Abstract 32: No-ledge about stress dosing in adrenal insufficiency

Context: Acute adrenal insufficiency has a mortality rate of 0.5/100 patient-years and remains a significant cause of death in patients with adrenal insufficiency. One of the causebeing inadequate stress dosing by the patient. Adequate knowledge of the need for steroid replacement and stress dosing may help prevent such preventable cause of crisis. Objective: To assess the insight and knowledge pertaining to the disease and stress dosing among patients with adrenal insufficiency Methods: All the patients with adrenal insufficiency visiting endocrine OPD at SJMCH during their follow up visit were subjected to answering the questionnaire. All of them had been given steroid alert card, explained about the stress dosing (including administration of hydrocortisone injection) during previous visit. Results: Out of the 88 patients asssed, 50 were males. Only 86.3% were aware that steroid was essential for survival. In-spite of prior explanation, only few were aware of the situations in which dose of steroid needs to be increased as in- moderate fever (66%), vomiting (41%), and loose stools (27.3%). 13.6% of patients failed to increase the dose of steroid during stress. Conclusion: Despite adequate explanation regarding the disease and stress dosing, significant percentage of the patients were unable to recollect the same, necessitating the need to educate the patients at every follow up visit and reiterate the knowledge, to prevent the preventable cause of adrenal crisis.