Prevention of adrenal crisis has been the focus of care for individuals with primary and secondary adrenal insufficiency. The key to prevention is through patient and health professional education. Recognition of impending adrenal crisis is often missed as patients may appear clinically stable initially and health professionals are not aware that they can deteriorate rapidly. We developed a “parachute” concept called “Parachutes to Prevention” as a tool to better illustrate in pictorial form the elements considered critical in the prevention and treatment of acute adrenal insufficiency. This was presented at the Sydney Chapter of the Australian Addison’s Disease Association (AADA) annual meeting recently and a survey of the efficacy of the tool pre- and post- presentation was conducted.
Twenty-five participants completed a questionnaire. Twenty one (84%) were female with a mean age of 48.3yrs and average duration of adrenal insufficiency (since diagnosis) of 5.6yrs. All participants spoke English at home. This was the first Addison’s Awareness meeting for 40% of the respondents.
Participants were asked several questions around their management of sick days. They were then given a 20-minute presentation using the “Parachutes to Prevention” tool. Following this, a repeat questionnaire demonstrated a significant increase in the number of safety measures that individuals could nominate for themselves, with a median increase of 5 additional preventative measures. Furthermore, they were able to individualise their own set of parachutes.
This tool was also used recently at Emergency Department nurses’ education sessions and resulted in strongly positive feedback from paramedical staff who indicated that these simple, yet clear, images were imprinted in their memory.
Given the success of the initial education sessions with this tool, we are now working with the Sydney AADA group to further develop the “Parachutes to Prevention” concept. This includes its application within the high risk non-english speaking group.