Patient education for adrenal insufficiency

Patient and carer education is crucial for successful long-term management of adrenal insufficiency. See Key aspects of self-care for a patient with adrenal insufficiency for key aspects of self-care. In particular, patients and carers must be able to manage glucocorticoid dose adjustments during periods of illness or stress—see Glucocorticoid replacement therapy during intercurrent illness and surgery—and be able to administer intramuscular hydrocortisone in an emergency. A patient with well-controlled adrenal insufficiency does not usually require frequent follow-up, so can forget crucial advice that was given years before; periodic reminders about self-care are essential.

An alert bracelet or necklace is strongly recommended for all patients with adrenal insufficiency. Knowledge about the patient’s condition and usual treatment is helpful in the case of acute illness or hospitalisation. Advise patients to carry a wallet card with this information; a template wallet card is available on the Hormones Australia website.

The Royal Children’s Hospital website provides information for patients and carers about dosing of glucocorticoids during illness to prevent adrenal crisis, and recognising signs of impending adrenal crisis.

Patients with adrenal insufficiency who live in remote areas, or who are travelling overseas or remotely, should carry:

• injectable hydrocortisone¹
• syringes
• instructions for intramuscular administration.