Endocrine Abstracts (2017) 49 GP115 | DOI: 10.1530/endoabs.49.GP115

Education, patient empowerment and admission avoidance

Anna Hawkins, Edel Casey & Khash Nikookam


Barking, Havering & Redbridge University NHS Trust, ESSEX, UK.


It is paramount to educate our patients, thereby empowering them to manage their chronic conditions. This is an evidence based fact. As healthcare professionals our challenge is to provide and ensure patients have been well informed in order to understand and manage their condition successfully on a daily basis.

In today’s healthcare service patient education has become a casualty of the reduced resources; there are ever increasing restrictions on both the length and frequency of consultations.

Endocrine teams and in particular the specialist nurses role involves teaching patients with new diagnosis as well as building on information they have gained from their consultations etc. We wanted to see how many patients with pituitary/adrenal failure have gaps in the understanding of their condition, particularly in relation to their sick day rules.

We surveyed 18 patients on hydrocortisone replacement who completed a questionnaire assessing their knowledge and understanding of their condition. When asked what action they would take if they had flu and a high temperature, nine would double their steroid dose, three would triple it. This leaves six patients at potential risk of admission. When asked about vomiting and/or diarrhoea, six said they would double their dose, one would triple it and one would take their emergency hydrocortisone injection, potentially leaving ten patients at risk of an Addisonian crisis. Within this group of patients seven had been given intra muscular hydrocortisone, but only four had been shown how to use it.

The national annual admission rate for patients with Addison’s disease/syndrome is 8%. Within this sample group the admission rate was 27.7%.

We need more resources to build on our initial and ongoing education/teaching programme to work on patient awareness of their condition as a whole, including sick day rules.

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