Observational studyFrontiers in endocrinology2025
Patient and caregiver experiences with hydrocortisone injections in adrenal crisis: a mixed-methods cross-sectional study.
Observational study in Frontiers in endocrinology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Group education improves self-management of adrenal insufficiency in patients and their relative.Endocrine connections · 2026Article
- A structured approach to address variability in the global management of adrenal insufficiency in Duchenne muscular dystrophy: the 2025 PJ Nicholoff steroid protocol.Frontiers in neurology · 2026Review
- Perceptions of CAH self-management and stress dosing in relation to health-related quality of life as measured by CAHQL.Frontiers in endocrinology · 2026Article
- Identifying Knowledge Gaps in Individuals With Primary Adrenal Insufficiency: A Critical Step in Preventing Adrenal Crisis.Clinical endocrinology · 2025Article
- Factors influencing self-management of adrenal crisis in patients with adrenal insufficiency: a qualitative study.Endocrine connections · 2025Article
Corrections and comments
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Authors and funding
5 authors.
Funding
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Abstract
Background: Adrenal crisis is the leading cause of death in patients with adrenal insufficiency, and prevention requires immediate parenteral hydrocortisone administration. However, most patients do not receive their home emergency hydrocortisone injection. Our study aimed to investigate barriers and enablers to using emergency hydrocortisone injections in managing adrenal crises. Methods: This mixed-methods observational study utilized an online survey distributed through two U.S.-based patient advocacy groups. A total of 688 respondents completed the survey, including 485 (70%) parents/caregivers of individuals with adrenal insufficiency and 203 (30%) adults with adrenal insufficiency. Qualitative free-text responses were analyzed using thematic content analysis, with subsequent quantification of identified barriers and enablers to administering parenteral hydrocortisone during adrenal crises. Results: Over 60% of patients with adrenal insufficiency had required parenteral hydrocortisone for an adrenal crisis, yet fewer than 20% managed to self-inject. Thirteen barriers and nine enablers were identified across three thematic domains: Conclusion: Effective adrenal crisis management requires comprehensive, evidence-based interventions across patient, healthcare, and societal levels. This should include the development of user-friendly hydrocortisone delivery devices, individualized patient education, healthcare system reforms, and public awareness.
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