Quality of self-care in patients on replacement therapy with hydrocortisone

J Intern Med. 1999 Nov;246(5):497-501. doi: 10.1046/j.1365-2796.1999.00538.x.


Objectives: To assess the quality of self-care in patients receiving replacement therapy with hydrocortisone for primary or secondary adrenal insufficiency.

Design: A questionnaire-based survey.

Setting: The outpatient Clinic of Endocrinology at the University Hospital in Herlev, Denmark.

Subjects: Ninety-seven patients identified from the case reports of the clinic. All patients had received repeated oral information about hydrocortisone treatment and dose adjustments. Eighty-four (87%) patients completed the questionnaire.

Main outcome measures: Ability to act appropriately in case of physical stress, possession of a 'Steroid warning card', number and nature of episodes of physical stress during the past year and self-experienced level of information was recorded.

Results: Thirty-nine (46%) of the patients were not sufficiently skilled in coping with physical stress. This was more prominent in the elderly patients. Seventeen (20%) did not possess a 'steroid warning card'. Thirty-seven (44%) had experienced at least one febrile episode and 24 (29%) had been admitted to hospital during the past year. Fifty (60%) felt themselves to be well informed, but this did not correlate with the ability to act appropriately.

Conclusions: The study shows the need for continuous education of patients with adrenal insufficiency. Oral instructions should be supplemented with written information or a more detailed and structured education.

MeSH terms

  • Adrenal Insufficiency / drug therapy
  • Adrenal Insufficiency / etiology
  • Adrenal Insufficiency / therapy*
  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Hydrocortisone / therapeutic use*
  • Male
  • Middle Aged
  • Patient Education as Topic
  • Self Care / standards*
  • Surveys and Questionnaires


  • Hydrocortisone