SFEBES2018 Nurse Session Nurse Session 2: Adrenal crisis & steroid education; raising the safety bar (4 abstracts)
Goethe-University Hospital, Frankfurt, Germany.
Appropriate hydrocortisone adjustment by the patient himself in situations of increased demand, e.g. in gastrointestinal or febrile infections, is indispensable to prevent adrenal crises (AC). Previous studies revealed a lack of knowledge concerning self-management in patients with AI. A comprehensive patient education is one of the key measures to avoid life-threatening AC. In November 2014, a working group of the adrenal section in the German Endocrine Society (DGE) met to develop a structured and consistent patient education programme. Starting from nine participating centres, a growing number of teams, each comprising an endocrine nurse and an endocrinologist, completed the teachers training program. Up to now, more than 70 German centres have been qualified to offer the DGE-certified education to their patients. The patient programme provides general information on AI, encourages and enables patients to increase their hydrocortisone medication in critical situations and instruct them how to self-inject hydrocortisone in case of emergency. The structured education consists of a two-hours group training with 410 participants, including patients and their relatives or spouses. All standardised training materials are updated regularly and are available to all qualified teaching teams via an internet-based platform. To evaluate the education programme, n=399 patients from eight certified centres completed questionnaires comprising questions on individual course and perception of AI as well as knowledge questions, each before, shortly after and 69 month after training. Data show a significant gain of knowledge on AI and an increased willingness and self-confidence to manage AC after participation. At present the program is freely offered but not compensated by health care providers. A future aim is financial reimbursement similar to education programmes for other chronic diseases such as diabetes in order to empower more patients for the prevention of AC.