RT Journal Article
SR Electronic
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
FD British Medical Journal Publishing Group
SP e001484
DO 10.1136/bmjoq-2021-001484
VO 11
IS 1
A1 E Naomi Smith
A1 Siobhan Gee
A1 Gerri O’Brien
A1 Pitchy-Ann Vicente
A1 Rosemary Griffith
A1 Rina Patel
A1 Joshua Stapleton
A1 Emily Finch
A1 Naina Shah
A1 Fiona Gaughran
A1 David Taylor
A1 John Strang
A1 Nicola J Kalk
YR 2022
UL http://bmjopenquality.bmj.com/content/11/1/e001484.abstract
AB 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.