Prescribed vitamin D and calcium preparations in patients treated with bone remodelling agents in primary care: a report of a pilot study.
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.
Bayly
J R
JR
Gloucestershire Primary and Community Care Audit Group, Gloucester, UK. jonathan@bayly.org
Hollands
R D
RD
Riordan-Jones
S E
SE
Yemm
S J
SJ
Brough-Williams
I
I
Thatcher
M
M
Woodman
N M
NM
Dixon
T
T
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*
D050071:Bone Density Conservation Agents; D014807:Vitamin D; D002118:Calcium