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Use of medical identification jewellery in children and young adults with adrenal insufficiency in Australia

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Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusion

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.

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Data availability

Data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restriction.

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Acknowledgements

We thank MedicAlert Australia for provision of the data and for their support of the study.

Author information

Authors and Affiliations

  1. School of Medicine, Sydney, The University of Notre Dame Australia, Darlinghurst, NSW, Australia

    Georgina L. Chrisp, Maria Quartararo & R. Louise Rushworth

  2. Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide, SA, Australia

    David J. Torpy

  3. The University of Adelaide, Adelaide, SA, 5000, Australia

    David J. Torpy

  4. Department of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden

    Henrik Falhammar

  5. Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden

    Henrik Falhammar

Authors
  1. Georgina L. Chrisp
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  2. Maria Quartararo
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  3. David J. Torpy
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  4. Henrik Falhammar
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  5. R. Louise Rushworth
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Correspondence to Georgina L. Chrisp.

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The authors declare that they have no conflict of interest.

Ethics approval

Permission to conduct this study was given by the Board of the subscription service and by the Human Research Ethics Committee of the University of Notre Dame, Australia (HREC Reference Number: 018070S).

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Chrisp, G.L., Quartararo, M., Torpy, D.J. et al. Use of medical identification jewellery in children and young adults with adrenal insufficiency in Australia. Endocrine 72, 539–545 (2021). https://doi.org/10.1007/s12020-020-02595-9

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  • DOI: https://doi.org/10.1007/s12020-020-02595-9

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