Inappropriate vitamin D supplementation among multimorbid older patients: a multicountry analysis
Abstract
BACKGROUND: The prevalence of vitamin D supplementation and the percentage of participants with a lack of appropriate vitamin D supplementation ("potential underuse") or potentially inappropriate vitamin D supplementation ("potential overuse") and risk factors for these are currently unclear.
METHODS: Cross-sectional analysis from the OPERAM study, a multicenter cluster randomized controlled trial in four European countries (Belgium, Ireland, The Netherlands, Switzerland) including multimorbid (≥ 3 chronic conditions) older patients, with polypharmacy (≥ 5 chronic medications). For the definition of potential underuse and overuse we used high-risk conditions, which were defined according to the START criteria (version 2) for potential prescribing omissions in older people i.e., E2) long-term systemic corticosteroid therapy, known osteoporosis or osteopenia, E3) previous fragility fractures, and E5) housebound/in nursing homes or experiencing falls. We used mixed effect logistic regression to identify factors associated with underuse and overuse.
RESULTS: 2008 patients (79.4y, SD 6.3, 45% female) were included. 825/2008 (41.1%) were supplemented with vitamin D. We identified 681 participants with potential underuse (33.9% of all participants, 69.7% of non-vitamin D users) and 204 with potential overuse (10.2% of all participants, 24.7% of vitamin D users). In the multivariable logistic regression analysis increasing age and being male were associated with underuse, while the…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 681 participants or records.
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