Study finds key factors influencing glucocorticoid therapy adherence in Addison’s disease

Non-adherence to glucocorticoid replacement therapy is common in patients with Addison’s disease (AD) and is significantly associated with poorer health outcomes and quality of life, according to a study.

Improving patients’ knowledge about their disease through therapeutic education is essential to enhance adherence to treatment, particularly among younger patients.

In this cross-sectional study, researchers evaluated 58 patients with AD (mean age of 48.4±13.3 years) for glucocorticoid adherence using the Girerd questionnaire, a specially designed questionnaire to gauge disease knowledge, and the AddiQol questionnaire to measure quality of life. Adherence was deemed poor if patients scored ≤3 negative responses on the Girerd questionnaire.

Overall, 46% of patients were non-adherent to their glucocorticoid therapy. Factors independently associated with non-adherence included being younger than 48 years, poor adherence to treatments for other conditions, higher baseline cortisolemia at diagnosis (>5μg/dl), history of adrenal crisis, limited disease knowledge, lower BMI (<26.7kg/m2), smaller waist circumference (<90cm), low systolic blood pressure, low fasting blood glucose (<0.9g/l), and low triglyceride levels (<1g/l).

The study also identified a positive correlation between the scores of the disease knowledge questionnaire and the Girerd adherence score (P = 0.02, r = 0.31), as well as between the AddiQol quality of life score and the Girerd adherence score (P = 0.01, r = 0.32).

Reference
Yazidi M, Salem MB, Oueslati I, et al. Adherence to glucocorticoid replacement therapy in Addison’s disease: Association with patients’ disease knowledge and quality of life. Endocrinol Diabetes Nutr (Engl Ed). 2023;70(8):532-539. doi: 10.1016/j.endien.2023.10.004. PMID: 38783727.