title: Vitamin D Deficiency Treatment Patterns in Academic Urban Medical Center.
abstract: OBJECTIVE
  Assess racial/ethnic and sex differences in treatment of vitamin D deficiency with high dose ergocalciferol ('vitamin D2') or other forms of vitamin D in a northeastern U.S. ambulatory clinic of an academic urban medical center.
  
  
  METHODS
  Cross-sectional observational review of electronic medication prescribing records of patients with 25-hydroxyvitamin D (25OHD) deficiency (25OHD < 20 ng/ml) from 2004-2008.
  
  
  METHODS
  Using multivariable logistic regression adjusting for patients' demographics, and Elixhauser comorbidity score, we examined the association of sex and race/ethnicity with prescription for at least one dose of vitamin D.
  
  
  RESULTS
  Among 2,140 patients without renal disease and tested for 25OHD deficiency (25OHD < 20 ng/ml), 66.2% received no vitamin D prescription for vitamin D deficiency. Blacks and Hispanics received vitamin D prescriptions at a higher frequency than whites, 37.8% 38.4% and 30.9%, respectively, p=0.003. The vitamin D prescription rate for women versus men was 26.3% and 7.5%, respectively, p=0.04. In a fully adjusted model, no difference in prescription likelihood for blacks and whites [OR=1.18 95% CI, 0.88-1.58; p=0.29] or Hispanics and whites was noted [OR=1.01 95% CI, 0.70-1.45;p=0.73]. Similarly, fully adjusted model showed no difference in prescription likelihood for females and males [OR=1.23 95% CI, 0.93-1.63; p=0.12].
  
  
  CONCLUSIONS
  Among primary care patients with vitamin D deficiency, vitamin D supplementation was low and white patients were less likely to receive vitamin D treatment than blacks or Hispanics. Interventions to correct the high prevalence of vitamin D deficiency should address the markedly low rate of vitamin D prescribing when 25OHD levels are measured.
authors.affiliation: Division of General Medicine and Primary Care, Brigham and Women's Hospital, Boston, MA ; Harvard Medical School, Boston, MA.
authors.forename: Paulette D
authors.initials: PD
authors.lastname: Chandler
authors.affiliation: Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA ; Harvard Medical School, Boston, MA.
authors.forename: Edward L
authors.initials: EL
authors.lastname: Giovannucci
authors.affiliation: Harvard Medical School, Boston, MA ; Harvard School of Public Health, Boston, MA.
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Williams
authors.affiliation: Endocrine, Diabetes and Hypertension Division, Brigham and Women's Hospital, Boston, MA ; Harvard Medical School, Boston, MA.
authors.forename: Meryl S
authors.initials: MS
authors.lastname: LeBoff
authors.affiliation: Division of General Medicine and Primary Care, Brigham and Women's Hospital, Boston, MA ; Harvard Medical School, Boston, MA.
authors.forename: David W
authors.initials: DW
authors.lastname: Bates
authors.affiliation: Department of Health Care Policy, Harvard Medical School, Boston, MA ; UMass Memorial Medical Center, University of Massachusetts, Boston, MA.
authors.forename: LeRoi S
authors.initials: LS
authors.lastname: Hicks
keywords: Vitamin D; ambulatory; electronic prescribing