Glucocorticoid therapy for adrenal insufficiency: nonadherence, concerns and dissatisfaction with information
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Summary: Objective: Appropriate self‐management of glucocorticoid therapy (GC) is crucial for patients with adrenal insufficiency (AI). We aimed to describe patients’ self‐reported nonadherence to GC, evaluate perceived doubts about need for GC, concerns about adverse effects, and dissatisfaction with information received about GC. Design: Cross‐sectional survey. Patients: Patients prescribed GC for AI (n = 81) from five European countries. Measurements: Online survey including the Medication Adherence Report Scale (MARS), Beliefs about Medicines Questionnaire© (BMQ Specific, adapted for AI) and Satisfaction with Information about Medicines Scale© (Prof Rob Horne; SIMS). Results: Most patients (85·2%) reported a degree of nonadherence to GC. The most frequent types of nonadherence concerned changing the timing of GC doses, for example taking a dose later in the day than advised (37·0%). Few patients doubted their personal need for daily GC, but most reported high concerns about GC including potential weight gain (50·6%), osteoporosis (53·6%) and the continuing risk of adrenal crisis (50·6%). Dissatisfaction with information about GC was frequent, with participants particularly dissatisfied with the amount of information they had received about potential problems with GC. People who expressed dissatisfaction with information about GC, and concerns about its adverse effects were also more likely to report nonadherence (P < 0·05). Conclusions: Nonadherence to treatment, concerns about potential adverse effects and dissatisfaction with the information provided about treatment were frequently reported by this European sample of AI patients. Many AI patients may need additional information about their GC and support to address concerns about GC and facilitate adherence.
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In a cross-sectional survey of AI patients, more than 50% were dissatisfied with the level of information they received from their physician about their glucocorticoid medication.
“In a cross-sectional survey of AI patients, Chapman et al. found that more than 50% were dissatisfied with the level of information they received from their physician about their glucocorticoid medication.61”
From Adrenal crisis: prevention and management in adult patients (2019) · cites this paper as [61]
The Method describes a cross-sectional survey of AI patients, and the GC concerns section reports that more than 50% were dissatisfied with information on several specific aspects of their medication, including side effects and interactions. It does not report that more than 50% were dissatisfied with their medication information overall, or identify their physician as the source of that information. Page numbers are unavailable in our copy. (LLM, conf=0.86)
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Horne, R., Chapman, S. C. E., Parham, R., Freemantle, N., Forbes, A., & Cooper, V. (2013) · PLoS ONE · doi:10.1371/journal.pone.0080633 · Cited by 1,174 · see citing works
Self-citationArlt, W., & Allolio, B. (2003) · The Lancet · doi:10.1016/s0140-6736(03)13492-7 · Cited by 819 · see citing works
Charmandari, E., Nicolaides, N. C., & Chrousos, G. P. (2014) · The Lancet · doi:10.1016/s0140-6736(13)61684-0 · Cited by 644 · see citing works
The approach to the adult with newly diagnosed adrenal insufficiency
Arlt, W. (2009) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2009-0032 · Cited by 165 · see citing works
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- Bjornsdottir, S., Sundstrom, A., Blomqvist, P. et al. (2011) Prevalence and incidence of autoimmune addison disease in Sweden -Using two different nationwide registers. Endocrine Reviews Conference: 93rd Annual Meeting and Expo of the Endocrine Society, ENDO; 32(3 Meeting Abstracts).
- van Eck, J.P., Gobbens, R.J., Beukers, J. et al. (2014) Much to be desired in self-management of patients with adrenal insuffi- ciency. International Journal of Nursing Practice. doi: 10.1111/ ijn.12368. · DOI
- Tiemensma, J., Andela, C.D., Pereira, A.M. et al. (2014) Patients with adrenal insufficiency hate their medication: concerns and stronger beliefs about the necessity of hydrocortisone intake are associated with more negative illness perceptions. The Journal of Clinical Endocrinology and Metabolism, 99, 3668-3676.
- Arlt, W. & Allolio, B. (2003) DHEA replacement in adrenal insufficiency. The Journal of Clinical Endocrinology and Metabo- lism, 88, 4001; author reply -2.
- © 2015 The Authors. Clinical Endocrinology Published by John Wiley & Sons Ltd. Clinical Endocrinology (2016), 84, 664-671
- Komninos, J., Kohler, S. & Wass, J. (2011) Epidemiology of Addison's disease in the area of Banbury, Oxfordshire. Society for Endocrinology BES 2011, Birmingham, UK: Endocrine Abstracts, p. P307.
- Clatworthy, J., Bowskill, R., Parham, R. et al. (2009) Under- standing medication non-adherence in bipolar disorders using a Necessity-Concerns Framework. Journal of Affective Disorders, 116, 51-55.
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Rushworth, R. L., Torpy, D. J., & Falhammar, H. (2019) · New England Journal of Medicine · doi:10.1056/nejmra1807486 · Cited by 262 · see citing works
Adrenal crisis: prevention and management in adult patients
Dineen, R., Thompson, C. J., & Sherlock, M. (2019) · Therapeutic Advances in Endocrinology and Metabolism · doi:10.1177/2042018819848218 · Cited by 123 · see citing works
Quinkler, M., Ekman, B., Zhang, P., Isidori, A. M., Murray, R. D., & on behalf of the EU‐AIR Investigators (2018) · Clinical Endocrinology · doi:10.1111/cen.13609 · Cited by 71 · see citing works
Iwasaku, M., Shinzawa, M., Tanaka, S., Kimachi, K., & Kawakami, K. (2017) · BMC Endocrine Disorders · doi:10.1186/s12902-017-0208-0 · Cited by 32 · see citing works
- Authors
- Chapman, S. C. E., Llahana, S., Carroll, P., & Horne, R.
- Affiliations
- UCL School of Pharmacy (GB)
- University College Hospital (GB)
- Guy's and St Thomas' NHS Foundation Trust (GB)
- Corresponding author
- Horne, R.
- Venue
- Clinical Endocrinology
- Publisher
- Wiley
- Published
- 2016-02-15
- Volume
- 84
- Issue
- 5
- Pages
- 664-671
- ISSN
- 0300-0664 (ISSN-L)
- 1365-2265
- OpenAlex
- W2205108875
- Cited by
- 56
- References
- 4
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 8 · 2023: 4 · 2022: 2 · 2021: 2 · 2020: 6 · 2019: 12 · 2018: 6 · 2017: 7 · 2016: 3
- FWCI
- 4.63
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Clinical Endocrinology (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- City Research Online (City University London) (acceptedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- Viropharma
- National Institute on Handicapped Research
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacy and Medical Practices
- Keywords
- adrenal insufficiency, glucocorticoid therapy, medication adherence, medication beliefs, adrenal crisis, self-management, timing of drug administration
- MeSH terms
- Adrenal Insufficiency, Adult, Cross-Sectional Studies, Europe, Female, Glucocorticoids, Humans, Male, Middle Aged, Osteoporosis, Surveys and Questionnaires, Weight Gain, Chi-Square Distribution, Drug Monitoring, Patient Satisfaction, Outcome Assessment, Health Care, Internet
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