{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T17:30:45Z","timestamp":1761845445070,"version":"3.41.2"},"reference-count":21,"publisher":"The Endocrine Society","issue":"4","license":[{"start":{"date-parts":[[2021,12,9]],"date-time":"2021-12-09T00:00:00Z","timestamp":1639008000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100013200","name":"Government of Alberta","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100013200","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>Adrenal insufficiency (AI) is an uncommon, life-threatening disorder requiring lifelong treatment with steroid therapy and special attention to prevent adrenal crisis. Little is known about the prevalence of AI in Canada or healthcare utilization rates by these patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>We aimed to assess the prevalence and healthcare burden of AI in Alberta, Canada.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This study used a population-based, retrospective administrative health data approach to identify patients with a diagnosis of AI over a 5-year period and evaluated emergency and outpatient healthcare utilization rates, steroid dispense records, and visit reasons.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The period prevalence of AI was 839 per million adults. Patients made an average of 2.3 and 17.8 visits per year in the emergency department and outpatient settings, respectively. This was 3 to 4 times as frequent as the average Albertan, and only 5% were coded as visits for AI. The majority of patients were dispensed glucocorticoid medications only.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The prevalence of AI in Alberta is higher than published data in other locations. The frequency of visits suggests a significant healthcare burden and emphasizes the need for a strong understanding of this condition across all clinical settings. Our most concerning finding is that 94.3% of visits were not labeled with AI, even though many of the top presenting complaints were consistent with adrenal crisis. Several data limitations were discovered that suggest improvements in the standardization of data submission and coding can expand the yield of future studies using this method.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/jendso\/bvab184","type":"journal-article","created":{"date-parts":[[2021,12,10]],"date-time":"2021-12-10T09:35:56Z","timestamp":1639128956000},"source":"Crossref","is-referenced-by-count":2,"title":["Adrenal Insufficiency: Investigating Prevalence and Healthcare Utilization Using Administrative Data"],"prefix":"10.1210","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2716-5721","authenticated-orcid":false,"given":"Sarpreet S","family":"Sekhon","sequence":"first","affiliation":[{"name":"Core Internal Medicine Program, Faculty of Medicine and Dentistry, University of Alberta, AB, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katelynn","family":"Crick","sequence":"additional","affiliation":[{"name":"Office of Lifelong Learning & the Physician Learning Program, Faculty of Medicine and Dentistry, University of Alberta, AB, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tyler W","family":"Myroniuk","sequence":"additional","affiliation":[{"name":"Department of Public Health, School of Health Professions, University of Missouri, Columbia, MO, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin S C","family":"Hamming","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Medicine, University of Saskatchewan, SK, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahua","family":"Ghosh","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Medicine, University of Alberta, AB, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denise","family":"Campbell-Scherer","sequence":"additional","affiliation":[{"name":"Office of Lifelong Learning & the Physician Learning Program, Faculty of Medicine and Dentistry, University of Alberta, AB, Canada"},{"name":"Department of Family Medicine, University of Alberta, AB, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7670-4923","authenticated-orcid":false,"given":"Roseanne O","family":"Yeung","sequence":"additional","affiliation":[{"name":"Office of Lifelong Learning & the Physician Learning Program, Faculty of Medicine and Dentistry, University of Alberta, AB, Canada"},{"name":"Division of Endocrinology and Metabolism, Department of Medicine, University of Alberta, AB, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"80","published-online":{"date-parts":[[2021,12,9]]},"reference":[{"issue":"1","key":"2022032918044696400_CIT0001","doi-asserted-by":"crossref","first-page":"30","DOI":"10.4158\/EP15754.OR","article-title":"Increasing prevalence of Addison disease: results from a nationwide study","volume":"22","author":"Olafsson","year":"2016","journal-title":"Endocr Pract."},{"issue":"6","key":"2022032918044696400_CIT0002","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1046\/j.1365-2265.2002.t01-1-01552.x","article-title":"High prevalence and increasing incidence of Addison\u2019s disease in western Norway","volume":"56","author":"L\u00f8v\u00e5s","year":"2002","journal-title":"Clin Endocrinol (Oxf)."},{"issue":"9935","key":"2022032918044696400_CIT0003","doi-asserted-by":"crossref","first-page":"2152","DOI":"10.1016\/S0140-6736(13)61684-0","article-title":"Adrenal insufficiency","volume":"383","author":"Charmandari","year":"2014","journal-title":"Lancet."},{"issue":"3","key":"2022032918044696400_CIT0004","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1530\/EJE-13-0756","article-title":"Increasing prevalence of Addison\u2019s disease in German females: health insurance data 2008-2012","volume":"170","author":"Meyer","year":"2014","journal-title":"Eur J Endocrinol."