title: Oral cobalamin remains medicine's best kept secret.
abstract: A cross-sectional survey was conducted in order to describe the use of oral cobalamin among geriatricians, hematologists, and general practitioners, and to explore factors related to its use. The study population consisted of all geriatricians (n = 138) and hematologists (n = 317) listed in the Canadian Medical Directory plus a random sample of 307 general practitioners. The overall response rate was 40%. Intramuscular and oral cobalamin was prescribed by 76 and 32% of the respondents, respectively. Twenty seven percent reported using both oral and intramuscular cobalamin and 6% reported using only oral cobalamin. Only 25% of respondents indicated they were aware of a RCT demonstrating the efficacy of oral cobalamin prior to reading a synopsis of the study in the survey. After multivariate adjustment, only the belief that oral cobalamin was effective and certainty about who carried oral preparations remained independently associated with oral cobalamin use. Oral cobalamin has been shown to be an efficacious, cost efficient and safe method of treating cobalamin deficiency. Nonetheless, it is not used by the majority of physicians treating this condition. Strategies to promote the use of oral cobalamin should be directed at educating physicians of its efficacy and providing them with prescribing information on where it can be purchased.
authors: Clinical Epidemiology Program, Ottawa Health Research Institute, Room 2-008, Administrative Services Building, 1053 Carling Ave., Ottawa, Ont., Canada K1Y 4E9. igraham@ohri.ca
authors: Ian D
authors: ID
authors: Graham
authors: Nathalie
authors: N
authors: Jette
authors: Jacqueline
authors: J
authors: Tetroe
authors: Nicole
authors: N
authors: Robinson
authors: Sarah
authors: S
authors: Milne
authors: Susan L
authors: SL
authors: Mitchell