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维生素 D 辅助治疗儿童各类疾病:基于标准指南的情况分析。

Adjunctive vitamin D therapy in various diseases in children: a scenario according to standard guideline.

机构信息

Department of Pharmacy Quaid-i-Azam University, Islamabad, 45320, Pakistan.

Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, 710061, China.

出版信息

BMC Pediatr. 2022 May 7;22(1):257. doi: 10.1186/s12887-022-03297-z.

Abstract

BACKGROUND

Adherence to standard guidelines is imperative when question comes to disease management. The present study aimed to evaluate the administration of adjunctive vitamin D therapy in various diseases, its adherence to standard guideline and the effect of socioeconomic status on the consumption of vitamin D in children.

METHODS

Cross sectional observational study was conducted among 400 ambulatory pediatric patients at Children's Hospital, Pakistan Institute of Medical Sciences Islamabad, from November 2017 to June 2018. Data were collected by a self-designed structured questionnaire from the patient's medical chart. Adjunctive vitamin D therapy adherence was evaluated by the U. S endocrinology clinical practice guideline of vitamin D deficiency. The association between socioeconomic status and consumption of vitamin D was examined by chi-square. Alpha value (p ≤ 0.005) was considered statistically significant. Statistical analysis was done by SPSS version 25.

RESULTS

In 400 patients, 9 diseases and 21 comorbid conditions were identified, in which adjunctive vitamin D therapy was prescribed. Adherence to vitamin D testing in high-risk vitamin D deficiency diseases as; seizures (3.8%), bone deformities (13.3%), steroid-resistant nephrotic syndrome (0.0%), cerebral palsy (5.9%) and meningitis (14.3%). Adherence to prescribed vitamin D dose was in (41.3%) patients in various diseases. Significant association (p < 0.05) was found between socioeconomic status and consumption of vitamin D in children and mothers.

CONCLUSIONS

It was found that adjunctive vitamin D was being prescribed in various diseases and comorbidities. Overall poor adherence to the standard guideline was observed in disease management in children. Low socioeconomic status affects vitamin D supplementation consumption in children.

摘要

背景

在疾病管理中,遵循标准指南至关重要。本研究旨在评估各种疾病中辅助维生素 D 治疗的应用、其对标准指南的遵循情况以及社会经济地位对儿童维生素 D 消费的影响。

方法

本横断面观察性研究于 2017 年 11 月至 2018 年 6 月在巴基斯坦伊斯兰堡巴基斯坦医学科学院儿童医院的 400 名门诊儿科患者中进行。通过从患者病历中收集的自我设计的结构化问卷收集数据。通过美国内分泌临床实践指南评估维生素 D 缺乏症的辅助维生素 D 治疗依从性。通过卡方检验评估社会经济地位与维生素 D 消费之间的关系。α 值(p≤0.005)被认为具有统计学意义。统计分析采用 SPSS 版本 25。

结果

在 400 名患者中,确定了 9 种疾病和 21 种合并症,其中开了辅助维生素 D 治疗。在高风险维生素 D 缺乏症中,对维生素 D 检测的依从性为:癫痫(3.8%)、骨畸形(13.3%)、类固醇耐药性肾病综合征(0.0%)、脑瘫(5.9%)和脑膜炎(14.3%)。在各种疾病中,有(41.3%)患者遵循了规定的维生素 D 剂量。发现社会经济地位与儿童和母亲的维生素 D 消费之间存在显著关联(p<0.05)。

结论

研究发现,在各种疾病和合并症中都开了辅助维生素 D。在儿童疾病管理中,总体上对标准指南的遵循情况较差。低社会经济地位会影响儿童维生素 D 补充剂的消费。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/050a/9077968/556dc755b5de/12887_2022_3297_Fig1_HTML.jpg

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