title: A glucocorticoid education group meeting: an effective strategy for improving self-management to prevent adrenal crisis.
abstract: OBJECTIVE
  To assess self-management in patients receiving glucocorticoid replacement therapy for primary or secondary adrenal failure before and 6 months after a glucocorticoid education group meeting.
  
  
  METHODS
  All patients with primary or secondary adrenal insufficiency, treated at the Department of Medicine, Division of Endocrinology, were invited by their endocrinologist to participate in a 3-h glucocorticoid education group meeting, consisting of a lecture about the disease and glucocorticoid doses adjustments in case of stress, followed by an instruction on how to inject hydrocortisone i.m. Finally, all participants could practise the i.m. injection and discuss their experience with (imminent) adrenal crises with other patients and the health care providers. Two weeks before the meeting and 6 months after the meeting, patients were asked to fill out a questionnaire about how they would act in six different conditions (e.g. febrile illness or vomiting).
  
  
  RESULTS
  Of the 405 patients who were invited, 246 patients (61%) participated. At baseline the response by the participants on the questionnaire was 100% (n=246) and at follow-up 74% (n=183). At follow-up, significantly more participants (P≤0.005) gave the correct answers to how to act in different situations (e.g. self-administration of a glucocorticoid injection and phone contact in case of vomiting/diarrhoea without fever). Moreover, the use of self-management tools, such as having a 'medicine passport (travel document with information about disease and medication) (P=0.007) or SOS medallion (P=0.0007)', increased.
  
  
  CONCLUSIONS
  A glucocorticoid education group meeting for patients with adrenal failure seems helpful to improve self-management and proper use of stress-related glucocorticoid dose adjustment.
authors: Division of Endocrinology, Department of Medicine, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands. j.repping-wuts@reuma.umcn.nl
authors: Han J W J
authors: HJ
authors: Repping-Wuts
authors: Nike M M L
authors: NM
authors: Stikkelbroeck
authors: Alida
authors: A
authors: Noordzij
authors: Mies
authors: M
authors: Kerstens
authors: Ad R M M
authors: AR
authors: Hermus
mesh_terms: D000309:Adrenal Insufficiency / Q000150:complications* / Q000188:drug therapy*; D000328:Adult; D000368:Aged; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D008875:Middle Aged; D012646:Self Administration; D012648:Self Care / Q000379:methods; D012657:Self-Help Groups; D011795:Surveys and Questionnaires
chemical_list: D005938:Glucocorticoids