Steroid Replacement Education: Impact on Patients and their Carers
Mujahid Saeed, Theingi Aung, Judy MacDonald, John Wass & Niki Karavitaki
Steroid replacement is life-saving in patients with steroid axis deficiency; education surrounding steroid replacement is vital in their management.
We organised Steroid Replacement Education Days for patients and their family members/carers to help enhance their knowledge on steroids and intercurrent illness. Lectures detailed manifestations, causes, management of steroid deficiency and the practical issues surrounding steroid replacement. This was followed by a practical demonstration of steroid emergency injections by our endocrine specialist nurse team. Questionnaires were offered to attendees to look at the impact of the course.
The patient questionnaire had 16 questions and there were 33 respondents. 51.5% (n=17) reported that they had received prior training on adjusting the dose of steroids during intercurrent illness, with 45.5% (n=15) having underwent adrenal crisis due to untimely adjustment of their steroids. 27.2% (n=9) were already fully confident (score rating of 810 on a 010 scale) in adjusting their steroids; this increased to 81.8% (n=27) after the training day. From 6.1% (n=2), 45.5% (n=15) felt fully confident in injecting steroids after the course. 94% (n=31) found the practical demonstration by the nurses extremely useful and a similar percentage rated the course excellent (score rating of 810 on a 010 scale). The questionnaire given to guests had 12 questions and 24 responded. 16.7% (n=4) had been trained on steroids and intercurrent illness prior to the course. 12.5% (n=3) felt confident in injecting steroids before; this rose to 50% (n=12) after the practical demonstration, which 87.5% (n=21) rated as excellent. 91.6% (n=22) rated the event as excellent.
Surprisingly, the confidence of patients on steroid replacement in dealing with intercurrent illness remains suboptimal. Events educating them and their carers are required on a regular basis aiming to enhance understanding of steroid treatment and to improve confidence in the emergency and life-saving management.