title: Glucocorticoid therapy for adrenal insufficiency: nonadherence, concerns and dissatisfaction with information.
abstract: OBJECTIVE
  Appropriate self-management of glucocorticoid therapy (GC) is crucial for patients with adrenal insufficiency (AI). We aimed to describe patients' self-reported nonadherence to GC, evaluate perceived doubts about need for GC, concerns about adverse effects, and dissatisfaction with information received about GC.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  Patients prescribed GC for AI (n = 81) from five European countries.
  
  
  METHODS
  Online survey including the Medication Adherence Report Scale (MARS), Beliefs about Medicines Questionnaire(©) (BMQ Specific, adapted for AI) and Satisfaction with Information about Medicines Scale(©) (Prof Rob Horne; SIMS).
  
  
  RESULTS
  Most patients (85·2%) reported a degree of nonadherence to GC. The most frequent types of nonadherence concerned changing the timing of GC doses, for example taking a dose later in the day than advised (37·0%). Few patients doubted their personal need for daily GC, but most reported high concerns about GC including potential weight gain (50·6%), osteoporosis (53·6%) and the continuing risk of adrenal crisis (50·6%). Dissatisfaction with information about GC was frequent, with participants particularly dissatisfied with the amount of information they had received about potential problems with GC. People who expressed dissatisfaction with information about GC, and concerns about its adverse effects were also more likely to report nonadherence (P < 0·05).
  
  
  CONCLUSIONS
  Nonadherence to treatment, concerns about potential adverse effects and dissatisfaction with the information provided about treatment were frequently reported by this European sample of AI patients. Many AI patients may need additional information about their GC and support to address concerns about GC and facilitate adherence.
authors.affiliation: Centre for Behavioural Medicine, Research Department of Practice and Policy, UCL School of Pharmacy, London, UK.
authors.forename: S C E
authors.initials: SC
authors.lastname: Chapman
authors.affiliation: Centre for Behavioural Medicine, Research Department of Practice and Policy, UCL School of Pharmacy, London, UK.|Department of Endocrinology, University College Hospital, London, UK.
authors.forename: S
authors.initials: S
authors.lastname: Llahana
authors.affiliation: Guys and St Thomas' NHS Foundation Trust, London, UK.
authors.forename: P
authors.initials: P
authors.lastname: Carroll
authors.affiliation: Centre for Behavioural Medicine, Research Department of Practice and Policy, UCL School of Pharmacy, London, UK.
authors.forename: R
authors.initials: R
authors.lastname: Horne
mesh_terms: D000309:Adrenal Insufficiency / Q000188:drug therapy*; D000328:Adult; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005060:Europe; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000209:etiology; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D015430:Weight Gain; D016903:Drug Monitoring
chemical_list: D005938:Glucocorticoids