The role of nurses in supporting self-management for patients with hypopituitarism

Abstract Pituitary conditions are associated with several physical, psychological, and social symptoms. Most patients with pituitary conditions have permanent hypopituitarism (congenital or acquired) and require lifelong hormone replacement therapy. Polypharmacy with complex treatment regimens, varied modalities and/or multiple daily dosing adds to the complexity of managing hypopituitarism. Nonadherence, treatment discontinuation and low persistence are often common for patients on pituitary replacement therapy. Medication-taking behavior is complex, and at times not exclusively the responsibility or within the control of the patient. Self-management skills and person-centered care are crucial for patients to optimize their hormone replacement therapy, to improve their well-being and quality of life, and to minimize adverse effects associated with hormone deficiency or overreplacement. Nurses with specialist skills in Endocrinology working at an advanced practice level are key players in the pituitary multidisciplinary team to support patients’ self-management and treatment optimization. Endocrine nurses have a leading role in patient education and in the development and delivery of evidence-based and structured patient education programs. This chapter discusses how endocrine nurses use their advanced practice skills to support self-management and treatment optimization for patients with hypopituitarism. Approaches and strategies for patient education and adherence to treatment are also discussed with a focus on the nursing role. Each section is illustrated with patient case scenarios and good clinical practice examples.