Endocrine Abstracts

Introduction: Adrenal insufficiency (AI) can pose a life-threatening risk in case of acute decompensation. The absence of specific signs of acute adrenal insufficiency (AAI) and lack of awareness about this medical emergency may lead to diagnostic and therapeutic delays, jeopardizing the patient’s prognosis. Hence, the importance of well-conducted therapeutic education for adrenal-insufficient patients. The objective of this study is to assess the level of knowledge among adrenal-insufficient patients regarding the pathology and management of their replacement therapy.

Patients and Methods: A prospective descriptive study was conducted on patients with adrenal insufficiency who had already undergone therapeutic education about the disease. The reassessment was carried out during the subsequent consultation at the Endocrinology Department of the University Hospital Center of Casablanca between 2021-2023. Data analysis was performed using Excel 2017 software.

Results: The study included 54 adrenal-insufficient patients, of whom 64.8% were women. The average age was 38.9 years. Adrenal insufficiency was of peripheral origin in 51.85% (Addison’s disease 37%, autoimmune adrenalitis 4.7%, tuberculosis 3.7%, and bilateral adrenalectomy 3.7%) and secondary in 48% (post-corticosteroid therapy 33.33%, antehypopituitarism 14.8%). The definition of adrenal insufficiency was correct in 36% of cases, insufficient in 48%, and no response in 16% of cases, correlating with the level of education. The vital need for treatment was known in 88%, triggers for AAI and management were known in 37%. The average hydrocortisone dose was 30 mg. Episodes of AAI were found in 79.6%, with 44.44% occurring upon treatment cessation. Knowledge of a normosodic diet was present in 33.33%, and awareness of medications to avoid, especially diuretics and laxatives, was observed in 18.5%. All patients received an Addison’s card. Therapeutic adherence was observed in 59.2%.

Conclusions: The knowledge of adrenal-insufficient patients remains insufficient. The establishment of a therapeutic education program is necessary to enhance patient understanding.