TY - JOUR T1 - Golden opportunity for intervention? Identifying vitamin D deficiency in patients with substance use disorders in hospital JF - BMJ Open Quality JO - BMJ Open Qual DO - 10.1136/bmjoq-2021-001484 VL - 11 IS - 1 SP - e001484 AU - E Naomi Smith AU - Siobhan Gee AU - Gerri O’Brien AU - Pitchy-Ann Vicente AU - Rosemary Griffith AU - Rina Patel AU - Joshua Stapleton AU - Emily Finch AU - Naina Shah AU - Fiona Gaughran AU - David Taylor AU - John Strang AU - Nicola J Kalk Y1 - 2022/02/01 UR - http://bmjopenquality.bmj.com/content/11/1/e001484.abstract N2 - Setting Based at a busy city hospital, the alcohol care team is a drug and alcohol specialist service, taking referrals for a wide range of patients with substance use disorders (SUD).Objectives Patients with SUD are at high risk of vitamin D deficiency; this relates to frequent fractures and proximal myopathy. The coronavirus pandemic brought vitamin D into focus. Local guidelines advise that patients at high risk of vitamin D deficiency are offered replacement. There were no local data on vitamin D deficiency prevalence or any mention of patients with SUD in local vitamin D guidelines. The main aim of this project was to offer vitamin D checks and replacement to all appropriate patients.Results We collected data on 207 patients, [pilot study (n=50) and two subsequent samples (n=95 and n=62)]. Our pilot study showed that no patients were offered vitamin D testing or replacement. We then offered vitamin D checks to 95 patients. Most had low vitamin D (30 patients were vitamin D deficient and 26 were vitamin D insufficient). We provided vitamin D replacement and follow-up advice. Quality improvement was demonstrated 6 months later. We collected data on a further 62 patients who were all on our current or recent caseload. Following exclusions, nearly half (48%) of patients had had a vitamin D check. Almost all of these (95%) had low vitamin D (60% being classified as deficient).Conclusions Patients had not been offered vitamin D replacement despite often having multiple risk factors for vitamin D deficiency. Vitamin D checks (and subsequent replacement) rose in frequency since the outset of this project. Local guidelines should add SUD as a risk factor for vitamin D deficiency. Hospital admission provides a rich opportunity to offer this simple intervention to patients who are often poorly engaged with community services.Data are available upon request. ER -