1665 Adherence to ESPGHAN guidelines for diagnosing paediatrics coeliac disease in an English district general hospital

Abstract

patients (41/313) had a vitamin D level <25nmol/L (deemed deficient as per NICE guidelines).We reviewed 184 patients in-person/over the telephone in a 4 month period during the COVID pandemic and asked about their current supplementation. 49.45% (91/184) of patients reviewed reported taking 400 international units (IU) daily with 26% (48/184) taking >400IU daily. 12.5% (23/184) of these patients reviewed had a vitamin D level <25nmol/L. In those with a level <25nmol/L, 30.43% (7/23) were taking 400IU, 26% (6/23) were taking >400IU daily and 34.78% (8/ 23) were on no supplements at all. The average age was much higher at 16.86 years in this group compared to the overall average age of 12.34 years. Conclusions In our audit we established that 56.52% (13/23) patients reviewed in-person or over the telephone who were Vitamin D deficient as per the NICE definition (<25nmol/ L), were taking at least 400IU of Vitamin D daily (the recommended dose for children at increased risk of Vitamin D deficiency). This highlights the need for further studies and clearer international guidance re. prevention of and management of Vitamin D deficiency in these high risk SCD patients. The Sickle Cell Society and Public Health England (2019) guidelines recommend that Vitamin D deficiency be identified and treated according to local guidelines in all SCD patients. Those identified as Vitamin D deficient during the audit process were prescribed a higher dose of Vitamin D where possible with regular input from our hospital pharmacy team. We continued our policy of aiming to check Vitamin D levels twice per year with increased frequency of checks for those who required high dose Vitamin D treatment. Given the above findings, a plan was placed to make a more concerted effort to continuously ask patients re. vitamin D supplements during clinic and hospital visits.