A national survey of Brazilian endocrinologists' practices in educating patients with adrenal insufficiency on stress-induced glucocorticoid adjustments.

Abstract

Objective: To investigate the practices of Brazilian endocrinologists in educating patients with adrenal insufficiency about stress-induced glucocorticoid adjustments.

Methods: This was a cross-sectional online survey carried out with 280 endocrinologists across Brazil. The survey included demographic questions and ten clinical vignettes assessing knowledge of appropriate glucocorticoid adjustments during various stressful situations. All participants provided informed consent, and the study protocol was approved by the local Ethics Committee. Statistical analysis compared responses based on physician demographics and practice settings.

Results: The mean percentage of correct answers was 63.3%. A significant proportion of respondents (41.1%) incorrectly believed that patients should not self-administer intramuscular hydrocortisone during an adrenal crisis. Older physicians tended to provide more conservative (and potentially harmful) glucocorticoid dosing recommendations in certain scenarios. Physicians working in both outpatient and hospital settings demonstrated better knowledge of patient education and emergency glucocorticoid administration.

Conclusion: The results of this study revealed moderate adherence to guidelines among Brazilian endocrinologists regarding adrenal insufficiency management and patient education. There is a need for improved education on glucocorticoid self-administration and targeted interventions to address knowledge gaps across different clinical scenarios. Further research is needed to evaluate the impact of these findings on patient outcomes and develop strategies to optimize the management of adrenal insufficiency in Brazil.