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Determinants of vitamin D supplementation prescription in nursing homes: a survey among general practitioners

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Abstract

Summary

A total of 119 GPs participated to a survey aimed to assess the profile and determinants of vitamin D supplementation prescription in nursing homes. Among the respondent GPs, 65 (54.6 %) systematically prescribe vitamin D to their institutionalized patients and the 54 (45.4 %) others prescribe only sometimes.

Introduction

The aim of this study is to assess the profile and determinants of vitamin D supplementation prescription in nursing homes.

Methods

General practitioners (GPs) having at least one patient in a nursing home in Liège, Belgium, were asked to complete the survey.

Results

A total of 119 GPs participated in the survey. Among the respondent GPs, 65 (54.6 %) systematically prescribe vitamin D to their institutionalized patients and the 54 (45.4 %) others prescribe only sometimes. The main reasons for prescribing vitamin D cited by GPs who do so systematically are as follows: because they believe nursing home residents are mostly deficient in vitamin D status (92.1 %), because they believe that vitamin D supplementation prevents osteoporotic fractures (77.8 %), and because vitamin D supplementation is recommended by various scientific societies (38.1 %). GPs who only prescribe vitamin D supplementation in some patients mainly do so following a diagnosis of osteoporosis (82.4 %), on the basis the 25(OH)D level (78.4 %), in the case of history of fracture (54.9 %) or after a recent fracture (43.4 %). Surprisingly, 16 physicians (31.4 %) only prescribe vitamin D when they think of it. Interestingly, while 40.7 % of GPs always prescribe the same dose of vitamin D, the remaining 59.3 % prescribe a dose that will mainly depend on the results of the 25(OH)D level (94.0 %), the patient’s bone health (49.3 %), or history of fracture (43.3 %).

Conclusions

More than half of GPs systematically prescribe vitamin D to their patients living in nursing homes. The other GPs usually prescribe vitamin D following the result of the vitamin D status or after a diagnosis of osteoporosis.

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References

  1. Bruyere O et al (2014) Prevalence of vitamin D inadequacy in European women aged over 80 years. Arch Gerontol Geriatr 59(1):78–82

    Article  CAS  PubMed  Google Scholar 

  2. Holick MF, Chen TC (2008) Vitamin D deficiency: a worldwide problem with health consequences. Am J Clin Nutr 87(4):1080S–1086S

    CAS  PubMed  Google Scholar 

  3. Tang BM et al (2007) Use of calcium or calcium in combination with vitamin D supplementation to prevent fractures and bone loss in people aged 50 years and older: a meta-analysis. Lancet 370(9588):657–666

    Article  CAS  PubMed  Google Scholar 

  4. Bischoff-Ferrari HA et al (2007) Calcium intake and hip fracture risk in men and women: a meta-analysis of prospective cohort studies and randomized controlled trials. Am J Clin Nutr 86(6):1780–1790

    CAS  PubMed  Google Scholar 

  5. Visser M et al (2003) Low vitamin D and high parathyroid hormone levels as determinants of loss of muscle strength and muscle mass (sarcopenia): the Longitudinal Aging Study Amsterdam. J Clin Endocrinol Metabol 88(12):5766–5772

    Article  CAS  Google Scholar 

  6. Bischoff-Ferrari HA et al (2009) Fall prevention with supplemental and active forms of vitamin D: a meta-analysis of randomised controlled trials. BMJ 339:b3692

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Beveridge LA et al (2013) Allopurinol use is associated with greater functional gains in older rehabilitation patients. Age Ageing 42(3):400–404

    Article  PubMed  Google Scholar 

  8. Mosekilde L (2005) Vitamin D and the elderly. Clin Endocrinol (Oxf) 62(3):265–281

    Article  CAS  Google Scholar 

  9. Stein MS et al (1999) Falls relate to vitamin D and parathyroid hormone in an Australian nursing home and hostel. J Am Geriatr Soc 47(10):1195–1201

    Article  CAS  PubMed  Google Scholar 

  10. Cutolo M et al (2007) Vitamin D in rheumatoid arthritis. Autoimmun Rev 7(1):59–64

    Article  CAS  PubMed  Google Scholar 

  11. Autier P, Gandini S (2007) Vitamin D supplementation and total mortality: a meta-analysis of randomized controlled trials. Arch Intern Med 167(16):1730–1737

