Therapeutic patient education in adrenal insufficiency

Ann Endocrinol (Paris). 2018 Jun;79(3):167-173. doi: 10.1016/j.ando.2018.03.002. Epub 2018 Mar 29.

Abstract

It is essential to encourage patient autonomy in the management of their illness, and notably their participation in treatment education programs; specific programs target avoidance or early preventive treatment of acute adrenal insufficiency, which is a life-threatening complication. Therapeutic patient education is recommended by the two international consensus statements on the management of primary adrenal insufficiency and the French consensus on adrenal insufficiency. Although there is no common international reference framework to date, the objective of the French consensus was to provide a frame of reference to facilitate the development of therapeutic education for patients with adrenal insufficiency. The principal educational objectives were: for the patient to always carry the necessary emergency equipment; be able to identify situations of increased risk and the early signs of adrenal crisis; know how to adjust oral glucocorticoid treatment; be capable of administering hydrocortisone by subcutaneous injection; be able to adjust treatment to different situations (heat, physical exercise, travel); and be able to appropriately use the resources of the healthcare services. Other programs could also be developed to respond to patients' needs and expectations, notably concerning hydrocortisone dose adjustment to avoid overdose in the context of chronic fatigue syndrome.

Keywords: Addison's disease; Adrenal crisis; Corticotropin deficiency; Insuffisance corticotrope; Insuffisance surrénale aiguë; Insuffisance surrénale primaire; Maladie d’Addison; Prevention; Primary adrenal insufficiency; Prévention; Quality of life; Qualité de vie; Therapeutic patient education; Éducation thérapeutique du patient.

Publication types

  • Review

MeSH terms

  • Addison Disease / therapy
  • Adrenal Insufficiency / therapy*
  • Consensus
  • France
  • Glucocorticoids / therapeutic use
  • Hormone Replacement Therapy
  • Humans
  • Patient Education as Topic* / methods
  • Practice Guidelines as Topic

Substances

  • Glucocorticoids