title: Prescribed vitamin D and calcium preparations in patients treated with bone remodelling agents in primary care: a report of a pilot study.
abstract: BACKGROUND
  Recent guidelines recommend that patients receiving treatment for osteoporosis should also receive supplementation with calcium and vitamin D unless they are calcium and vitamin D replete. Given that the majority of elderly patients have inadequate levels of vitamin D and that determining nutritional status is time-consuming and costly, it seems prudent to ensure that the majority of patients aged over 65 and receiving medication for osteoporosis should receive supplementation as a matter of course.
  
  
  OBJECTIVE
  To determine the level of co-prescription of calcium and vitamin D in patients receiving treatment for osteoporosis with bisphosphonates, teriparatide, raloxifene or strontium.
  
  
  METHODS
  A pilot audit of nine general practices covering a population of 61 202.
  
  
  RESULTS
  Overall, 1.1% (n = 662) of patients were receiving treatment for osteoporosis; of those, only 34.1% of patients were co-prescribed calcium or calcium and vitamin D. Levels of co-prescription varied considerably across practices from 74.0% to 12.2%.
  
  
  CONCLUSIONS
  Despite national guidelines, co-prescription of calcium and vitamin D with treatment for osteoporosis remains sub-optimal with considerable variation between practices. Strategies should be adopted to increase physician awareness of widespread vitamin D inadequacy, the rationale for supplementation and poor compliance.
authors.affiliation: Gloucestershire Primary and Community Care Audit Group, Gloucester, UK. jonathan@bayly.org
authors.forename: J R
authors.initials: JR
authors.lastname: Bayly
authors.forename: R D
authors.initials: RD
authors.lastname: Hollands
authors.forename: S E
authors.initials: SE
authors.lastname: Riordan-Jones
authors.forename: S J
authors.initials: SJ
authors.lastname: Yemm
authors.forename: I
authors.initials: I
authors.lastname: Brough-Williams
authors.forename: M
authors.initials: M
authors.lastname: Thatcher
authors.forename: N M
authors.initials: NM
authors.lastname: Woodman
authors.forename: T
authors.initials: T
authors.lastname: Dixon
mesh_terms: D000328:Adult; D000368:Aged; D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002118:Calcium / Q000008:administration & dosage / Q000627:therapeutic use*; D011307:Drug Prescriptions; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000188:drug therapy*; D010821:Physicians, Family; D010865:Pilot Projects; D014807:Vitamin D / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D050071:Bone Density Conservation Agents; D014807:Vitamin D; D002118:Calcium