TY - JOUR
T1 - Interventions for the prevention of adrenal crisis in adults with primary adrenal insufficiency
T2 - a systematic review
AU - Shepherd, Lisa M
AU - Schmidtke, Kelly Ann
AU - Hazlehurst, Jonathan M
AU - Melson, Eka
AU - Dretzke, Janine
AU - Hawks, Noel
AU - Arlt, Wiebeke
AU - Tahrani, Abd A
AU - Swift, Amelia
AU - Carrick-Sen, Debbie M
PY - 2022/6/1
Y1 - 2022/6/1
N2 - Objective: The incidence of adrenal crisis (AC) remains high, particularly for people with primary adrenal insufficiency, despite the introduction of behavioural interventions. The present study aimed to identify and evaluate available evidence of interventions aiming to prevent AC in primary adrenal insufficiency.Design: This study is a systematic review of the literature and theoretical mapping.Methods: MEDLINE, MEDLINE in Process, EMBASE, ERIC, Cochrane CENTRAL, CINAHL, PsycINFO, the Health Management Information Consortium and trial registries were searched from inception to November 2021. Three reviewers independently selected studies and extracted data. Two reviewers appraised the studies for the risk of bias.Results: Seven observational or mixed methods studies were identified where interventions were designed to prevent AC in adrenal insufficiency. Patient education was the focus of all interventions and utilised the same two behaviour change techniques, 'instruction on how to perform a behaviour' and 'pharmacological support'. Barrier and facilitator themes aiding or hindering the intervention included knowledge, behaviour, emotions, skills, social influences and environmental context and resources. Most studies did not measure effectiveness, and assessment of knowledge varied across studies. The study quality was moderate.Conclusion: This is an emerging field with limited studies available. Further research is required in relation to the development and assessment of different behaviour change interventions to prevent AC.
AB - Objective: The incidence of adrenal crisis (AC) remains high, particularly for people with primary adrenal insufficiency, despite the introduction of behavioural interventions. The present study aimed to identify and evaluate available evidence of interventions aiming to prevent AC in primary adrenal insufficiency.Design: This study is a systematic review of the literature and theoretical mapping.Methods: MEDLINE, MEDLINE in Process, EMBASE, ERIC, Cochrane CENTRAL, CINAHL, PsycINFO, the Health Management Information Consortium and trial registries were searched from inception to November 2021. Three reviewers independently selected studies and extracted data. Two reviewers appraised the studies for the risk of bias.Results: Seven observational or mixed methods studies were identified where interventions were designed to prevent AC in adrenal insufficiency. Patient education was the focus of all interventions and utilised the same two behaviour change techniques, 'instruction on how to perform a behaviour' and 'pharmacological support'. Barrier and facilitator themes aiding or hindering the intervention included knowledge, behaviour, emotions, skills, social influences and environmental context and resources. Most studies did not measure effectiveness, and assessment of knowledge varied across studies. The study quality was moderate.Conclusion: This is an emerging field with limited studies available. Further research is required in relation to the development and assessment of different behaviour change interventions to prevent AC.
KW - Addison Disease/prevention & control
KW - Adult
KW - Humans
KW - Patient Education as Topic
UR - http://www.scopus.com/inward/record.url?scp=85131270308&partnerID=8YFLogxK
U2 - 10.1530/EJE-21-1248
DO - 10.1530/EJE-21-1248
M3 - Article
C2 - 35536876
SN - 0804-4643
VL - 187
SP - S1-S20
JO - European Journal of Endocrinology
JF - European Journal of Endocrinology
IS - 1
ER -