Endocrine Abstracts

Introduction: Lifelong corticosteroid replacement is the treatment for patients with Addison’s disease. Steroid therapy need to be altered in the event of illness such as infection, accident or any other major stress. Patients need to be advised on sick day rules and this information should be reiterated at every time of patient contact.

We conducted an online survey among doctors across all specialties in the Countess of Chester hospital to assess the knowledge of doctors of varying grades on the management of patients on long term steroids.

Results: 47.1% respondents were consultants. 94% said they usually enquire how long patients have been on steroids. 100% said they usually enquire the reason for taking steroids. When asked about changes to be made to steroid therapy during times of illness, 53% answered they will double the dose. 44% answered that the management is not different for patients taking steroids for COPD or rheumatoid arthritis compared to Addison’s disease.

88% answered they will give steroids intravenously if patients present with gastrointestinal illness and 94% answered they will give steroids intravenously if patients are nil by mouth. When asked about information which should be given to patients who are taking long steroids, only 50% answered correctly. 82.4% answered that this information should be reiterated at every time of patient contact. 94% answered that they would identify a steroid user by a medic alert bracelet.

When asked to identify oral steroid therapy from a list, 100% answered that prednisolone and dexamethasone are oral steroids. 68.8% identified hydrocortisone as an oral steroid and 47% identified fludrocortisone.

Conclusions: Awareness regarding steroid therapy needs to be improved among doctors of all training grades. Focused education need to be given to all trainees to improve awareness so that patients get appropriate and timely advice.