Guignat, Laurence · Annales d'endocrinologie · 2018 · DOI
This study describes educational programs that help patients with adrenal insufficiency (a condition where the adrenal glands don't make enough hormones) manage their condition safely. The programs teach patients to recognize warning signs of a dangerous crisis, carry emergency medication, adjust their doses for different situations like exercise or travel, and know when to seek medical help. The study notes that similar programs could help people with chronic fatigue syndrome avoid taking too much of their medication.
For ME/CFS patients with concurrent adrenal insufficiency, structured patient education is critical to prevent life-threatening adrenal crises while avoiding medication overuse during periods of exertion or physical stress. The guideline explicitly recognizes the need for dose-adjustment education in the context of chronic fatigue, making it directly relevant to intersecting patient populations who struggle with balancing symptom management and medication safety.
This is a consensus guideline rather than an efficacy trial; it does not empirically demonstrate that educational programs improve patient outcomes or reduce adrenal crisis rates. The study does not establish causal relationships between education and safety, nor does it provide comparative data on different educational approaches. The brief mention of chronic fatigue syndrome is speculative and not based on data presented in this document.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Guignat, Laurence (2018). Therapeutic patient education in adrenal insufficiency.. Annales d'endocrinologie. https://doi.org/10.1016/j.ando.2018.03.002
BibTeX
@article{mecfsatlas-guignat-2018-therapeutic-patient,
author = {Guignat, Laurence},
title = {Therapeutic patient education in adrenal insufficiency.},
journal = {Annales d'endocrinologie},
year = {2018},
doi = {10.1016/j.ando.2018.03.002},
note = {PubMed: 29606279},
url = {https://www.mecfsatlas.com/evidence/guignat-2018-therapeutic-patient},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/guignat-2018-therapeutic-patient
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