Identifying Knowledge Gaps in Individuals With Primary Adrenal Insufficiency: A Critical Step in Preventing Adrenal Crisis
Authors' conclusion
This is the first study to compare knowledge of adrenal crisis prevention in individuals with PAI across two countries with distinct healthcare services, highlighting significant knowledge gaps in both cohorts, particularly in the SA cohort. Targeted education and support group engagement are needed to address knowledge gaps and reduce adrenal crisis incidence.
Study context
- Population
- Individuals with primary adrenal insufficiency (PAI) on glucocorticoid replacement therapy in South Africa (SA) and the United Kingdom (UK)
- Participants
- 286 individuals
- Exposure
- UK vs SA cohort
- UKn = 239
- SAn = 47reference
- Outcome
- Knowledge of glucocorticoid stress dosing and adrenal crisis prevention
Methodological detailsresearcher-administered telephone survey (SA), online questionnaire (UK)
- Researcher-administered telephone survey (SA)
- Online questionnaire (UK)
Main finding
As reported in the abstract
Knowledge score (% correct)
P < 0.001
- Correct answers across both cohorts: infection
- 72%
- Correct answers across both cohorts: vomiting
- 54%
- Correct answers across both cohorts: fever
- 52%
- Correct answers across both cohorts: emotional stress
- 40%
Observational data: associations, not effects.
Further findings
Adrenal crisis in past year
- Prior adrenal crisis correlated with higher knowledge scores
- P = 0.049
- Nearly a third reported ≥1 adrenal crisis
Vulnerability score vs adrenal crisis frequency (SA cohort)
- Positive correlation, r
- 0.382
- P
- P = 0.008
Original publication
Identifying Knowledge Gaps in Individuals With Primary Adrenal Insufficiency: A Critical Step in Preventing Adrenal Crisis. Clin Endocrinol (Oxf). Published 22 July 2025. doi:10.
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