Management of Primary Adrenal Insufficiency: Review of Current Clinical Practice in a Developed and a Developing Country

Treatment of primary adrenal insufficiency (PAI) requires lifelong hormone replacement with glucocorticoids (GCs) and mineralocorticoids. Impaired quality of life and increased standardized mortality ratio in these patients emphasize the importance of tailoring therapy to individual needs. Role of e...

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Autores principales: Khan, Uzma, Lakhani, Om J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5628554/
https://www.ncbi.nlm.nih.gov/pubmed/28989892
http://dx.doi.org/10.4103/ijem.IJEM_193_17
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author Khan, Uzma
Lakhani, Om J.
author_facet Khan, Uzma
Lakhani, Om J.
author_sort Khan, Uzma
collection PubMed
description Treatment of primary adrenal insufficiency (PAI) requires lifelong hormone replacement with glucocorticoids (GCs) and mineralocorticoids. Impaired quality of life and increased standardized mortality ratio in these patients emphasize the importance of tailoring therapy to individual needs. Role of education is paramount in improving patient compliance and in anticipating and preventing adrenal crises. Although discovery of synthetic GCs was a major breakthrough in treatment of patients with this life-threatening condition, management of PAI continues to be challenging. The obstacles for clinicians appear to vary widely across the globe. While optimization and individualization of therapy after diagnosis of PAI remain the main challenges for clinicians in the developed world, doctors in a developing country face problems at almost every stage from the diagnosis to the treatment and follow-up of these patients; cost of therapy, lack of resources, and funding are the main hindrances. Adherence to therapy and patient education are found to be common issues in most parts of the world. This commentary highlights the challenges from both developed and developing country's perspective in treating PAI; it also provides an update on current management scenario and future treatment options.
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spelling pubmed-56285542017-10-06 Management of Primary Adrenal Insufficiency: Review of Current Clinical Practice in a Developed and a Developing Country Khan, Uzma Lakhani, Om J. Indian J Endocrinol Metab Brief Communication Treatment of primary adrenal insufficiency (PAI) requires lifelong hormone replacement with glucocorticoids (GCs) and mineralocorticoids. Impaired quality of life and increased standardized mortality ratio in these patients emphasize the importance of tailoring therapy to individual needs. Role of education is paramount in improving patient compliance and in anticipating and preventing adrenal crises. Although discovery of synthetic GCs was a major breakthrough in treatment of patients with this life-threatening condition, management of PAI continues to be challenging. The obstacles for clinicians appear to vary widely across the globe. While optimization and individualization of therapy after diagnosis of PAI remain the main challenges for clinicians in the developed world, doctors in a developing country face problems at almost every stage from the diagnosis to the treatment and follow-up of these patients; cost of therapy, lack of resources, and funding are the main hindrances. Adherence to therapy and patient education are found to be common issues in most parts of the world. This commentary highlights the challenges from both developed and developing country's perspective in treating PAI; it also provides an update on current management scenario and future treatment options. Medknow Publications & Media Pvt Ltd 2017 /pmc/articles/PMC5628554/ /pubmed/28989892 http://dx.doi.org/10.4103/ijem.IJEM_193_17 Text en Copyright: © 2017 Indian Journal of Endocrinology and Metabolism http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Brief Communication
Khan, Uzma
Lakhani, Om J.
Management of Primary Adrenal Insufficiency: Review of Current Clinical Practice in a Developed and a Developing Country
title Management of Primary Adrenal Insufficiency: Review of Current Clinical Practice in a Developed and a Developing Country
title_full Management of Primary Adrenal Insufficiency: Review of Current Clinical Practice in a Developed and a Developing Country
title_fullStr Management of Primary Adrenal Insufficiency: Review of Current Clinical Practice in a Developed and a Developing Country
title_full_unstemmed Management of Primary Adrenal Insufficiency: Review of Current Clinical Practice in a Developed and a Developing Country
title_short Management of Primary Adrenal Insufficiency: Review of Current Clinical Practice in a Developed and a Developing Country
title_sort management of primary adrenal insufficiency: review of current clinical practice in a developed and a developing country
topic Brief Communication
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5628554/
https://www.ncbi.nlm.nih.gov/pubmed/28989892
http://dx.doi.org/10.4103/ijem.IJEM_193_17
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