School of Medicine, Sydney, The University of Notre Dame Australia, Darlinghurst, NSW, Australia.
Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide, SA, Australia.
Endocrine. 2021 May;72(2):539-545. doi: 10.1007/s12020-020-02595-9. Epub 2021 Mar 11.
Patients with adrenal insufficiency (AI) are at risk of life-threatening illness. Medical jewellery is recommended for emergencies, but its uptake is unknown. This study assessed the use of medical jewellery among Australian AI patients aged 25 years and under.
Data on the age, sex, region, and diagnosis of subscribers to the largest medical jewellery provider in Australia were analysed. Subscription rates were calculated using 2017 Australian population data.
There were 666 patients aged 25 years and under in the database but only 358 (53.8%) had an active (up to date) subscription, corresponding to a subscription rate of 43.67/million or approximately 14.6% of the estimated patient population. The majority (n = 238, 66.5%) had primary AI; followed by secondary AI (n = 82, 22.9%); and the remaining patients (n = 38, 10.6%) could not be classified. Congenital adrenal hyperplasia (CAH) was the most frequent diagnosis (n = 153, 42.7%), corresponding to a subscription rate of 18.67/ million or 28.9% of the estimated number of patients with CAH. The mean age of subscribers was 15.9 (SD = 5.8) years. Only 18 (5%) patients were aged under 5 years. More females (n = 199, 55.9%) than males were active subscribers and subscription rates differed significantly by geographic area. Inactive (lapsed) subscriptions increased with age and were highest in the 20-25 year age group.
Subscription rates were lower than recommended; increased with age; and were more common in females. Older age was associated with higher levels of lapsed subscriptions. Factors leading to low use and discontinuation in young adults should be addressed.
患有肾上腺功能不全（AI）的患者有生命危险。建议在紧急情况下使用医疗首饰，但尚不清楚其使用情况。本研究评估了澳大利亚 25 岁及以下 AI 患者使用医疗首饰的情况。
分析了澳大利亚最大医疗首饰供应商数据库中订阅者的年龄、性别、地区和诊断信息。使用 2017 年澳大利亚人口数据计算订阅率。
数据库中有 666 名 25 岁及以下的患者，但只有 358 名（53.8%）有有效（最新）订阅，对应的订阅率为 43.67/百万人，或约占估计患者人群的 14.6%。大多数患者（n=238，66.5%）患有原发性 AI；其次是继发性 AI（n=82，22.9%）；其余患者（n=38，10.6%）无法分类。先天性肾上腺增生症（CAH）是最常见的诊断（n=153，42.7%），对应的订阅率为 18.67/百万人，或占估计 CAH 患者人数的 28.9%。订阅者的平均年龄为 15.9（SD=5.8）岁。只有 18 名（5%）患者年龄在 5 岁以下。女性（n=199，55.9%）比男性活跃订阅者更多，且订阅率因地理位置而异。不活跃（过期）订阅随年龄增长而增加，20-25 岁年龄组最高。
订阅率低于推荐水平；随年龄增长而增加；在女性中更为常见。年龄较大与更高水平的过期订阅相关。应解决导致年轻成年人使用率低和停用的因素。
