文章基本信息

标题：Clinical Management of Low Vitamin D: A Scoping Review of Physicians’ Practices
本地全文：下载
作者：Michelle Rockwell ; Vivica Kraak ; Matthew Hulver 等
期刊名称：Nutrients
电子版ISSN：2072-6643
出版年度：2018
卷号：10
期号：4
页码：493
DOI：10.3390/nu10040493
语种：English
出版社：MDPI Publishing
摘要：The role of vitamin D in the prevention and treatment of non-skeletal health issues has received significant media and research attention in recent years. Costs associated with clinical management of low vitamin D (LVD) have increased exponentially. However, no clear evidence supports vitamin D screening to improve health outcomes. Authoritative bodies and professional societies do not recommend population-wide vitamin D screening in community-dwelling adults who are asymptomatic or at low risk of LVD. To assess patterns of physicians’ management of LVD in this conflicting environment, we conducted a scoping review of three electronic databases and the gray literature. Thirty-eight records met inclusion criteria and were summarized in an evidence table. Thirteen studies published between 2006 and 2015 across seven countries showed a consistent increase in vitamin D lab tests and related costs. Many vitamin D testing patterns reflected screening rather than targeted testing for individuals at high risk of vitamin D deficiency or insufficiency. Interventions aimed at managing inappropriate clinical practices related to LVD were effective in the short term. Variability and controversy were pervasive in many aspects of vitamin D management, shining a light on physicians’ practices in the face of uncertainty. Future research is needed to inform better clinical guidelines and to assess implementation practices that encourage evidence-based management of LVD in adult populations.
关键词：vitamin D; 25-hydroxyvitamin-D; 25-OH-D; low vitamin D; screening; physician practices; low value care; test overutilization vitamin D ; 25-hydroxyvitamin-D ; 25-OH-D ; low vitamin D ; screening ; physician practices ; low value care ; test overutilization