},{"issue":"10","key":"2022032918044696400_CIT0005","doi-asserted-by":"crossref","first-page":"dgaa499","DOI":"10.1210\/clinem\/dgaa499","article-title":"Prevalence of opioid-induced adrenal insufficiency in patients taking chronic opioids","volume":"105","author":"Li","year":"2020","journal-title":"J Clin Endocrinol Metab."},{"issue":"5","key":"2022032918044696400_CIT0006","doi-asserted-by":"crossref","first-page":"2009","DOI":"10.1210\/jc.2012-3561","article-title":"Drug prescription patterns in patients with Addison\u2019s disease: a Swedish population-based cohort study","volume":"98","author":"Bj\u00f6rnsdottir","year":"2013","journal-title":"J Clin Endocrinol Metab."},{"key":"2022032918044696400_CIT0007","doi-asserted-by":"crossref","first-page":"164s","DOI":"10.1016\/S0753-3322(00)80036-0","article-title":"Epidemiologic study of adrenal gland disorders in Japan","volume":"54(suppl 1)","author":"Takayanagi","year":"2000","journal-title":"Biomed Pharmacother."},{"issue":"7","key":"2022032918044696400_CIT0008","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.1176\/appi.ps.54.7.1017","article-title":"Using administrative data to analyze the prevalence and distribution of schizophrenic disorders","volume":"54","author":"Goldner","year":"2003","journal-title":"Psychiatr Serv."},{"issue":"8","key":"2022032918044696400_CIT0009","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.3899\/jrheum.130675","article-title":"Estimating disease prevalence and incidence using administrative data: some assembly required","volume":"40","author":"Ward","year":"2013","journal-title":"J Rheumatol."},{"issue":"5","key":"2022032918044696400_CIT0010","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1210\/js.2016-1064","article-title":"Health care burden in patients with adrenal insufficiency","volume":"1","author":"Gunnarsson","year":"2017","journal-title":"J Endocr Soc."},{"issue":"12","key":"2022032918044696400_CIT0011","doi-asserted-by":"crossref","first-page":"4843","DOI":"10.1210\/jc.2016-2221","article-title":"Exploring inpatient hospitalizations and morbidity in patients with adrenal insufficiency","volume":"101","author":"Stewart","year":"2016","journal-title":"J Clin Endocrinol Metab."},{"key":"2022032918044696400_CIT0012","article-title":"Supplementary appendix from adrenal insufficiency: investigating prevalence and healthcare utilization using administrative data (S1)","author":"Sekhon","year":"2022","journal-title":"Figshare."},{"author":"Statistics Canada.","key":"2022032918044696400_CIT0013"},{"author":"Alberta Health Services.","key":"2022032918044696400_CIT0014"},{"issue":"8","key":"2022032918044696400_CIT0015","doi-asserted-by":"crossref","first-page":"935","DOI":"10.1530\/EC-17-0295","article-title":"Adrenal Tumors Study Group of the Portuguese Society of Endocrinology. Primary adrenal insufficiency in adult population: a Portuguese multicentre study by the Adrenal Tumours Study Group","volume":"6","author":"Ferreira","year":"2017","journal-title":"Endocr Connect."},{"issue":"12","key":"2022032918044696400_CIT0016","doi-asserted-by":"crossref","first-page":"4882","DOI":"10.1210\/jc.2009-1368","article-title":"Clinical, immunological, and genetic features of autoimmune primary adrenal insufficiency: observations from a Norwegian registry","volume":"94","author":"Erichsen","year":"2009","journal-title":"J Clin Endocrinol Metab."},{"key":"2022032918044696400_CIT0017","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1186\/1756-0500-7-682","article-title":"Mining rich health data from Canadian physician claims: features and face validity","volume":"7","author":"Cunningham","year":"2014","journal-title":"BMC Res Notes."},{"year":"2020","author":"Canadian Institute for Health Information.","key":"2022032918044696400_CIT0018"},{"issue":"3","key":"2022032918044696400_CIT0019","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1016\/S2213-8587(14)70142-1","article-title":"Diagnosis and management of adrenal insufficiency","volume":"3","author":"Bancos","year":"2015","journal-title":"Lancet Diabetes Endocrinol."},{"issue":"4","key":"2022032918044696400_CIT0020","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1517\/13543784.17.4.497","article-title":"Replacement therapy for Addison\u2019s disease: recent developments","volume":"17","author":"L\u00f8v\u00e5s","year":"2008","journal-title":"Expert Opin Investig Drugs."},{"issue":"5","key":"2022032918044696400_CIT0021","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1007\/s00431-019-03348-1","article-title":"Adrenal crises in children with adrenal insufficiency: epidemiology and risk factors","volume":"178","author":"Eyal","year":"2019","journal-title":"Eur J Pediatr."}],"container-title":["Journal of the Endocrine Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jes\/article-pdf\/6\/4\/bvab184\/43143538\/bvab184.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jes\/article-pdf\/6\/4\/bvab184\/43143538\/bvab184.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,29]],"date-time":"2022-03-29T19:10:51Z","timestamp":1648581051000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jes\/article\/doi\/10.1210\/jendso\/bvab184\/6458461"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,9]]},"references-count":21,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2022,4,1]]}},"URL":"https:\/\/doi.org\/10.1210\/jendso\/bvab184","relation":{},"ISSN":["2472-1972"],"issn-type":[{"type":"electronic","value":"2472-1972"}],"subject":[],"published-other":{"date-parts":[[2022,4,1]]},"published":{"date-parts":[[2021,12,9]]},"article-number":"bvab184"}}