Endocrine Abstracts (2010) 21 P331

Group education improves patient confidence in managing steroid sick day rules

Linda Jean Munday, Lina Chong & Partha Kar


Queen Alexandra Hospital, Portsmouth, UK.


Background: Group education for patients with diabetes is a well validated method of enhancing self-management skills. More recently some departments have used group education to teach endocrine patients how to administer IM hydrocortisone.

Innovation: Patients on steroid replacement, identified by the endocrine nurse and GPs, were invited to attend a group session. The aim was to ensure every relevant patient in the locality had the opportunity to be educated about dose adjustment in times of illness, etc. and supplied with an emergency hydrocortisone injection.

Method: The first 57 patients who attended the groups were asked to complete a questionnaire, including a measurement of their level of confidence regarding steroid medication adjustment during intercurrent illness. This was assessed using a likert scale pre and post group education.

Results: Fifty-seven patients: 21 Addison’s, 30 hypopituitarism, 3 Cushing’s, 2 CAH, 1 isolated ACTH deficiency.

Likert scale 1=not confident, 10=very confident.

Pre group average confidence levelPost group average confidence level
Addison’s6.199.86
Hypopituitary4.738.03
Cushings4.09.0
CAH5.510.0
ACTH def.7.010.0

Conclusion: Patients who have participated in a group education session have higher levels of confidence regarding managing their steroid replacement therapy (P=0.003). The increase in confidence is demonstrated irrespective of their diagnosis. The challenge now is to maintain patient self management skills which may require development of a new group education programme.

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