1 "risk medication". Seven hundred eighty-seven patients (6.5%) had been tested during the 2-year period. There were no differences regarding testing frequency between groups. Concomitant supplements were prescribed to 3,911 patients (32.1%). It was more common to be prescribed supplements when treated with corticosteroids. Vitamin D supplementation was more common among tested patients in all three groups. Women were tested and supplemented to a higher extent. The mean vitamin D level was 69 nmol/L. Vitamin D deficiency was found in 24.1% of tested patients, while 41.3% had optimal levels. It was less common to be deficient and more common to have optimal levels among patients prescribed corticosteroids.CONCLUSION: Adherence to medical guidelines comprising testing and supplementation of patients prescribed drugs causing vitamin D deficiency needs improvement in Sweden." />
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Nordqvist O, Lönnbom Svensson U, Brudin L, et al. Adherence to risk management guidelines for drugs which cause vitamin D deficiency - big data from the Swedish health system. Drug Healthc Patient Saf. 2019;11:19-28doi: 10.2147/DHPS.S188187.
Nordqvist, O., Lönnbom Svensson, U., Brudin, L., Wanby, P., & Carlsson, M. (2019). Adherence to risk management guidelines for drugs which cause vitamin D deficiency - big data from the Swedish health system. Drug, healthcare and patient safety, 1119-28. https://doi.org/10.2147/DHPS.S188187
Nordqvist, Ola, et al. "Adherence to risk management guidelines for drugs which cause vitamin D deficiency - big data from the Swedish health system." Drug, healthcare and patient safety vol. 11 (2019): 19-28. doi: https://doi.org/10.2147/DHPS.S188187
Nordqvist O, Lönnbom Svensson U, Brudin L, Wanby P, Carlsson M. Adherence to risk management guidelines for drugs which cause vitamin D deficiency - big data from the Swedish health system. Drug Healthc Patient Saf. 2019 Mar 22;11:19-28. doi: 10.2147/DHPS.S188187. eCollection 2019. PMID: 30962725; PMCID: PMC6432880.
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Drug Healthc Patient Saf. 2019 Mar 22;11:19-28. doi: 10.2147/DHPS.S188187. eCollection 2019.

Adherence to risk management guidelines for drugs which cause vitamin D deficiency - big data from the Swedish health system.

Drug, healthcare and patient safety

Ola Nordqvist, Ulrika Lönnbom Svensson, Lars Brudin, Pär Wanby, Martin Carlsson

Affiliations

  1. The Pharmaceutical Department, Region Kalmar County, Kalmar, Sweden, [email protected].
  2. eHealth Institute, Data Intensive Sciences and Applications (DISA), Department of Medicine and Optometry, Linnaeus University, Kalmar, Sweden, [email protected].
  3. Department of Chemistry and Biomedical Sciences, Linnaeus University, Kalmar, Sweden.
  4. Department of Clinical Physiology, County Hospital of Kalmar, Kalmar, Sweden.
  5. Department of Medical and Health Sciences, University of Linkoping, Linköping, Sweden.
  6. Section of Endocrinology, Department of Internal Medicine, County Hospital of Kalmar, Kalmar, Sweden.
  7. Department of Clinical Chemistry, County Hospital of Kalmar, Kalmar, Sweden.

PMID: 30962725 PMCID: PMC6432880 DOI: 10.2147/DHPS.S188187

Abstract

PURPOSE: Several medications are known to cause vitamin D deficiency. The aim of this study is to describe vitamin D testing and supplementation in patients using these "risk medications", thereby assessing adherence to medical guidelines.

PATIENTS AND METHODS: A database with electronic health records for the population in a Swedish County (≈240,000 inhabitants) was screened for patients prescribed the pre-defined "risk medications" during a 2-year period (2014-2015). In total, 12,194 patients were prescribed "risk medications" pertaining to one of the three included pharmaceutical groups. Vitamin D testing and concomitant vitamin D supplementation, including differences between the included pharmaceutical groups, was explored by matching personal identification numbers.

RESULTS: Corticosteroids were prescribed to 10,003 of the patients, antiepileptic drugs to 1,101, and drugs mainly reducing vitamin D uptake to 864. Two hundred twenty-six patients were prescribed >1 "risk medication". Seven hundred eighty-seven patients (6.5%) had been tested during the 2-year period. There were no differences regarding testing frequency between groups. Concomitant supplements were prescribed to 3,911 patients (32.1%). It was more common to be prescribed supplements when treated with corticosteroids. Vitamin D supplementation was more common among tested patients in all three groups. Women were tested and supplemented to a higher extent. The mean vitamin D level was 69 nmol/L. Vitamin D deficiency was found in 24.1% of tested patients, while 41.3% had optimal levels. It was less common to be deficient and more common to have optimal levels among patients prescribed corticosteroids.

CONCLUSION: Adherence to medical guidelines comprising testing and supplementation of patients prescribed drugs causing vitamin D deficiency needs improvement in Sweden.

Keywords: big data; drug-induced vitamin D deficiency; electronic health records; medication risk management; precision medicine; vitamin D

Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

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