title: Vitamin d deficiency/insufficiency practice patterns in a veterans health administration long-term care population: a retrospective analysis.
abstract: OBJECTIVE
  To evaluate the prevalence of vitamin D deficiency/insufficiency in long-term care patients at a Veterans Health Administration (VHA) hospital and to assess treatment and follow-up of low vitamin D levels.
  
  
  METHODS
  Observational cohort study.
  
  
  METHODS
  VA hospital extended care center (ECC).
  
  
  METHODS
  2218 ECC patients between January 2001 and December 2006 were screened.
  
  
  METHODS
  Serum 25-hydroxyvitamin D (25[OH]D) level, vitamin D therapy regimen, time to follow-up, documented adverse event to vitamin D therapy.
  
  
  RESULTS
  Of 2218 patients admitted to the ECC during the study period, 229 (10%) had a vitamin D level measured. Among these 229 patients, 49% were vitamin D sufficient (25[OH]D > or =30 ng/mL), 14% were insufficient (25[OH]D=21-29 ng/mL), and 37% were deficient (25[OH]D < or =20 ng/mL). Sixty-nine percent of patients with low vitamin D levels received some form of vitamin D therapy, whereas 43% received treatment as well as follow-up evaluation of vitamin D status within 3 months. Only 13% received a formulation of vitamin D appropriate for the severity of their deficiency/insufficiency with concurrent calcium supplementation and had a repeat vitamin D level within 3 months.
  
  
  CONCLUSIONS
  Vitamin D levels were measured infrequently in long-term care patients. Among those monitored, the rate of vitamin D deficiency/insufficiency is high. Few patients with low vitamin D status received proper treatment and follow-up. These data support the need to educate physicians regarding the high prevalence of vitamin D insufficiency/deficiency among long-term care patients to ensure that patients with low vitamin D levels are identified and treated appropriately.
authors.affiliation: Edward Hines, Jr. VA Hospital, Hines, IL, USA. kathryn.kuhn@va.gov
authors.forename: Kathryn K
authors.initials: KK
authors.lastname: Braddy
authors.forename: Syed N
authors.initials: SN
authors.lastname: Imam
authors.forename: Kavita R
authors.initials: KR
authors.lastname: Palla
authors.forename: Todd A
authors.initials: TA
authors.lastname: Lee
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D019587:Dietary Supplements; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006707:Homes for the Aged; D006787:Hospitals, Veterans; D006801:Humans; D008134:Long-Term Care / Q000592:standards / Q000639:trends; D008297:Male; D009735:Nursing Homes; D015995:Prevalence; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014807:Vitamin D / Q000097:blood / Q000627:therapeutic use*; D014808:Vitamin D Deficiency / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology*
chemical_list: D014807:Vitamin D