Current practice of glucocorticoid replacement therapy and patient-perceived health outcomes in adrenal insufficiency – a worldwide patient survey
Open accessAbstract
BACKGROUND: The aim was to survey current practice in glucocorticoid replacement therapy and self-perceived health outcomes in patients with adrenal insufficiency. METHODS: Participants were recruited via patient organizations to respond anonymously to a web-based survey developed by clinical experts. Unique entries were set up for each patient organization enabling geographical localization of the entries. RESULTS: 1245 participants responded (primary adrenal insufficiency: 84%; secondary adrenal insufficiency: 11%; unsure: 5%). Therapies included hydrocortisone (75%), prednisone/prednisolone (11%), cortisone acetate (6%) and dexamethasone (4%). Dosing regimens were once daily (10%), twice daily (42%), thrice daily (32%) or other (17%). Compromised subjective health necessitating changes to physical activity or social-, work- or family life was reported by 64% of the participants. 40% of the participants reported absence from work/school in the last 3 months. Irrespective of diagnosis, 76% were concerned about long-term side-effects of therapy, mainly osteoporosis (78%), obesity (64%) and cardiovascular morbidity (46%). 38% of the participants had been hospitalized in the last year. CONCLUSIONS: Glucocorticoid replacement therapy among the respondents consisted primarily of hydrocortisone administered twice or thrice daily. A majority reported impact of their disease or treatment on subjective health requiring alterations in e.g. physical activity or family life. Three quarters reported concerns about long-term side-effects of the treatment. These data demonstrate - from the patients' perspective - a need for improvement in the management of adrenal insufficiency.
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Less-frequent dosing may be associated with better compliance.
“However, outcome studies confirming this hypothesis are lacking, and less-frequent dosing may be associated with better compliance (100).”
From Diagnosis and Treatment of Primary Adrenal Insufficiency: An Endocrine Society Clinical Practice Guideline (2016) · cites this paper as [100]
Prednisolone and prednisone are the most commonly prescribed exogenous glucocorticoids.
“Prednisolone and prednisone are the most commonly prescribed exogenous glucocorticoids (20 ).”
From Serum cortisol: an up-to-date assessment of routine assay performance (2016) · cites this paper as [20]
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Self-citation
- Authors
- Forss, M., Batcheller, G., Skrtic, S., & Johannsson, G.
- Affiliations
- University of Gothenburg (SE)
- Corresponding author
- Forss, M
- Venue
- BMC Endocrine Disorders
- Published
- 2012-06-13
- Volume
- 12
- Issue
- 1
- Pages
- 8-8
- ISSN
- 1472-6823 (ISSN-L)
- PMC
- PMC3403959
- OpenAlex
- W2158270876
- Cited by
- 109
- References
- 28
- Citations by year
- 2026: 2 · 2024: 7 · 2023: 3 · 2022: 3 · 2021: 10 · 2020: 10 · 2019: 10 · 2018: 15 · 2017: 10 · 2016: 15 · 2015: 8 · 2014: 13 · 2013: 3
- FWCI
- 6.16
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Endocrine Disorders (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Keywords
- adrenal insufficiency, glucocorticoid replacement therapy, cortisol, prednisone, cortisone acetate, dexamethasone, dosing regimen, quality of life, absenteeism, osteoporosis, late effects, hospitalization, patient survey
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