Low patient compliance—A major negative factor in achieving vitamin D adequacy in elderly hip fracture patients supplemented with 800 IU of vitamin D 3 daily

Abstract

Achievement of adequate vitamin D 3 level is crucial for the treatment of hip fracture patients. Currently used vitamin D 3 supplementation in Israel ranges between 200 and 800 IU/day. The study objectives were to evaluate the effects of 800 IU/day vitamin D 3 and 1.200 mg of calcium carbonate supplementation to achieve adequate vitamin D 3 level of 30 ng/ml in elderly hip fracture patients. One hundred and twenty-two elderly patients after surgical hip fracture correction aged 73.0 ± 9.5, who were enrolled in a post-surgical treatment program (PSTP). The patients received 800 IU of vitamin D 3 and 1.200 mg of calcium carbonate daily. Serum 25(OH)D and plasma PTH levels were assessed during initial hospital stay and at quarterly follow-up visits for 2 years. At baseline, 120 patients (98.4%) had 25(OH)D serum level <30 ng/ml. Forty-two patients (34.4%) had 25(OH)D serum level <10 ng/ml and these were considered as vitamin D 3 deficient. After 3 months, 29 patients (23.8%) were fully adherent to the supplement, 32 were (26.2%) partially adherent. The dropout rate at 1 year was 55.7%. The major reason for the discontinuation of participation was non-compliance. We conclude that the majority of elderly hip fracture patients had inadequate 25(OH)D serum levels. Compliance with calcium and vitamin D 3 supplements was extremely low. An adequate vitamin D status was not achieved with daily vitamin D 3 supplementation of 800 IU. Supplementation strategies using a periodic single high dose of vitamin D 3 might be more appropriate and should be considered in these patients.