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Need for hydrocortisone linked to negative disease perception among adrenal-insufficient patients
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In patients with adrenal insufficiency, strong beliefs about the necessity of hydrocortisone replacement and concerns about its adverse effects are associated with a more negative perception of adrenal insufficiency, according to recent findings.
In the cross-sectional study, 107 patients being treated for adrenal insufficiency (AI) at Leiden University Medical Center in the Netherlands, were invited to fill out two questionnaires, the Beliefs About Medicines Questionnaire and the Illness Perception Questionnaire-Revised. The patients included in the study were on a regimen of hydrocortisone replacement either for Addison’s disease (n=49), followed treatment for Cushing’s syndrome (n=29) or nonfunctioning pituitary adenomas (n=29). Patients were followed at the outpatient facility of the medical center and were monitored for disease recurrence.
The researchers found that patients who had stronger beliefs about the necessity of hydrocortisone to stay healthy and greater concerns its adverse effects had a greater likelihood of the following: ascribing symptoms to AI, the perceiving of AI being more cyclical, perceiving AI as having more negative outcomes and having more intense emotional portrayals of the disease (P<.05).
Moreover, the investigators found that more unwavering beliefs about the need for hydrocortisone intake were linked to a feeling of less personal control over AI (P<.05). Greater concerns about hydrocortisone adverse effects were also correlated with less perceived treatment control and lower illness coherence (both P<.05).
The researchers also found that patients with Cushing’s syndrome had stronger beliefs about hydrocortisone vs. those with Addison’s disease (P=.039) or nonfunctioning pituitary adenoma (P<.001).
According to the researchers, these findings provide insight into some key patient barriers to successful hydrocortisone use.
“The result obtained from this study can be used for the improvement of discussing patient views about [hydrocortisone] use and for the adaption of a self-management intervention aiming to improve [quality of life] in patients treated with hydrocortisone replacement,” the researchers wrote.
Disclosure: The researchers report no relevant financial disclosures.
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