Vitamin D Supplementation in Tasmanian Nursing Home Residents

Curtain, Colin; Williams, Mackenzie; Cousins, Justin; Peterson, Gregory M.; Winzenberg, Tania

doi:10.1007/s40266-016-0398-6

Cited by 7 publications

(8 citation statements)

References 29 publications

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“…The association of vitamin D supplement use with age and sex in this study contradicted a recent audit in Tasmania, where older age (p = 0.003), but not sex (p = 0.398) was associated with vitamin D supplement use [46]. This suggests that variation in outcomes is the result of a knowledge translation gap, rather than the cohort and respective care needs of residents.…”

Section: Discussioncontrasting

confidence: 99%

Increasing the uptake of vitamin D supplement use in Australian residential aged care facilities: results from the vitamin D implementation (ViDAus) study

et al. 2020

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Background Adequate (≥800 IU/day) vitamin D supplement use in Australian residential aged care facilities (RACFs) is variable and non-optimal. The vitamin D implementation (ViDAus) study aimed to employ a range of strategies to support the uptake of this best practice in participating facilities. The aim of this paper is to report on facility level prevalence outcomes and factors associated with vitamin D supplement use. Methods This trial followed a stepped wedge cluster, non-randomised design with 41 individual facilities serving as clusters pragmatically allocated into two wedges that commenced the intervention six months apart. This multifaceted, interdisciplinary knowledge translation intervention was led by a project officer, who worked with nominated champions at participating facilities to provide education and undertake quality improvement (QI) planning. Local barriers and responsive strategies were identified to engage stakeholders and promote widespread uptake of vitamin D supplement use. Results This study found no significant difference in the change of vitamin D supplement use between the intervention (17 facilities with approx. 1500 residents) and control group (24 facilities with approx. 1900 residents) at six months (difference in prevalence change between groups was 1.10, 95% CI − 3.8 to 6.0, p = 0.6). The average overall facility change in adequate (≥800 IU/day) vitamin D supplement use over 12 months was 3.86% (95% CI 0.6 to 7.2, p = 0.02), which achieved a facility level average prevalence of 59.6%. The variation in uptake at 12 months ranged from 25 to 88% of residents at each facility. In terms of the types of strategies employed for implementation, there were no statistical differences between facilities that achieved a clinically meaningful improvement (≥10%) or a desired prevalence of vitamin D supplement use (80% of residents) compared to those that did not. Conclusions This work confirms the complex nature of implementation of best practice in the RACF setting and indicates that more needs to be done to ensure best practice is translated into action. Whilst some strategies appeared to be associated with better outcomes, the statistical insignificance of these findings and the overall limited impact of the intervention suggests that the role of broader organisational and governmental support for implementation should be investigated further. Trial registration Retrospectively registered (ANZCTR ID: ACTRN12616000782437).

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Section: Discussioncontrasting

confidence: 99%

Increasing the uptake of vitamin D supplement use in Australian residential aged care facilities: results from the vitamin D implementation (ViDAus) study

et al. 2020

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“…Thirdly this sample may not be representative of the Australian aged care population, as only three states were included in the sample. A recent audit conducted in Tasmania however has reported similar results with a prevalence of adequate (≥1000 IU/day) vitamin D supplement use of 50% (n = 811) [ 18 ].…”

Section: Limitationsmentioning

confidence: 69%

“…Despite the current recommendation for vitamin D supplementation in Australian aged care facilities, the uptake of this evidence into practice has not been widely investigated. Of seven identified publications reporting baseline vitamin D supplement use, each has only investigated one aged care facility or one Australian town or region [ 12 – 18 ]. Four of the seven audits were small with less than 100 residents, and the largest study (5391 residents) is now over a decade old [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

