Experience pays off! Endocrine centres are essential in the care of patients with adrenal insufficiency

Kampmeyer, Daniela; Lehnert, Hendrik; Moenig, H.; Haas, Christian; Harbeck, Birgit

doi:10.1016/j.ejim.2016.07.008

Cited by 6 publications

(6 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Detailed results on the evaluation of the program will be published elsewhere. In a recent prospective analysis of the emergency management in 150 German patients with AI, 32 % reported that they had performed self-injection and further 15 % of patients reported glucocorticoid injection by a family member [37]. Of these study participants, 71 % had participated in the standardized patient education program.…”

Section: Results Of Patient Educationmentioning

confidence: 99%

“…One reason for this shortcoming might be insufficient knowledge of physicians of AI. Only less than 10 % of interviewed physicians identified all situations requiring glucocorticoid adjustment correctly [38,39]. Another reason might be the low recognition value of different emergency cards handed out to patients.…”

Section: Current Shortcomingsmentioning

confidence: 97%

“…A recent prospective evaluation of emergency management showed a large variability in emergency measures: the median time from showing the emergency card to a medical professional to parenteral glucocorticoid administration by a medical professional (card-injectiontime) was 60 min (5-360). Only 45 % of the patients received glucocorticoids by a physician within 30 min [37]. One reason for this shortcoming might be insufficient knowledge of physicians of AI.…”

Section: Current Shortcomingsmentioning

confidence: 99%

“…Relatives are involved in patient education only in 52 % of the centers [35]. Recent data from a prospective study showed that patients who performed a self-injection had an improved outcome: after initial parenteral (intramuscular or subcutaneous) glucocorticoid administration by patients or their relatives, significantly more patients were treated on an outpatient basis (62 %) compared to patients who did not self-inject (27 %), (p = 0.008) [37]. Two surveys from 2013 and 2017/18 in British patients revealed that within a 5-year interval more patients performed self-injection for treatment of emergency situations (16.7 % versus 24 %) [40].…”

Section: Current Shortcomingsmentioning

confidence: 99%

See 3 more Smart Citations

Therapeutic Patient Education for Adrenal Insufficiency under COVID-19 Pandemic Conditions

Kienitz¹,

Hahner

Burger-Stritt

et al. 2020

Exp Clin Endocrinol Diabetes

View full text Add to dashboard Cite

Adrenal insufficiency (AI) requires life-long treatment with glucocorticoid replacement therapy. Over- or under-substitution carries the risk of increased morbidity in the form of side effects or adrenal crises. Glucocorticoid replacement therapy needs to be flexible with dose adaptation in special situations. This could not be managed by medical personnel on a daily basis, but requires an educated patient who has a good knowledge of the disease, understands his medical therapy and is able to perform situational dose adaptation. The rarity of the disease in combination with the need to respond to stressful situations with rapid glucocorticoid dose adjustment underlines that a well-trained patient is crucial for optimal management of the disease.In this literature review we provide background information further clarifying the need of education in patients with AI including the current shortcomings of medical therapy and of the treatment of patients with AI. We outline the aims of therapeutic patient education, present the concept of structured patient education in Germany, and discuss available results of patient group education programs. Furthermore, we propose strategies how therapeutic patient education for adrenal insufficiency can be organized under COVID-19 pandemic conditions.

show abstract

Section: Results Of Patient Educationmentioning

confidence: 99%

Section: Current Shortcomingsmentioning

confidence: 97%

Section: Current Shortcomingsmentioning

confidence: 99%

Section: Current Shortcomingsmentioning

confidence: 99%

See 2 more Smart Citations

Therapeutic Patient Education for Adrenal Insufficiency under COVID-19 Pandemic Conditions

Kienitz¹,

Hahner

Burger-Stritt

et al. 2020

Exp Clin Endocrinol Diabetes

View full text Add to dashboard Cite

show abstract

“…Data from health insurance databases have shown a higher incidence of ACs than we report here ( 15 , 25 ). This may be because in insurance databases many patients with AI will have been treated by family physicians or non-specialists, as opposed to endocrinologists, and will therefore not have received specialist training ( 26 , 27 ) or be equipped to recognize or manage an AC ( 12 , 28 ). In a recent US study, which reported a much higher incidence of 24 ACs per 100 patient-years, the authors highlighted possible reasons for the different AC rates found across studies ( 29 ).…”

Section: Discussionmentioning

confidence: 99%

Characterization of patients with adrenal insufficiency and frequent adrenal crises

Quinkler¹,

Murray

Zhang

et al. 2021

European Journal of Endocrinology

View full text Add to dashboard Cite

Objective: This study aimed to characterize the clinical and biochemical features of patients with primary (PAI) and secondary (SAI) adrenal insufficiency who developed adrenal crises (ACs) and estimate the incidence of ACs in these patients. Design: Retrospective case-control analysis of the European Adrenal Insufficiency Registry (EU-AIR; NCT01661387). Methods: 2694 patients with AI (1054 PAI; 1640 SAI) enrolled in EU-AIR. Patients who developed ≥1 AC were matched 1:3 with patients without ACs for age, sex and AI type. Data were collected at baseline and follow-up (mean±SD: PAI 3.2±1.7 years; SAI 2.9±1.7 years). Results: 148/2694 patients (5.5%; n=84 PAI; n=64 SAI) had an AC during the study: 6.53 (PAI) and 3.17 (SAI) ACs/100 patient-years. Of patients who experienced an AC, 16% (PAI) and 9.4% (SAI) experienced ≥1 AC/year. The incidence of adverse events, infectious intercurrent illnesses and infectious serious adverse events were higher in patients with ACs than without ACs. No differences were observed in BMI, HbA1c, blood pressure and frequencies of diabetes mellitus or hypertension between subgroups (PAI and SAI, with and without ACs). At baseline, PAI patients with AC had higher serum potassium (4.3±0.5 vs 4.2±0.4mmol/L; P=0.03) and lower sodium (138.5±3.4 vs 139.7±2.9mmol/L; P=0.004) than patients without AC. At last observation, SAI patients with AC had higher hydrocortisone doses than patients without AC (11.9±5.1 vs 10.1±2.9mg/m2; P<0.001). Conclusions: These results demonstrate that concomitant diseases and cardiovascular risk factors do not feature in the risk profile of AC; however, patients with AC had a higher incidence of infectious events.

show abstract

Diagnosis and management of secondary adrenal crisis

Martel-Duguech,

Poirier,

Bourdeau

et al. 2024

Rev Endocr Metab Disord

View full text Add to dashboard Cite

Experience pays off! Endocrine centres are essential in the care of patients with adrenal insufficiency

Cited by 6 publications

References 5 publications

Therapeutic Patient Education for Adrenal Insufficiency under COVID-19 Pandemic Conditions

Therapeutic Patient Education for Adrenal Insufficiency under COVID-19 Pandemic Conditions

Characterization of patients with adrenal insufficiency and frequent adrenal crises

Diagnosis and management of secondary adrenal crisis

Contact Info

Product

Resources

About