Medizinische Universität Graz - Research portal
Selected Publication:
Ratz, B.
Therapeutical and Educational Aspects of Adults Suffering from Primary Adrenal Insufficiency - a Systematic Review
Humanmedizin; [ Diplomarbeit ] Graz Medical University; 2017. pp. 66
[OPEN ACCESS]
FullText
- Authors Med Uni Graz:
- Advisor:
- Pilz Stefan
- Trummer Christian
- Altmetrics:
- Abstract:
- Primary adrenal insufficiency is a rare, but chronic disease which is characterized by a deficient production of glucocorticoids and mineralocorticoids. Since the discovery of glucocorticoid therapy in 1949, this disease was expected to be manageable. Nevertheless, patients under glucocorticoid therapy are still dying from adrenal crisis, an acute deterioration of the patient’s health due to a shortage in glucocorticoids. Unfortunately, these acute episodes are frequent, since one out of 13 patients will experience a crisis within the next twelve months. Thus, morbidity and mortality are unreasonably high. But why is there such a high death-toll in a disease whose fatality can be avoided by appropriate and timely medication? This systematic review provides insight in the state-of-the-art in treating adrenal insufficiency, i.e. patient medication, influencing factors, recommendations/suggestions for monitoring and adaptation of medication, and proper patient education. Particular emphasis is placed on compulsory knowledge and skills to prevent adrenal crisis, or at least its fatality. Subsequently, statistics are provided from various studies investigating the actual patients’ knowledge, and its application under physical stress. These studies highlight the requirement for structured education strategies. Consequently, details are provided about recommended educational aspects which are completed by an overview of online information which include excellently intelligible educational videos. In summary, primary adrenal insufficiency seems to be a manageable but under-managed event leading to preventable deaths. Sophisticated education strategies have to be implemented to keep the patient and her/his family in a constant teaching-evaluation-feedback cycle to guarantee for adequate patients’ actions under physical stress.