    Article  CAS  PubMed  Google Scholar 

  12. Bischoff-Ferrari HA et al (2006) Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes. Am J Clin Nutr 84(1):18–28

    CAS  PubMed  Google Scholar 

  13. Cavalier E et al (2009) Vitamin D: current status and perspectives. Clin Chem Lab Med 47(2):120–127

    Article  CAS  PubMed  Google Scholar 

  14. Ginde AA, Liu MC, Camargo CA Jr (2009) Demographic differences and trends of vitamin D insufficiency in the US population, 1988–2004. Arch Intern Med 169(6):626–632

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Bruyere O et al (2014) Effects of vitamin D in the elderly population: current status and perspectives. Arch Public Health 72(1):32

    Article  PubMed  PubMed Central  Google Scholar 

  16. Botros, R.M., et al., Vitamin D deficiency among healthy Egyptian females. Endocrinol Nutr, 2015

  17. O’Dowd KJ et al (1993) Exogenous calciferol (vitamin D) and vitamin D endocrine status among elderly nursing home residents in the New York City area. J Am Geriatr Soc 41(4):414–421

    Article  PubMed  Google Scholar 

  18. McMurtry CT et al (1992) Mild vitamin D deficiency and secondary hyperparathyroidism in nursing home patients receiving adequate dietary vitamin D. J Am Geriatr Soc 40(4):343–347

    Article  CAS  PubMed  Google Scholar 

  19. Toss G et al (1980) Vitamin D deficiency in welfare institutions for the aged. Acta Med Scand 208(1–2):87–89

    CAS  PubMed  Google Scholar 

  20. Kojima G et al (2013) Prevalence of vitamin D deficiency and association with functional status in newly admitted male veteran nursing home residents. J Am Geriatr Soc 61(11):1953–1957

    Article  PubMed  Google Scholar 

  21. MacLaughlin J, Holick MF (1985) Aging decreases the capacity of human skin to produce vitamin D3. J Clin Invest 76(4):1536–1538

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Beaudart C et al (2014) The effects of vitamin D on skeletal muscle strength, muscle mass, and muscle power: a systematic review and meta-analysis of randomized controlled trials. J Clin Endocrinol Metab 99(11):4336–4345

    Article  CAS  PubMed  Google Scholar 

  23. Silk LN, Greene DA, Baker MK (2015) The effect of calcium or calcium and vitamin D supplementation on bone mineral density in healthy males: a systematic review and meta-analysis., Int J Sport Nutr Exerc Metab

    Google Scholar 

  24. Kalyani RR et al (2010) Vitamin D treatment for the prevention of falls in older adults: systematic review and meta-analysis. J Am Geriatr Soc 58(7):1299–1310

    Article  PubMed  PubMed Central  Google Scholar 

  25. Adami S et al (2011) Guidelines on prevention and treatment of vitamin D deficiency. Italian Society for Osteoporosis, Mineral Metabolism and Bone Diseases (SIOMMMS). Reumatismo 63(3):129–147

    Article  CAS  PubMed  Google Scholar 

  26. Morley JE et al (2013) Frailty consensus: a call to action. J Am Med Dir Assoc 14(6):392–397

    Article  PubMed  PubMed Central  Google Scholar 

  27. Cianferotti, L., et al., Changing patterns of prescription in vitamin D supplementation in adults: analysis of a regional dataset. Osteoporos Int, 2015

  28. Bruyere O et al (2009) Highest prevalence of vitamin D inadequacy in institutionalized women compared with noninstitutionalized women: a case-control study. Womens Health (Lond Engl) 5(1):49–54

    Article  Google Scholar 

  29. Caillet P et al (2013) Vitamin D supplementation in a healthy, middle-aged population: actual practices based on data from a French comprehensive regional health-care database. Eur J Clin Nutr 67(11):1133–1137

    Article  CAS  PubMed  Google Scholar 

  30. Varenna M et al (2012) Determinants and effects of vitamin D supplementation on serum 25-hydroxy-vitamin D levels in patients with rheumatoid arthritis. Clin Exp Rheumatol 30(5):714–719

    PubMed  Google Scholar 

  31. Breysse C, Guillot P, Berrut G (2015) Study of vitamin D supplementation in people over 65 years in primary care. Geriatr Psychol Neuropsychiatr Vieil 13(2):123–132

    PubMed  Google Scholar 

  32. Sanfelix-Gimeno G et al (2013) Prevalence, determinants, and inappropriateness of calcium supplementation among men and women in a Spanish Mediterranean area: cross-sectional data from the ESOSVAL cohort. J Bone Miner Res 28(11):2286–2294