“…There has been one recent audit in metropolitan WA, reporting a mean prevalence of 41.5% of residents (n = 779), however like most other audits it is not clear whether the adequacy of the dosage prescribed was considered [ 17 ]. Of the only two studies to report on dosages, one included residents that were prescribed between 10 and 1000 IU/day and the other only included residents from one state [ 16 , 18 ]. To date there has been no large scale, multi-state audit of adequate (≥800 IU/day) vitamin D supplement use in Australian aged care homes.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of vitamin D supplement use in Australian residential aged care facilities in November 2014

et al. 2017

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ObjectiveWe sought to establish the prevalence and predictors of adequate vitamin D supplement use, as per current falls prevention guidelines in Australian aged care homes. De-identified medication chart data from November 2014 were collected from pharmacists. The proportion of residents prescribed vitamin D and associations between adequate vitamin D supplementation and state, calcium use and osteoporosis medication use were assessed.ResultsThe prevalence of adequate vitamin D supplement use (≥800 IU) was 47.1% of residents (95% CI 41.4, 52.8%). There was no significant difference between states (p = 0.3), however there was large variation between individual facilities (15.9–85.0%). Residents were more likely to be prescribed an adequate dose of vitamin D if they were prescribed a calcium supplement (p = 0.0001) or an osteoporosis medication (p = 0.03).

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“…Vitamin D deficiency, as assessed using the serum 25(OH)D 3 level, has been reported in children, adults and elderly people from all continents [18][19][20]. Because deficiency occurs worldwide [21,22], further population studies are needed even in countries thought to have a high annual solar incidence [23][24][25][26].…”

Section: Introductionmentioning

confidence: 99%

Vitamin D: Correlation with biochemical and body composition changes in a southern Brazilian population and induction of cytotoxicity in mesenchymal stem cells derived from human adipose tissue

Pesarini

Oliveira

Pessatto

et al. 2017

Biomedicine & Pharmacotherapy

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Studies have shown that metabolic disorders, serum inflammatory markers and weight gain (obesity) are correlated with vitamin D deficiency. Therefore, the present study correlated the serum calcidiol (s25(OH)D) levels in a sample of individuals from southern Brazil with variables related to metabolic disorders, obesity and lifestyle habits and assessed the cytotoxic effect of calcitriol on adipose tissue-derived mesenchymal stem cells (ADSCs). The results showed a 79.23% prevalence of hypovitaminosis D in the study population and a correlation (p<0.05) between a low serum vitamin D concentration and an elevated low-density lipoprotein cholesterol (LDL-c) level. Univariate linear regression analysis using 25(OH)D as a regressor showed a negative association (p<0.05) with an indoor work environment (β=-2.305), increased body fat (β=-0.095), age (β=-0.065) and high-density lipoprotein cholesterol (HDL-c; β=-0.109). An in vitro 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay performed with ADSCs using five calcitriol concentrations (15.625, 31.25, 62.5, 125 and 250nM) indicated cytotoxic potential (p<0.05) at the 62.5nM concentration at 48 and 72h and at the 125 and 250nM concentrations at 24, 48 and 72h. The results reported herein corroborate one another and suggest a key association between vitamin D deficiency and the development of obesity because ADSCs are involved in adipose tissue hyperplasia and differentiate into adipocytes that can sequester the bioavailable vitamin D necessary for homeostasis.

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Vitamin D Supplementation in Tasmanian Nursing Home Residents

Abstract: The prevalence of vitamin D supplementation in nursing home residents was relatively low, suggesting poor adherence to the relevant clinical guidelines. Additionally, most residents do not access sunlight. Interventions addressing this evidence-practice gap are needed.

Cited by 7 publications

References 29 publications

Increasing the uptake of vitamin D supplement use in Australian residential aged care facilities: results from the vitamin D implementation (ViDAus) study

Increasing the uptake of vitamin D supplement use in Australian residential aged care facilities: results from the vitamin D implementation (ViDAus) study

Prevalence of vitamin D supplement use in Australian residential aged care facilities in November 2014

Vitamin D: Correlation with biochemical and body composition changes in a southern Brazilian population and induction of cytotoxicity in mesenchymal stem cells derived from human adipose tissue

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