title: Relevance of a "Dear Doctor letter" to alert healthcare providers to new recommendations for vitamin D administration.
abstract: OBJECTIVE
  After reports of malaise in infants immediately after the oral administration of two brands of vitamin D solutions, a "Dear Doctor letter" (DDL) containing recommendations for the administration of vitamin D was sent to all French paediatricians and pharmacies and a large number of French general practitioners (GPs) with a predominantly paediatric practice. The DDL and a press release were published on the French Medicines Agency website and distributed via a mailing list. The objective of this study was to assess the effectiveness of such a DDL and to collect the opinions of healthcare professionals on the best way to provide them with information.
  
  
  METHODS
  A questionnaire was sent to a national random sample of 145 paediatricians, 680 GPs and 230 pharmacists.
  
  
  RESULTS
  Only 49% of responding paediatricians, 48% of GPs and 67% of pharmacists were aware of the warning. Among the participating healthcare professionals aware of the warning and who prescribed/dispensed these vitamins, 50% of paediatricians and 68% of GPs stated that they had changed their prescribing behaviour, and 68% of pharmacists stated that they had modified their advice when dispensing. According to the responding healthcare professionals, postal letters remained the best way to issue safety warnings. Some of the respondents suggested that the DDL be more distinctive in terms of being a DDL and that the information be more widely disseminated to other stakeholders involved in the healthcare system.
  
  
  CONCLUSIONS
  This survey of a national random sample of healthcare professionals revealed that many of the respondents paid little attention to the DDL and were therefore unlikely to change their practices. A potential supplementary method for disseminating recommendations for medicine administration could be to apply stickers on medicine boxes, as this approach has the additional advantage of directly informing the concerned population, i.e. the parents.
authors: INSERM, U657, 33000 Bordeaux, France. helene.theophile@pharmaco.u-bordeaux2.fr
authors: Hélène
authors: H
authors: Théophile
authors: Ghada
authors: G
authors: Miremont-Salamé
authors: Philip
authors: P
authors: Robinson
authors: Nicholas
authors: N
authors: Moore
authors: Bernard
authors: B
authors: Bégaud
authors: Françoise
authors: F
authors: Haramburu
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