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

Osteoporos Int. 2016 Mar;27(3):881-886. doi: 10.1007/s00198-015-3469-3. Epub 2016 Jan 5.

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.

Keywords: General practitioners; Nursing homes; Survey; Vitamin D.

MeSH terms

  • Aged
  • Attitude of Health Personnel
  • Belgium
  • Dietary Supplements / statistics & numerical data*
  • Drug Prescriptions / statistics & numerical data
  • Drug Utilization / statistics & numerical data
  • Family Practice / statistics & numerical data*
  • Health Care Surveys
  • Homes for the Aged / statistics & numerical data
  • Humans
  • Nursing Homes / statistics & numerical data*
  • Osteoporosis / drug therapy
  • Physicians, Family / psychology
  • Practice Patterns, Physicians' / statistics & numerical data
  • Vitamin D / administration & dosage*
  • Vitamin D / analogs & derivatives
  • Vitamin D / blood
  • Vitamin D / therapeutic use
  • Vitamin D Deficiency / diagnosis
  • Vitamin D Deficiency / drug therapy*

Substances

  • Vitamin D
  • 25-hydroxyvitamin D