Vitamin D Deficiency in Aged‐Care Facilities: Prescribing Support through Residential Medication Management Reviews

Abstract

ABSTRACTBackgroundVitamin D deficiency is common in residents in aged‐care facilities, contributing to muscle and bone weakness, falls and fractures. Although supplementation is recommended by guidelines for the treatment and prevention of vitamin D deficiency, implementation remains a challenge.AimTo improve vitamin D supplementation in an aged‐care facility in a rural Australian town.MethodAn audit of vitamin D supplementation and serum 25‐hydroxyvitamin D (25‐OHD) levels was conducted by the pharmacist providing residential medication management review services and the results were reported to attending general practitioners (GPs).Results21% of residents were prescribed vitamin D. Serum 25‐OHD levels were available for 8 residents and indicated deficiency/insufficiency for 7. This information was reported to attending GPs with an offer to identify other residents who would benefit from vitamin D supplementation. 41 residents were identified solely on clinical criteria such as falls risk, malabsorption, malnutrition, osteoporosis and fracture risk, inadequate exposure to sunlight and medication use. These residents were referred to the GPs for assessment without an expressed recommendation to measure 25‐OHD levels. Within 40 days of the dissemination of the audit results, 33 residents were started on vitamin D supplements, increasing the level of supplementation at the facility from 21% to 65%. This level of supplementation was maintained without further pharmacist intervention for 9 months.ConclusionAn audit of vitamin D prescribing and subsequent GP‐pharmacist collaboration is an effective way of increasing vitamin D supplementation in aged‐care facilities.