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Use of Quick Response (QR) coded bracelets and cards for the improvement of cortisol deficiency/Addison’s disease management: an audit of quality of care of the management of steroid deficiency in acute illness


Background An adrenal crisis is a rare but life-threatening condition in which hydrocortisone and fluid resuscitation must be given promptly to prevent hypotensive shock and death. A clinical audit assessed healthcare professionals’ experience of adrenal crisis management and if there was a need for immediate access to clinical guidelines. The proposed system in which a patient-worn Quick Response (QR) coded bracelet provides healthcare professionals with web-based clinical information in acute settings was explored for the management of adrenal crisis.

Methods Fifty-four healthcare professionals, 21 doctors, 12 nurses, 15 paramedics and 6 dentists completed a questionnaire about the care, confidence in managing an adrenal crisis and the feasibility of using a QR-coded bracelet designed and linked to a website dedicated to patient information on steroid replacement therapy we have developed.

Results 37% of healthcare professionals have never seen and 59% have never managed an adrenal crisis. The median confidence score (1—low to 7—high) in managing an adrenal crisis varied for doctors, nurses, paramedics and dentists between 5, 2, 4.5 and 1.5, respectively. 94% of healthcare professionals thought the proposed QR code-linked system was useful and 84% would use it in an acute setting. The median usability score (1—low to 7—high) for the QR code-linked system for healthcare professionals was 6.5 out of 7.

Conclusion There is a clinical need to improve the acute management of adrenal crisis and QR code-linked information was desired by healthcare professionals. QR code-linked information may allow patients with rare diseases presenting acutely to receive improved management through immediate access to treatment protocols.

  • addison’s disease
  • adrenal crisis
  • addisonian crisis
  • cortisol deficiency
  • hydrocortisone
  • QR code
  • treatment protocols
  • web
  • patient information
  • patient education

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