SFEBES2021 Poster Presentations Nursing Practice (4 abstracts)
Systematic review of behavioural change interventions for the prevention of adrenal crisis in adults with primary adrenal insufficiency – An infographic interpretation
Lisa Shepherd 1,2 , Kelly Ann Schmidtke 3 , Jonathan Hazelhurst 1 , Wiebke Arlt 1,2 , Debbie Carrick-Sen 2 , Janine Dretzke 2 , Amelia Swift 2 , Noel Hawks 4 & Abd Tahrani 1,2
1University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom; 2University of Birmingham, Birmingham, United Kingdom; 3University of Warwick, Warwick, United Kingdom; 4Patient and Public Involvement, London, United Kingdom
Background: The incidence of adrenal crisis remains constant, despite the introduction of behavioural interventions to educate and empower patients. To increase the success of future behaviour change interventions, theoretically informed and empirically supported behaviour change frameworks are available. The current review aimed to identify and evaluate available evidence of interventions used to prevent adrenal crisis in people with primary adrenal insufficiency to inform future intervention development.
Methods: We performed a search of 10 databases and trial registries up to October 2020 for studies about adults ≥ 18-years-old with primary adrenal insufficiency, taking glucocorticoid replacement, and exposed to a behavioural intervention. Risk of bias in each study was assessed using the AXIS and Mixed Method Appraisal Tools. Findings were reported narratively. Intervention components were described using the TiDIER checklist. The behaviour change techniques employed in each intervention were synthesised and then mapped to behaviour change techniques taxonomy, theoretical domains framework, and Capabilities-Opportunities-Motivation-Behaviour (COM-B) model.
Results: Seven European studies (1999 – 2020) were included. One study focused on patients with primary adrenal insufficiency, and the remaining studies focused on both primary and secondary adrenal insufficiency. Patient education was the focus of all interventions to improve patient knowledge and self-management. Most studies did not measure their intervention’s effectiveness. All studies utilised the same two behaviour change techniques, ‘instruction on how to perform a behaviour’ and ‘pharmacological support’. Six out of 14 theoretical domains were not targeted. Study quality was moderate to high. There were no randomised controlled trials.
Conclusions: The systematic review showed that most studies examining behavioural interventions developed to improve knowledge and self-management and prevent adrenal crisis, did not measure their effectiveness. Interventions targeted limited theoretical domains and behaviour change techniques. Effectiveness of interventions require testing in randomised controlled trials. The review extends knowledge and informs development of future behavioural interventions.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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