Schedule Follow-Up Visits Based on Age: Annual for Adults/Children, Every 3-4 Months for Infants
STEP 1 — Gather Information
Collect patient age, confirmed PAI diagnosis, and current clinical status (symptoms, growth parameters, recent illnesses).
Action: Proceed to age‑based classification.
STEP 2 — Rule In / Rule Out
Is the patient an infant (<12 months of age)?
- Yes → infant pathway
- No → adult/child pathway
Action: If infant (<12 months), go to Step 3 for infant schedule; otherwise, go to Step 3 for adult/child schedule.
STEP 3 — Classify or Stratify
For infants: recommend follow‑up every 3–4 months.
For adults and children: recommend follow‑up at least annually.
Action: Assign follow‑up interval: every 3–4 months for infants; annually for adults and children.
STEP 4 — Decide
Schedule the next visit according to the determined interval and document the plan in the patient’s care plan.
Action: Schedule the next visit accordingly and document in the patient’s care plan.
Clinical Guardrails / Mimics / Pitfalls
- Do not apply the same interval to all age groups; infants require more frequent assessment.
- Avoid delaying infant visits beyond 4 months, as growth and adrenal crisis risk change rapidly.
- Do not rely solely on patient‑reported symptoms; objective assessment (weight, blood pressure, developmental milestones) is essential.
- Ensure visits are conducted by an endocrinologist or provider with endocrine expertise.
- Do not skip scheduled visits during intercurrent illness without adjusting the plan; illness may necessitate earlier evaluation.
Concrete Clinical Example
A 6‑month‑old infant with newly diagnosed PAI is seen in clinic; per guideline, the next endocrine follow‑up is scheduled in 3 months. A 10‑year‑old child with stable PAI receives an annual visit schedule.
Source: Diagnosis and Treatment of Primary Adrenal Insufficiency: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2016, DOI:10.1210/jc.2015-1710
TODO: consider adding scripts/calc.py for the enda-follow-up-visits-age-based calculator