Oral Presentation ESA-SRB-ANZBMS 2024 in conjunction with ENSA

Survey on the awareness of sick day management plan amongst patients diagnosed with adrenal insufficiency. (#50)

Rupa Pudasaini Dahal 1 , Simon Edeghere 1 , Gerry Fegan 1
  1. Fiona Stanley Hospital, Murdoch, WA, Australia

INTRODUCTION

Adrenal insufficiency is a potentially life-threatening endocrine condition related to the inability of the adrenal glands to produce adequate glucocorticoids and/or mineralocorticoids hormones. This could be due to an intrinsic adrenal disease or hypothalamic and/or pituitary disorders. Sick day management plan guides patients and clinicians to adjust the glucocorticoid replacement during physical and psychological distress.

AIM

The aim of this survey was to assess patient’s awareness on sick day management plan, current availability of a written copy and their knowledge on self- administration of intramuscular hydrocortisone. It also aimed to assess general practitioner’s involvement in providing appropriate advice when these cohort of patients present to their practice unwell

METHOD

With a new role of Endocrine Nurse for adult patients being introduced in WA, patients attending the endocrine nurse led clinic for intramuscular hydrocortisone injection training completed a set of survey questionnaires. This survey was conducted between November 2023 and July 2024.

RESULTS

30 patients participated in this survey. Following are the findings from this survey:

  • 27 (90%) patients were aware of sick day management plan.
  • 22 (73%) patients were provided with a written copy by their endocrinologist.
  • 26 (86%) patients hadn’t received any training on Hydrocortisone self-injection.
  • 4 (13%) patients who were provided with a prescription for Solu Cortef Act-O-Vial (Hydrocortisone injection) didn’t receive any consumables or training on the preparation and administration of the injection. They were provided with a demonstration video link.
  • Only 17 (57%) patients mentioned that their general practitioners were comfortable in providing suggestions on sick day management plan, others would ask patients to contact their endocrinologists. 

CONCLUSION

Knowledge gap among patients and clinicians on sick day management plan has been identified from this survey.  Patient education on sick day management plan and IM hydrocortisone injection is crucial in preventing adrenal crisis.   

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