QR Code–Linked System Could Improve Adrenal Crisis Management in Addison Disease

When a patient experiences an adrenal crisis associated with Addison disease (primary adrenal failure), hydrocortisone and fluid resuscitation must be given immediately in order to prevent hypotensive shock and death. A recent clinical audit evaluated healthcare professionals’ management of adrenal crisis, and found that there is a clinical need to improve the acute management of this life-threatening condition.

The assessment included 54 healthcare professionals for the first audit, and 21 doctors, 12 nurses, 15 paramedics, and 6 dentists for the second audit. Each participant completed a questionnaire about care, confidence in managing an adrenal crisis, and the feasibility of using a Quick Response (QR) coded bracelet. The QR-coded bracelet, developed by the researchers, was designed to be linked to a website dedicated to patient information on steroid replacement therapy.

“As the medical use of QR codes is in its infancy, we have developed a novel system featuring a QR code printed on bracelets and cards which can be carried by patients with [Addison] disease or other patients on steroid therapy,” the researchers explained. “Our proposed, novel [Addison] Disease Information System (ADIS) uses a web app running on a smart device, linked to a QR-coded bracelet, that provides patients with [Addison] disease comprehensive clinical management advice for their condition.”

During the audits, the researchers found that many healthcare professionals reported a lack of experience in adrenal crisis management, with 37% never having seen and 59% never having managed an adrenal crisis. Additionally, the median confidence score (on a scale in which 1 is low and 7 is high), for managing an adrenal crisis was 5 for doctors, 2 for nurses, 4.5 for paramedics, and 1.5 for dentists.

The assessment of the QR code-linked system revealed that 94% of healthcare professionals found the proposed system to be useful, with 84% reporting they would use it in an acute setting. For healthcare professionals, the median usability score for the QR code-linked system was 6.5 out of 7.

The researchers concluded that their system will likely improve the experience of patients with Addison during acute illness by providing immediate access to clinical guidelines; however, this proposal needs to be validated in further research with a large group of patients.

“The ADIS system can be brought to the attention of health professionals in the emergency department by unwell patients with [Addison] disease or their friends and relatives so they are empowered to receive the correct treatment in a timely manner,” concluded the assessment.