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Clinical Epidemiology and Ageing

Vitamin D supplementation in a healthy, middle-aged population: actual practices based on data from a French comprehensive regional health-care database.

Caillet P, Souberbielle JC, Jaglal SB, Reymondier A, Van Ganse E, Chapurlat R, Schott AM Eur J Clin Nutr. 2013;67(11):1133-7.

<p><b>BACKGROUND/OBJECTIVES: </b>The debate surrounding recommendations for vitamin D supplementation in middle-aged patients (that is, 20-60 years of age) with low serum concentrations of 25-hydroxyvitamin D (25(OH)D) is growing. Our aim was to describe practices regarding vitamin D supplementation in this age group, which are basically unknown.</p><p><b>SUBJECTS/METHODS: </b>We performed an analysis using exhaustive reimbursement data from the individuals in Rhône-Alpes area, a French region regrouping more than 6 million of inhabitants. The data were collected from the French Insurance Health-care System. Patients who were 20-60 years of age, had no severe comorbidities, had a 25(OH)D assay between 1 December 2008 and 31 January 2009 were identified. Those who received a subsequent prescription for vitamin D were included in this analysis. We described patterns of vitamin D supplementation by frequency and daily dose.</p><p><b>RESULTS: </b>The sample in this study included 1311 patients. The mean age was 47.7 years (s.d.: 9.5) and the median age was 50.2 years. Most of the participants (that is, 85.9%) were women. A total of 372 distinct prescription patterns for vitamin D supplementation were observed. The two most frequent (that is, 32.6% in total) involved a unique dispensation of a high dose of either 200,000 (17.5%) or 100,000 IU (15.1%). Most prescribed supplements were based on vitamin D3 (65%), and the most prescribed forms were high dose ampoules (81.6%). Only 48.9% of the participants were given a maintenance prescription after the initial loading phase.</p><p><b>CONCLUSIONS: </b>Our results reveal a significant variability in the prescriptions for vitamin D supplementation from physicians in the French population. Moreover, less than half of the patients receive maintenance therapy after the initial loading phase of supplementation.</p>

MeSH terms: Adult; Bone Density Conservation Agents; Cholecalciferol; Comorbidity; Dietary Supplements; Female; France; Guidelines as Topic; Health; Humans; Male; Middle Aged; Practice Patterns, Physicians'; Prescriptions; Reference Values; Vitamin D; Vitamin D Deficiency; Vitamins; Young Adult
DOI: 10.1038/ejcn.2013.182