title: Programme to provide Quebec infants with free vitamin D supplements failed to encourage participation or adherence.
abstract: OBJECTIVE
  The aim of this study was to evaluate the uptake of a free vitamin D infant prescription programme and to determine the incidence of nutritional rickets.
  
  
  METHODS
  This was a retrospective cohort study of infants from Quebec, Canada, involving term infants born between 1998 and 2008 and covered by the public insurance programme. Data were extracted from the Quebec Pregnancy Cohort. Predictors of programme participation were identified through logistic regression.
  
  
  RESULTS
  A total of 123 018 infants were eligible, and the mean annual prevalence of supplemental vitamin D exposure was 17.9 ± 5.6%. The median age for obtaining the first bottle was 36 days and half only obtained one bottle of 50 doses. Mothers with higher socio-economic status, those who lived as a couple, older mothers or a prescription by a paediatrician significantly increased the odds of obtaining vitamin D. There was a decline in programme participation over time (OR 0.89/year, 95% CI = 0.88-0.90). The incidence of rickets was 23.9 cases per 100 000 live births, with an annual increase of 1.12 cases/year (95% CI = 1.01-1.24).
  
  
  CONCLUSIONS
  Without educational measures, a free prescription programme for vitamin D failed to encourage participation or adherence. Moreover, participation decreased with time. New strategies, including educational support, need to be developed to increase vitamin D supplementation rates.
authors: Department of Pediatrics, Montreal Children's Hospital, Montreal, QC, Canada.
authors: Maude
authors: M
authors: Millette
authors: Atul
authors: A
authors: Sharma
authors: Hope
authors: H
authors: Weiler
authors: Odile
authors: O
authors: Sheehy
authors: Anick
authors: A
authors: Bérard
authors: Celia
authors: C
authors: Rodd
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000706:statistics & numerical data; D019587:Dietary Supplements / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011792:Quebec / Q000453:epidemiology; D012189:Retrospective Studies; D012279:Rickets / Q000453:epidemiology / Q000517:prevention & control*; D014807:Vitamin D; D055815:Young Adult
chemical_list: D014807:Vitamin D
keywords: infant; rickets; supplements; vitamin D