Endocrine Abstracts

Background: During Covid-19 pandemic, we recognised the importance of optimising adrenal insufficient patients’ ability to manage adrenal crisis and seek medical intervention thereby reducing the need for more intensive support. Evidence suggests omission of steroids during an adrenal crisis is a medical emergency and can be fatal. Research by National Reporting Learning System (2020) identified 4 deaths, 4 admissions to critical care, 320 incidents relating to steroid replacement. ESN’s were unable to facilitate face to face education, an education video lasting 12 minutes was created for patients to access online. Video registered more than 4K views. Video included information - how to manage steroids during illness/stress and demonstrates how/when to administer emergency steroid injection.

Method: Randomly selected 150 adrenal insufficiency patients at Liverpool University Hospital. Using a mixed methodology approach, created a feedback questionnaire assessing patient’s knowledge base and suggestions to improve service. A retrospective audit analysed both qualitative and quantitative data.

Results: Received 56 responses over a 4 month period. 62% found video extremely helpful, 27% very helpful and 11% helpful. 90% information delivered; as much as they wanted, 5% more than and 5% not as much. 96%-video easily comprehendible. 91% previously received information – 60% via ESN’s, 32% via medical team, 5% from other source. Approximately 63.5% were fully aware of all symptoms of low cortisol. 41 % felt more confident about managing illness, 48% little more confident. 91% would administer the emergency steroid injection if they developed adrenal crisis symptoms. 93% already possess the emergency injection. Overall, 86% disclosed written responses to video – all positive.

Conclusions: 91% of patients’ would administer the emergency steroid injection, potentially reducing need for more intensive support /fatality. Aim of this initiative is to reach and support a larger number of patients in avoiding adrenal crisis and improving steroid management.