Programme to provide Quebec infants with free vitamin D supplements failed to encourage participation or adherence

Millette, Maude; Sharma, Atul; Weiler, Hope A.; Sheehy, Odile; Bérard, Anick; Rodd, Celia

doi:10.1111/apa.12727

Cited by 15 publications

(22 citation statements)

References 24 publications

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“…The QPC is created from a linkage of 3 administrative data bases including RAMQ (medical services and prescription claims), MED-ECHO (hospitalizations) and Institut de la Statistique du Québec (birth registry) using the maternal and child provincial health record numbers, date of births and names [10]. As described in more detail in the manuscript concerning term uptake, information such as prescription medications, socioeconomic status (SES), health care provider’s details, hospitalizations, and parental demographics are available in the QPC [8]. …”

Section: Methodsmentioning

confidence: 99%

“…Turkey provides vitamin D via prescription [7]. We have recently reported that the province of Quebec has for 20 years utilized a program of free supplements via prescription without a major educational component [8]. Participation (obtaining 1 or more bottles) was limited to only 18% of full term infants during the period 1998–2009.…”

Section: Introductionmentioning

confidence: 99%

“…of age from 2003-2009 [9]. This appeared to translate into a modest increase in the number of cases of rickets over this time [8]. …”

Section: Introductionmentioning

confidence: 99%

“…Secondary objectives including assessing whether uptake by early preterm infants (born <34 weeks) might be different than infants born closer to term (late preterm 34- 366/7 weeks) [11]. Long term adherence (obtaining 2 or more bottles) was also examined, as were likely predictors, such as maternal education and physician specialty providing the prescription, which we have previously identified as important and modifiable factors in term infants in Quebec [8]. …”

Section: Introductionmentioning

confidence: 99%

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Differential low uptake of free vitamin D supplements in preterm infants: the Quebec experience

et al. 2014

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BackgroundVitamin D is essential for bone mineralization, particularly in premature infants. For nearly 20 years, Quebec has offered a program of free vitamin D supplements via its public medication insurance plan Régie de l’Assurance Maladie du Québec (RAMQ). The objective of this study is to evaluate the number of preterm infants that obtained at least one bottle (50 doses) of vitamin D supplement through this program and to determine if uptake varied by gestational age.MethodsThis was a retrospective cohort study of preterm infants covered by RAMQ and born from 1998 to 2008; all infants had 1 year of follow-up data regarding supplement use. Data were extracted from the Quebec Pregnancy Cohort, a linked administrative database and were stratified by early (<34 weeks) or late gestational age premature infants. The number of infants obtaining supplements was the primary outcome and their characteristics were compared across gestational age groups. Predictors for participation (obtaining at least 1 bottle) or adherence (2 or more bottles) were identified via logistic regression (GEE).Results10288 infants were eligible; the percentage exposed to vitamin D was 24.5% (37.4%- early; 20.7%-late preterm infants, p < 0.001). The median number of bottles obtained was 2 for early and 1 for late preterms. For all premature infants, there was an apparent geometric decline in the infants obtaining subsequent bottles of supplements over the 12 month period. Additionally, there was a significant decline in program participation over time (OR = 0.90/year, 95% CI: 0.89-0.90) regardless of gestational age. Older or more educated mothers were positive predictors for participation. A prescription from a pediatrician significantly increased the odds of obtaining the supplement.ConclusionEarly preterm infants were more likely to obtain the supplement post-discharge; uptake was low and decreased with time for both age categories. Specifically, targeting late preterm infants and young mothers with less education could improve vitamin D uptake.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…of age from 2003-2009 [9]. This appeared to translate into a modest increase in the number of cases of rickets over this time [8]. …”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Differential low uptake of free vitamin D supplements in preterm infants: the Quebec experience

et al. 2014

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“…Free medication alone, however, is not a panacea: a free prescription program in Montreal failed to improve odds of obtaining vitamin D for the infant, with reduced prescription uptake and an increased prevalence of rickets cases over the 4-year study period. 12 WIC serves .50% of infants in the United States, and WIC dieticians are currently an untapped resource for educating, and supporting vitamin D supplementation.…”

Section: -7mentioning

confidence: 99%