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Master thesis

Evaluation des pratiques professionnelles concernant la qualité de prise en charge des patients présentant une forme classique d'hyperplasie congénitale des surrénales : Réalisation d'un audit clinique.

Abstract : Objective. High Authority for Health; "HAS" edited in April 2011 a national program of care and diagnostic; ?PNDS? concerning congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency in agreement with the international recommendation 2002 and 2010. To reduce long-term complications and improve the quality of life to our patients, we had tested our professional practices.Patients. All patients aged >18 years with classic CAH of the adult endocrine units in the Nancy's University Hospital Center.Methods. We have made a clinical audit. We checked all medical records to see whether the recommendation were applied or not between the last consultation before (Tour 1; T1) and after (Tour 2; T2) the introduction of the national guidelines.Results. 27 medicals records with classic CAH were analyzed. The collection of clinical data must be more systematic because if the weight appeared in 89 % of cases, body mass index missed (26 % only in T1), the measure of the blood pressure remained insufficient (74 % in T2). Concerning the therapeutic balance, 17-hydroxyprogestérone, testosterone, renin were correctly prescribed (> 80 %), Delta4-androstènedione in improvement (from 67 % to 100 %) some in defect (stable with 68 % sodium and potassium). The evaluation of the fertility considerably progressed on the other hand the markers of bone metabolism were still often too much lacking.Conclusions. Change in compliance since national guidelines is a slow process.
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Master thesis
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https://hal.univ-lorraine.fr/hal-01733688
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Cécile Janin. Evaluation des pratiques professionnelles concernant la qualité de prise en charge des patients présentant une forme classique d'hyperplasie congénitale des surrénales : Réalisation d'un audit clinique.. Sciences du Vivant [q-bio]. 2012. ⟨hal-01733688⟩

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