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Vitamin D compliance 3X higher when children with fractures actually knew their low vitamin D level – March 2019

Obtaining Vitamin D Levels in Children With Fractures Improves Supplementation Compliance

Journal of Pediatric Orthopaedics: March 06, 2019 – doi: 10.1097/BPO.0000000000001363
Minkowitz, Barbara, MD*; Nadel, Leah, BA†; McDermott, Meghan, BA†; Cherna, Zachary, BS*; Ristic, Jennifer, PA-C, MMSc*; Chiu, Stephanie, MPH‡ AHS Bone Health Compliance Group


Compliance = take at least 4 out of 7 days
Note: Study did not even consider the increased compliance from

  1. Less frequent dosing
  2. Starting with a loading dose so the benefits can be felt in days instead of months
  3. Recommending that could take missed pills in a single day
    Example - put 30 pills in a cup at the beginning of each month and just be sure that there are none at the end of the month
  4. Not really have to swallow pills - alternately use liquid, powder, topical, inhaled, etc,

 Download the PDF from VitaminDWiki

Background: Obtaining ideal serum 25-vitamin D (25VitD) levels (>30 ng/mL) is imperative in childhood to achieve peak bone mass. Supplementation compliance in children recommended to take vitamin D postfracture was evaluated. The questions we sought to answer were: Is there (1) a compliance difference between patients with known versus unknown 25VitD levels; (2) an association between compliance and age; and (3) an association between fracture severity and initial 25VitD level.

Methods: One physician analyzed compliance in 1818 fracture patients 2 to 18 years (42% female) with known (48%) and unknown 25VitD. Patient/caregiver’s self-reported adherence to supplementation as “yes” (4 d/wk minimum) or “no” defined compliance. Compliance relating to fracture severity via Abbreviated Injury Scale (AIS), 25VitD level, and age, was analyzed.

Results: Patients with 25VitD levels were more compliant than patients without (61%, n=532/872; 21%, n=206/946; P<0.001). In total, 83% (n=104/125) of AIS 3 patients were compliant, compared with 49% (n=628/1292) of AIS 1/2 patients (P<0.001). Compliance increased with age (odds ratio: 1.09, 95% confidence interval: 1.061-1.120, P<0.001).

Conclusions: Compliance increased when 25VitD levels were obtained, improving with fracture severity. Clinicians should order 25VitD levels on fracture patients to improve supplementation compliance.

Level of Evidence: This is a level IV prognostic study which aims to investigate the effects of various patient characteristics on compliance.

Created by admin. Last Modification: Wednesday May 1, 2019 17:00:37 GMT-0000 by admin. (Version 10)

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