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


METHODS
A questionnaire-based survey.


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


METHODS
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.


METHODS
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.
Flemming
T G
TG
Department of Internal Medicine, Herlev University Hospital, Herlev, Denmark.
Kristensen
L O
LO
D000309:Adrenal Insufficiency / Q000188:drug therapy / Q000209:etiology / Q000628:therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D012648:Self Care / Q000592:standards*; D011795:Surveys and Questionnaires
D006854:Hydrocortisone