Endocrine Abstracts (2011) 26 P7

Self-management in patients with adrenal insufficiency

J P van Eck1, R J Gobbens2, J Beukers1, W Geilvoet1, A J van der Lely1 & S J C M M Neggers1


1Erasmus MC, Rotterdam, The Netherlands; 2School of Health Care Studies, University of Applied Sciences, Rotterdam, The Netherlands.


Objective: The objective of this study was to asses the quality of self-management in patients with primary and secondary adrenal insufficiency and to find patient-related factors that influence quality of self-management.

Methods: The quantitative research was assessed by a questionnaire. Mainly focused topics were i) demographic data ii) daily medication intake iii) en route precautions and iv) dose adaptation during medical emergencies. One hundred and ninety-eight patients with primary and secondary adrenal insufficiency were assessed by the survey.

Results: Sixty percent (n=116) of the patients completed the questionnaire. For the propositions about daily medication intake, the score was 3.5 of 4 (mean:max). On the propositions about the way patients are prepared en route patients scored 3.4:5. Knowledge about dose adaptation in stress and strain was 1.9:3 assessed by propositions. Sex, age and education level influence the quality of self-management in the investigated subjects. The number of years patients receive long-term glucocortocoid replacement therapy or membership of a patient self-help group does not affect quality of self-management.

Conclusion: Patients demonstrate a high level of self-management according to daily medication intake. En route precautions and dose adaptation during medical emergencies need to be improved to prevent life threatening situations. Therefore, patients must be educated continuously to improve these self-management aspects that come with life-long substitution therapy. Involvement of endocrine nurses and nurse practitioners is likely to be a key factor in the effectiveness of patient education and training.

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