TVE during their care.

Investigators will then try to identify demographic, socioeconomic, and medical factors statistically associated with the absence of FTE proposal.

Inclusion Criteria:

• Patient whose age is ≥ 18 years
• Patient consulting the GHPSJ emergency department for any reason
• Patient with a chronic disease among type 2 diabetes and/or asthma and/or heart failure
• Francophone patient

Exclusion Criteria:

• Diagnosis of the chronic disease in the context of its current management in the emergency room
• Patient being followed outside of Ile de France for the chronic disease studied
• Patient with dementia or cognitive disorders
• Patient under guardianship or curatorship
• Patient deprived of liberty
• Patient under legal protection
• Patient opposing the use of his data for this research

Patients visit the emergency department for any reason between 12/15/2021 and 3/30/2022 and have at least one of the following chronic conditions: type 2 diabetes, asthma or heart failure.