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Chandler PD, Giovannucci EL, Williams MA, et al. Vitamin D Deficiency Treatment Patterns in Academic Urban Medical Center. Am J Pharm Benefits. 2014;6(1):e1-e8
Chandler, P. D., Giovannucci, E. L., Williams, M. A., LeBoff, M. S., Bates, D. W., & Hicks, L. S. (2014). Vitamin D Deficiency Treatment Patterns in Academic Urban Medical Center. The American journal of pharmacy benefits, 6(1), e1-e8.
Chandler, Paulette D, et al. "Vitamin D Deficiency Treatment Patterns in Academic Urban Medical Center." The American journal of pharmacy benefits vol. 6,1 (2014): e1-e8.
Chandler PD, Giovannucci EL, Williams MA, LeBoff MS, Bates DW, Hicks LS. Vitamin D Deficiency Treatment Patterns in Academic Urban Medical Center. Am J Pharm Benefits. 2014;6(1):e1-e8. PMID: 25328637; PMCID: PMC4199332.
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Am J Pharm Benefits. 2014;6(1):e1-e8.

Vitamin D Deficiency Treatment Patterns in Academic Urban Medical Center.

The American journal of pharmacy benefits

Paulette D Chandler, Edward L Giovannucci, Michelle A Williams, Meryl S LeBoff, David W Bates, LeRoi S Hicks

Affiliations

  1. Division of General Medicine and Primary Care, Brigham and Women's Hospital, Boston, MA ; Harvard Medical School, Boston, MA.
  2. Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA ; Harvard Medical School, Boston, MA.
  3. Harvard Medical School, Boston, MA ; Harvard School of Public Health, Boston, MA.
  4. Endocrine, Diabetes and Hypertension Division, Brigham and Women's Hospital, Boston, MA ; Harvard Medical School, Boston, MA.
  5. Department of Health Care Policy, Harvard Medical School, Boston, MA ; UMass Memorial Medical Center, University of Massachusetts, Boston, MA.

PMID: 25328637 PMCID: PMC4199332

Abstract

OBJECTIVE: Assess racial/ethnic and sex differences in treatment of vitamin D deficiency with high dose ergocalciferol ('vitamin D2') or other forms of vitamin D in a northeastern U.S. ambulatory clinic of an academic urban medical center.

STUDY DESIGN: Cross-sectional observational review of electronic medication prescribing records of patients with 25-hydroxyvitamin D (25OHD) deficiency (25OHD < 20 ng/ml) from 2004-2008.

METHODS: Using multivariable logistic regression adjusting for patients' demographics, and Elixhauser comorbidity score, we examined the association of sex and race/ethnicity with prescription for at least one dose of vitamin D.

RESULTS: Among 2,140 patients without renal disease and tested for 25OHD deficiency (25OHD < 20 ng/ml), 66.2% received no vitamin D prescription for vitamin D deficiency. Blacks and Hispanics received vitamin D prescriptions at a higher frequency than whites, 37.8% 38.4% and 30.9%, respectively, p=0.003. The vitamin D prescription rate for women versus men was 26.3% and 7.5%, respectively, p=0.04. In a fully adjusted model, no difference in prescription likelihood for blacks and whites [OR=1.18 95% CI, 0.88-1.58; p=0.29] or Hispanics and whites was noted [OR=1.01 95% CI, 0.70-1.45;p=0.73]. Similarly, fully adjusted model showed no difference in prescription likelihood for females and males [OR=1.23 95% CI, 0.93-1.63; p=0.12].

CONCLUSIONS: Among primary care patients with vitamin D deficiency, vitamin D supplementation was low and white patients were less likely to receive vitamin D treatment than blacks or Hispanics. Interventions to correct the high prevalence of vitamin D deficiency should address the markedly low rate of vitamin D prescribing when 25OHD levels are measured.

Keywords: Vitamin D; ambulatory; electronic prescribing

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