title: Impact of vitamin D supplementation on health-care use in a 25-hydroxyvitamin D-tested population in France: a population-based descriptive cohort study.
abstract: OBJECTIVE
  Chronic vitamin D deficiency has been associated in some patients with diffuse musculoskeletal pain. These unspecific symptoms may partly explain why vitamin D deficiency is often diagnosed late. Our aim was to analyse health-care claims after vitamin D supplementation in patients likely to have vitamin D deficiency.
  
  
  METHODS
  Ambulatory health-care claims were compared before and after a vitamin D supplementation prescribed following a 25-hydroxyvitamin D assay.
  
  
  METHODS
  Health Insurance Fund (FHIF) database of the Rhône-Alpes area, France.
  
  
  METHODS
  Among patients reimbursed for a 25-hydroxyvitamin D assay between 1 December 2008 and 31 January 2009, those supplemented with vitamin D after the assay were matched on the date of assay to patients who did not receive vitamin D.
  
  
  RESULTS
  Among the 3023 patients who had a 25-hydroxyvitamin D assay, 935 were consequently supplemented and matched to 935 patients not supplemented. Their median age was 50·0 and 49·5 years, respectively. Patients supplemented decreased their muscle relaxant consumption whereas no change was observed in the reference group, the difference between the two groups was significant (P=0·03). Second and third Pain Relief Ladder prescriptions decreased in both groups but not significantly differently between groups (P=0·58). There was a decrease in prescriptions of biological examination in both groups with no significant difference.
  
  
  CONCLUSIONS
  Besides a decrease in muscle relaxant prescriptions in the supplemented group, it was difficult to assess the impact of vitamin D supplementation in patients likely to have vitamin D deficiency. Prospective cohort studies and randomized trials are needed to assess the efficiency of screening and supplementing vitamin D deficiency.
authors.affiliation: 1Hospices Civils de Lyon,Pôle Information Médicale Evaluation,Recherche,Clinical Epidemiology Group,Lyon,F-69003 France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Caillet
authors.affiliation: 4University of Toronto,Department of Physical Therapy,Toronto,Ontario,Canada.
authors.forename: Susan B
authors.initials: SB
authors.lastname: Jaglal
authors.affiliation: 2Lyon 1 University, Faculty of Medicine,Lyon,France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Laforest
authors.affiliation: 2Lyon 1 University, Faculty of Medicine,Lyon,France.
authors.forename: Roland
authors.initials: R
authors.lastname: Chapurlat
authors.affiliation: 2Lyon 1 University, Faculty of Medicine,Lyon,France.
authors.forename: Muriel
authors.initials: M
authors.lastname: Rabilloud
authors.affiliation: 10Hospices Civils de Lyon,Geriatric Hospital Group,Francheville,France.
authors.forename: Michel
authors.initials: M
authors.lastname: Ducher
authors.affiliation: 1Hospices Civils de Lyon,Pôle Information Médicale Evaluation,Recherche,Clinical Epidemiology Group,Lyon,F-69003 France.
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Schott
mesh_terms: D015652:25-Hydroxyvitamin D 2 / Q000097:blood; D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care; D002112:Calcifediol / Q000097:blood; D015331:Cohort Studies; D057210:Delayed Diagnosis; D019587:Dietary Supplements; D011307:Drug Prescriptions; D005260:Female; D005500:Follow-Up Studies; D005602:France; D006801:Humans; D007348:Insurance, Health; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D009125:Muscle Relaxants, Central / Q000627:therapeutic use; D059352:Musculoskeletal Pain / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control*; D014807:Vitamin D / Q000627:therapeutic use*; D014808:Vitamin D Deficiency / Q000097:blood / Q000175:diagnosis / Q000178:diet therapy* / Q000503:physiopathology; D055815:Young Adult
chemical_list: D009125:Muscle Relaxants, Central; D014807:Vitamin D; D015652:25-Hydroxyvitamin D 2; D002112:Calcifediol
keywords: Adult; Population-based; Vitamin D; Vitamin D deficiency