Interventions for the prevention of adrenal crisis in adults with primary adrenal insufficiency: a systematic review
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
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.
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.
Date Issued
2022-07-01
Date Acceptance
2022-05-10
Citation
European Journal of Endocrinology (EJE), 2022, 187 (1), pp.S1-S20
ISSN
0804-4643
Publisher
Oxford University Press
Start Page
S1
End Page
S20
Journal / Book Title
European Journal of Endocrinology (EJE)
Volume
187
Issue
1
Copyright Statement
© The authors Published by Bioscientifica Ltd This is an open access article distributed under the terms of the Creative Commons CC BY license, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
License URL
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/35536876
Subjects
CARE
DIAGNOSIS
EDUCATION
Endocrinology & Metabolism
HEART-FAILURE
LIFE
Life Sciences & Biomedicine
OBESITY
QUALITY
Science & Technology
SELF-MANAGEMENT
Publication Status
Published
Coverage Spatial
England
Date Publish Online
2022-06-01