Endocrine Abstracts

Background: Effective management of adrenal insufficiency (AI) during sick day episodes requires adjusting oral glucocorticoid therapy or administering intramuscular injections to prevent adrenal crises. Given the critical nature of adrenal crisis management, educating families of young individuals with AI is essential.

Aim: To critically appraise patient education concerning adrenal crisis management through a systematic review of structured education programs in the published literature.

Methods: We performed a systematic review in four databases (Medline, Embase, Web of Science, CINAHL). Our key research questions were:• What structured educational programs exist for patients with adrenal insufficiency concerning the management during sick day episodes?• How effective are these structured educational programs?The systematic review was conducted in accordance to the PRISMA 2020 guidance. Eligible papers were fully reviewed and data extracted using a standardised proforma with focus on details of the structured programme, the patient population and efficacy of the program.

Results: The systematic literature search yielded three publications involving a total of 795 patients. Two publications were structured education programs in Europe (The Netherlands and Germany), whilst the third was in United States of America. Two publications included patients with a variety of underlying aetiologies of primary and secondary AI whilst the third involved patients with breast cancer who had undergone bilateral adrenalectomy as part of treatment. All of these three structured educational programs involved adult patients and were delivered face to face. Two programs were conducted by endocrinologists and endocrine nurses (a 2-hour small group training session and a 3-hour educational meeting), while one program was led by pharmacists (a three-step program taught over 3 consecutive days). All programs included opportunities for practicing injection techniques and resulted in improved knowledge and patient satisfaction based on patient questionnaires.

Conclusion: Limited evidence exists in the published literature regarding structured educational programs for patients with AI, with none specifically tailored to paediatric patients and their families. There is a crucial need to understand the educational requirements of families and young individuals with AI to develop accessible educational resources and programs in collaboration with them.