Vitamin D insufficiency and deficiency: New Zealand general practitioners' perceptions of risk factors and clinical management.
N Z Med J. 2013 Jun 14;126(1376):49-60.
Reeder AI, Jopson JA, Gray AR.
Preventive and Social Medicine, Dunedin School of Medicine, PO Box 913, Dunedin, New Zealand. tony.reeder at otago.ac.nz.
AIMS: To report perceptions regarding vitamin D sources; risk factors, prevention and management of vitamin D deficiency and insufficiency; supplement prescribing practices; patients' enquiries.
METHODS: A NSW survey instrument was adapted and pre-tested for NZ conditions. Royal NZ College of General Practitioners online weekly newsletter recipients were provided an electronic survey link. The Medical Council emailed an invitation and online survey link to non-respondents. Hard copy questionnaires were posted to remaining non-respondents.
RESULTS: 1089 GPs responded (32% participation). Several sources of information on vitamin D were identified. Sun exposure was considered the main vitamin D source in summer (85%), but in winter (47%) supplements (13%) and food sources were more commonly mentioned. Daily sunlight exposure at low UV times (79%) was identified as the main factor preventing deficiency, followed by high-dose supplements and fortified foods (54% each), winter sun-protection relaxation (48%), daily low-dose supplements (47%), daily sunlight exposure at peak UV times (35%) and relaxation of sun protection, year-round.
Patient characteristics prompting alertness to vitamin D status included
- being housebound or institutionalised (96%),
- wearing concealing clothing (88%),
- past history of bone fractures (87%),
- age over 65 years (84%),
- poor nutrition (71%) and
- current bone disease (69%).
Insufficiency and deficiency were managed primarily through high-dose supplementation and advice to receive more sunlight.
Almost half (47%) had received patient requests for vitamin D testing,
and 40% requests for prescribed vitamin D.
CONCLUSIONS: Study results should help inform possible educational and other interventions to optimise vitamin D and sun-exposure advice.
The abstract fails to mention some other reasons to be concerned about low vitamin D
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