Curtain Colin M, Williams Mackenzie, Cousins Justin M, Peterson Gregory M, Winzenberg Tania
Unit for Medication Outcomes Research and Education, University of Tasmania, Tasmania, Australia.
School of Medicine, University of Tasmania, Tasmania, Australia.
Drugs Aging. 2016 Oct;33(10):747-754. doi: 10.1007/s40266-016-0398-6.
It is currently recommended in Australia that nursing home residents are supplemented daily with 1000 IU vitamin D as they are at an increased risk of fractures. Historically, supplementation has been low, and current supplementation prevalence is not known.
The aim of this study was to determine the prevalence of vitamin D supplementation amongst nursing home residents in Tasmania, Australia.
Resident data, including demographics, medical conditions and medications (including vitamin D and calcium supplement use), exercise and sun exposure, were obtained from residents' files and staff in consenting nursing homes. Dietary calcium intake was estimated from the weekly menu of one nursing home and total calcium intake estimated from this and calcium supplement use. The prevalence of vitamin D supplementation was compared by resident characteristics and fracture risk factors.
Of 811 residents, 409 (50 %) received daily vitamin D supplementation of at least 1000 IU. Residents receiving vitamin D supplementation were slightly younger (mean 83 vs. 85 years for supplemented and unsupplemented groups, respectively, p = 0.003) and more likely to have osteoporosis (29 vs. 22 % for supplemented and unsupplemented groups, respectively, p = 0.019). Only 43 % of residents with osteoporosis received vitamin D supplements. Most residents (86 %) did not have regular sunlight exposure. The median estimated total calcium intake of 800 ± 275 mg daily was below guideline recommendations of 1000-1300 mg daily.
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.
目前澳大利亚建议养老院居民每日补充1000国际单位维生素D，因为他们骨折风险增加。从历史上看，补充率一直很低，目前的补充率尚不清楚。
本研究的目的是确定澳大利亚塔斯马尼亚州养老院居民中维生素D补充剂的使用情况。
从同意参与研究的养老院居民档案和工作人员处获取居民数据，包括人口统计学、医疗状况和药物使用情况（包括维生素D和钙补充剂的使用）、运动和阳光照射情况。从一家养老院的每周菜单估计膳食钙摄入量，并据此和钙补充剂使用情况估计总钙摄入量。根据居民特征和骨折风险因素比较维生素D补充剂的使用情况。
在811名居民中，409名（50%）每日接受至少1000国际单位的维生素D补充。接受维生素D补充的居民年龄稍小（补充组和未补充组的平均年龄分别为83岁和85岁，p = 0.003），患骨质疏松症的可能性更大（补充组和未补充组分别为29%和22%，p = 0.019）。只有43%的骨质疏松症居民服用了维生素D补充剂。大多数居民（86%）没有定期接受阳光照射。估计每日总钙摄入量中位数为800±275毫克，低于每日1000 - 1300毫克的指南建议。
养老院居民中维生素D补充剂的使用率相对较低，表明对相关临床指南的依从性较差。此外，大多数居民无法接触到阳光。需要采取干预措施来弥补这一证据与实践之间的差距。
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