SFEBES2022 Oral Communications Adrenal and Cardiovascular (6 abstracts)
University Hospital of Wales, Cardiff, United Kingdom
Introduction: Although significant developments have been achieved in the management of steroid-dependent patients, little progress has been made in ensuring their safety using smartphone technology. We present the use of a novel app in steroid-dependent patients.
Methods: A group of unselected individuals currently on steroid replacement due to adrenal insufficiency (AI) were assessed regarding their access to intramuscular (IM) hydrocortisone. A smartphone app, notifying both the healthcare team and patient when IM hydrocortisone nears expiry and enabling a timely repeat prescription to be issued, was offered to all patients.
Results: n=45 (primary AI: n=12, secondary AI: n=31; iatrogenic AI: n=2). Mean age 55.8±16.3 (18- 90) years, 42.2% females. Only 46.7% had an IM hydrocortisone supply in-date and 44.4% had problems renewing their prescription. 88.9% of the whole cohort were willing to be offered the app. To-date, 30 patients have started using the app with 20 renewal prescriptions already issued. The commonest feedback comment rating from patients and endocrine nurses is life-saving.
Age group(years) | N | No access to IM hydrocortisone currently (%) | Not aware of expiry date (%) | Current supply in-date (%) | Not aware how to get prescription renewed (%) | Problems getting prescription renewed (%) | Willingness to be offered a smartphone app for automatic reminders (%) |
18-40 | 9 | 22 | 33.3 | 55.6 | 55.6 | 33.3 | 100 |
41-65 | 21 | 19 | 19 | 33.3 | 19 | 52.4 | 85.7 |
66+ | 15 | 0 | 20 | 60 | 20 | 40 | 86.7 |
Whole cohort | 45 | 17.7 | 22.2 | 46.7 | 26.7 | 44.4 | 88.9 |
Conclusions: Current methods of ensuring patient safety in steroid-dependent individuals are ineffective. The introduction of a novel smartphone app is widely endorsed by patients irrespective of their age, and can help in providing better care and ensuring their safety. Based on these preliminary results, we plan to expand the apps use to all our steroid-dependent patients locally and regionally.