Reeder Anthony I, Jopson Janet A, Gray Andrew R
Cancer Society Social and Behavioural Research Unit, Preventive and Social Medicine, Dunedin School of Medicine, PO Box 913, Dunedin, New Zealand.
N Z Med J. 2013 Jun 14;126(1376):49-61.
To report perceptions regarding vitamin D sources; risk factors, prevention and management of vitamin D deficiency and insufficiency; supplement prescribing practices; patients' enquiries.
A NSW survey instrument was adapted and pre-tested for NZ conditions. Royal NZ College of General Practitioners online weekly newsletter recipients were provided an electronic survey link. The Medical Council emailed an invitation and online survey link to non-respondents. Hard copy questionnaires were posted to remaining non-respondents.
1089 GPs responded (32% participation). Several sources of information on vitamin D were identified. Sun exposure was considered the main vitamin D source in summer (85%), but in winter (47%) supplements (13%) and food sources were more commonly mentioned. Daily sunlight exposure at low UV times (79%) was identified as the main factor preventing deficiency, followed by high-dose supplements and fortified foods (54% each), winter sun-protection relaxation (48%), daily low-dose supplements (47%), daily sunlight exposure at peak UV times (35%) and relaxation of sun protection, year-round. Patient characteristics prompting alertness to vitamin D status included being housebound or institutionalised (96%), wearing concealing clothing (88%), past history of bone fractures (87%), age over 65 years (84%), poor nutrition (71%) and current bone disease (69%). Insufficiency and deficiency were managed primarily through high-dose supplementation and advice to receive more sunlight. Almost half (47%) had received patient requests for vitamin D testing, and 40% requests for prescribed vitamin D.
Study results should help inform possible educational and other interventions to optimise vitamin D and sun-exposure advice.
报告关于维生素D来源的认知;维生素D缺乏和不足的风险因素、预防及管理;补充剂处方实践;患者咨询情况。
对新南威尔士州的一项调查工具进行调整,针对新西兰的情况进行预测试。向新西兰皇家全科医师学院在线每周时事通讯的收件人提供电子调查链接。医学委员会向未回复者发送邀请和在线调查链接。将纸质问卷邮寄给其余未回复者。
1089名全科医生回复(参与率32%)。确定了几种维生素D的信息来源。阳光照射被认为是夏季维生素D的主要来源(85%),但在冬季(47%),补充剂(13%)和食物来源被更频繁提及。低紫外线时段的每日阳光照射(79%)被确定为预防缺乏的主要因素,其次是高剂量补充剂和强化食品(各占54%)、冬季防晒措施放宽(48%)、每日低剂量补充剂(47%)、紫外线高峰时段的每日阳光照射(35%)以及全年防晒措施放宽。促使关注维生素D状况的患者特征包括居家或住院(96%)、穿着遮盖性衣物(88%)、既往骨折史(87%)、65岁以上(84%)、营养不良(71%)和当前患有骨病(69%)。不足和缺乏主要通过高剂量补充以及增加阳光照射的建议来管理。近一半(47%)收到过患者对维生素D检测的请求,40%收到过开具维生素D的请求。
研究结果应有助于为优化维生素D和阳光照射建议的可能教育及其他干预措施提供信息。