Endocrine Abstracts

Introduction: Previous qualitative studies have explored perceptions of medication among patients with adrenal insufficiency (AI) as possible determinants of treatment satisfaction. This study is the first to quantify patients’ perceptions of AI medication (necessity beliefs and concerns) and their satisfaction with information and to assess whether medication beliefs and satisfaction are related to adherence.

Methods: Validated questionnaires were used to assess medication beliefs and reported adherence to medication in an online survey of AI patients recruited from the UK (n=20), Germany (n=9), France (n=18), Sweden (n=12) and Spain (n=11) using market research methodologies and patient support groups. Associations between medication beliefs, satisfaction with medicines information and reported adherence were examined by logistic regression analysis for causal relationships between variables.

Results: 81 participants completed the survey, of which 70 met the pre-determined criteria of currently being on conventional hydrocortisone replacement therapy. Mean age was 47.4 years (range 22–73, S.D. 14.4) and 21 patients (30%) reported low adherence to medication. Although most participants were convinced of their personal need for AI medication, 26 (37.1%) expressed doubts about the need for strict adherence to dose timings, reporting sometimes/always/often taking their dose at a different time of day than advised. 45 of the 70 patients had strong concerns about their medication. Participants reported more dissatisfaction with information about potential problems than information about action/usage of their AI medication. Patients dissatisfied with information were at greater risk of low adherence. Dissatisfaction with information about potential problems of taking AI medication was associated with higher concerns r(70)=0.375, P=0.001, as was dissatisfaction with information about the action/usage of AI medication r(70)=0.297, P=0.001.

Conclusion: There were considerable unmet needs in this European sample of AI patients, including dissatisfaction with information and concerns about potential adverse effects. Patients had high necessity beliefs, but also high concerns about current medications.