Abstract
Eighty-three per cent of patients had suboptimal vitamin D levels at initial test (41% deficient and 42% insufficient). This was seen among established patients and new admissions. Regression analysis of baseline vitamin D levels revealed no differences for levels of security, seasonality, whether patients were taking antipsychotic or anticonvulsant medication, or length of stay. Patients with deficiency or insufficiency were all offered supplementation. Those who opted in had significantly higher vitamin D levels at follow-up, compared with those who declined treatment. Clinical implications Established and newly admitted patients in our secure mental health services had substantial levels of vitamin D insufficiency. In the light of the morbidities that are associated with deficient vitamin D levels, routine screening and the offer of supplementation is advisable. Declaration of interest None.
Highlights
Based on National Health Service guidelines, in January 2013, a decision was made by the clinicians at Northgate Hospital, Northumberland, UK, to routinely screen for vitamin D deficiency and treat as necessary
We were interested in the effect of season of testing, and whether the decision to routinely screen for and treat 25OHD deficiency would lead to improvement in any such deficiencies
These existing patients, who were having blood tests taken as part of their annual health checks over the year, had a serum vitamin D level added to the standard biochemistry request form with no additional venepuncture over and above routine testing
Summary
Seventy-three established patents at Northgate Hospital had baseline 25OHD screening between January 2013 and February 2014 (cohort 1). Between January 2013 and July 2016, a further 27 patients had been admitted to the hospital and received baseline 25OHD screening on admission (cohort 2). The mean 25OHD level of the whole study population was 35.1 nmol/L (s.d. 28.1), and the median was 27.0 nmol/L, representing positively skewed values (Shapiro–Wilk: 0.699, P < 0.001). The regression analysis demonstrated no effect of season or level of security on the vitamin D status of the patient at baseline Table 3). The regression analysis was repeated for log10-transformed 25OHD levels at follow-up testing. As in the baseline data, there were no effects for seasonality, security level, or the prescription of antipsychotic or anticonvulsant medication
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