    Article  CAS  PubMed  Google Scholar 

  33. Rizzoli R et al (2013) Vitamin D supplementation in elderly or postmenopausal women: a 2013 update of the 2008 recommendations from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO). Curr Med Res Opin 29(4):305–313

    Article  CAS  PubMed  Google Scholar 

  34. Constans T, Deschasse G, Chavanne D (2009) Indications and therapeutic use of vitamin D and calcium. Cah Année Gérontol 1:196–200

    Article  Google Scholar 

  35. Veleva BI, Chel VG, Achterberg WP (2014) Efficacy of daily 800 IU vitamin D supplementation in reaching vitamin D sufficiency in nursing home residents: cross-sectional patient file study. BMC Geriatr 14:103

    Article  PubMed  PubMed Central  Google Scholar 

  36. Dawson-Hughes B et al (2010) IOF position statement: vitamin D recommendations for older adults. Osteoporos Int 21(7):1151–1154

    Article  CAS  PubMed  Google Scholar 

  37. JPPD, S., C. M, and F. G, Actualité sur les effets de la vitamine D et l’évaluation du statut vitaminique D. Rev Francoph Labo, 2009: p. 31–39.

  38. Heaney RP et al (2003) Human serum 25-hydroxycholecalciferol response to extended oral dosing with cholecalciferol. Am J Clin Nutr 77(1):204–210

    CAS  PubMed  Google Scholar 

  39. Boonen S et al (2007) Need for additional calcium to reduce the risk of hip fracture with vitamin d supplementation: evidence from a comparative metaanalysis of randomized controlled trials. J Clin Endocrinol Metab 92(4):1415–1423

    Article  CAS  PubMed  Google Scholar 

  40. Bolland MJ et al (2010) Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis. BMJ 341:c3691

    Article  PubMed  PubMed Central  Google Scholar 

  41. Eysenbach G, Wyatt J (2002) Using the Internet for surveys and health research. J Med Internet Res 4(2):E13

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Department of Public health, Epidemiology and health Economics, University of Liège, CHU - Sart Tilman, Bât. B23, Quartier Hôpital, Avenue Hippocrate, 13, 4000, Liège, Belgium

    F. Buckinx, J. Y. Reginster & O. Bruyère

  2. Support Unit in Epidemiology and Biostatistics, University of Liège, Liège, Belgium

    F. Buckinx, J. Y. Reginster & O. Bruyère

  3. Department of Medical Chemistry, CHU of Liège, Liège, Belgium

    E. Cavalier

  4. Geriatric Department, CHU of Liège, Liège, Belgium

    J. Petermans & C. Ricour

  5. “Maison Médicale Oxygène”, Seraing, Belgium

    C. Dardenne

  6. Department of Motricity Sciences, University of Liège, Liège, Belgium

    O. Bruyère

Authors
  1. F. Buckinx
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  2. J. Y. Reginster
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  3. E. Cavalier
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  4. J. Petermans
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  5. C. Ricour
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  6. C. Dardenne
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  7. O. Bruyère
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Corresponding author

Correspondence to F. Buckinx.

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Conflicts of interest

FB, CR, JP, and CD have no competing interest. OB has received grants or fees for research from GlaxoSmithKline, IBSA, Merck Sharp & Dohme, Theramex, Novartis, Pfizer, Rottapharm, Servier, and SMB. EC is consultant for DiaSorin and IDS and has received lecture fees from IDS, DiaSorin, Roche, Abbott, Pfizer, and Amgen. JYR has received consulting fees, paid advisory boards, lecture fees, and/or grant support from Servier, Novartis, Negma, Lilly, Wyeth, Amgen, GlaxoSmithKline, Roche, Merckle, Nycomed, NPS, Theramex, UCB, Merck Sharp, and Dohme, Rottapharm, IBSA, Genevrier, Teijin, Teva, Ebewee Pharma, Zodiac, Analis, Novo-Nordisk, and Bristol Myers Squibb.

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Buckinx, F., Reginster, J.Y., Cavalier, E. et al. Determinants of vitamin D supplementation prescription in nursing homes: a survey among general practitioners. Osteoporos Int 27, 881–886 (2016). https://doi.org/10.1007/s00198-015-3469-3

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  • DOI: https://doi.org/10.1007/s00198-015-3469-3

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