Abstract
Adrenal insufficiency (AI) requires life-long treatment with glucocorticoid
replacement therapy. Over- or under-substitution carries the risk of
increased morbidity in the form of side effects or adrenal crises.
Glucocorticoid replacement therapy needs to be flexible with dose adaptation
in special situations. This could not be managed by medical personnel on a
daily basis, but requires an educated patient who has a good knowledge of
the disease, understands his medical therapy and is able to perform
situational dose adaptation. The rarity of the disease in combination with
the need to respond to stressful situations with rapid glucocorticoid dose
adjustment underlines that a well-trained patient is crucial for optimal
management of the disease.
In this literature review we provide background information further
clarifying the need of education in patients with AI including the current
shortcomings of medical therapy and of the treatment of patients with AI. We
outline the aims of therapeutic patient education, present the concept of
structured patient education in Germany, and discuss available results of
patient group education programs. Furthermore, we propose strategies how
therapeutic patient education for adrenal insufficiency can be organized
under COVID-19 pandemic conditions.
Key words
adrenal crisis - hydrocortisone - secondary adrenal insufficiency - emergency card
