Vitamin D intervention by pharmacists in geriatric outpatients.
OBJECTIVE
To develop a pharmacist-provided educational intervention that instructs participants to consume 1,200 IU vitamin D daily and to evaluate its effect on serum 25-hydroxyvitamin D (vitamin D) concentrations and self-reported daily vitamin D intake in geriatric outpatients with insufficient vitamin D.


METHODS
Randomized controlled trial.


METHODS
University-affiliated geriatric clinic, December 2005 to May 2006.


METHODS
80 participants aged 65 to 89 years.


METHODS
Participants with insufficient vitamin D (12-31 ng/mL) were randomized to receive either the educational intervention (n = 23) or no intervention (n = 22).


METHODS
Difference in change from baseline to 12 weeks in vitamin D concentrations and self-reported daily vitamin D intake between groups.


RESULTS
At 12 weeks, vitamin D concentrations in the educational intervention group (n = 22) increased from a mean (+/- SD) of 23.5 +/- 5.0 to 30.4 +/- 6.3 ng/mL. Vitamin D concentrations in the nonintervention group (n = 21) increased from 22.8 +/- 5.4 to 26.9 +/- 6.2 ng/mL. The difference between the groups at 12 weeks did not reach statistical significance (P = 0.07). However, 12 participants (55%) in the educational intervention group achieved sufficient vitamin D concentrations compared with only 5 participants (24%) in the nonintervention group (P = 0.04). Self-reported daily vitamin D intake increased by a mean of 647 IU/day in the educational intervention group and 67 IU/day in the nonintervention group. The difference in self-reported intake between groups at 12 weeks, controlling for baseline, was significant (P < 0.0001). Serum parathyroid hormone concentrations decreased significantly among those in the intervention group (P = 0.04).


CONCLUSIONS
A pharmacist-developed and -administered vitamin D educational intervention increased the proportion of participants achieving sufficient vitamin D concentrations, increased the self-reported daily vitamin D intake, and lowered serum parathyroid hormone concentrations. However, it did not significantly increase the overall mean serum vitamin D concentration, compared with the control group. A daily recommendation of more than 1,200 IU vitamin D daily is likely necessary to ensure that all geriatric outpatients with insufficient vitamin D concentrations achieve the target of at least 32 ng/mL.
Vande Griend
Joseph P
JP
Department of Clinical Pharmacy, School of Pharmacy, University of Colorado-Denver, Aurora, CO 80045, USA. joseph.vandegriend@ucdenver.edu
Linnebur
Sunny A
SA
Ruscin
J Mark
JM
Vondracek
Sheryl F
SF
Wolfe
Pamela
P
McDermott
Michael T
MT
D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010281:Parathyroid Hormone / Q000097:blood; D010353:Patient Education as Topic; D010593:Pharmaceutical Services / Q000458:organization & administration; D010595:Pharmacists; D024382:Professional Role; D012646:Self Administration; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood / Q000627:therapeutic use; D014815:Vitamins / Q000627:therapeutic use*
D010281:Parathyroid Hormone; D014815:Vitamins; D014807:Vitamin D; C104450:25-hydroxyvitamin D