Paulette D Chandler1, Edward L Giovannucci2, Michelle A Williams3, Meryl S LeBoff4, David W Bates1, LeRoi S Hicks5. 1. Division of General Medicine and Primary Care, Brigham and Women's Hospital, Boston, MA ; Harvard Medical School, Boston, MA. 2. Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA ; Harvard Medical School, Boston, MA. 3. Harvard Medical School, Boston, MA ; Harvard School of Public Health, Boston, MA. 4. Endocrine, Diabetes and Hypertension Division, Brigham and Women's Hospital, Boston, MA ; Harvard Medical School, Boston, MA. 5. Department of Health Care Policy, Harvard Medical School, Boston, MA ; UMass Memorial Medical Center, University of Massachusetts, Boston, MA.
Abstract
OBJECTIVE: Assess racial/ethnic and sex differences in treatment of vitamin D deficiency with high dose ergocalciferol ('vitamin D2') or other forms of vitamin D in a northeastern U.S. ambulatory clinic of an academic urban medical center. STUDY DESIGN: Cross-sectional observational review of electronic medication prescribing records of patients with 25-hydroxyvitamin D (25OHD) deficiency (25OHD < 20 ng/ml) from 2004-2008. METHODS: Using multivariable logistic regression adjusting for patients' demographics, and Elixhauser comorbidity score, we examined the association of sex and race/ethnicity with prescription for at least one dose of vitamin D. RESULTS: Among 2,140 patients without renal disease and tested for 25OHD deficiency (25OHD < 20 ng/ml), 66.2% received no vitamin D prescription for vitamin D deficiency. Blacks and Hispanics received vitamin D prescriptions at a higher frequency than whites, 37.8% 38.4% and 30.9%, respectively, p=0.003. The vitamin D prescription rate for women versus men was 26.3% and 7.5%, respectively, p=0.04. In a fully adjusted model, no difference in prescription likelihood for blacks and whites [OR=1.18 95% CI, 0.88-1.58; p=0.29] or Hispanics and whites was noted [OR=1.01 95% CI, 0.70-1.45;p=0.73]. Similarly, fully adjusted model showed no difference in prescription likelihood for females and males [OR=1.23 95% CI, 0.93-1.63; p=0.12]. CONCLUSIONS: Among primary care patients with vitamin D deficiency, vitamin D supplementation was low and white patients were less likely to receive vitamin D treatment than blacks or Hispanics. Interventions to correct the high prevalence of vitamin D deficiency should address the markedly low rate of vitamin D prescribing when 25OHD levels are measured.
OBJECTIVE: Assess racial/ethnic and sex differences in treatment of vitamin D deficiency with high dose ergocalciferol ('vitamin D2') or other forms of vitamin D in a northeastern U.S. ambulatory clinic of an academic urban medical center. STUDY DESIGN: Cross-sectional observational review of electronic medication prescribing records of patients with 25-hydroxyvitamin D (25OHD) deficiency (25OHD < 20 ng/ml) from 2004-2008. METHODS: Using multivariable logistic regression adjusting for patients' demographics, and Elixhauser comorbidity score, we examined the association of sex and race/ethnicity with prescription for at least one dose of vitamin D. RESULTS: Among 2,140 patients without renal disease and tested for 25OHD deficiency (25OHD < 20 ng/ml), 66.2% received no vitamin D prescription for vitamin D deficiency. Blacks and Hispanics received vitamin D prescriptions at a higher frequency than whites, 37.8% 38.4% and 30.9%, respectively, p=0.003. The vitamin D prescription rate for women versus men was 26.3% and 7.5%, respectively, p=0.04. In a fully adjusted model, no difference in prescription likelihood for blacks and whites [OR=1.18 95% CI, 0.88-1.58; p=0.29] or Hispanics and whites was noted [OR=1.01 95% CI, 0.70-1.45;p=0.73]. Similarly, fully adjusted model showed no difference in prescription likelihood for females and males [OR=1.23 95% CI, 0.93-1.63; p=0.12]. CONCLUSIONS: Among primary care patients with vitamin D deficiency, vitamin D supplementation was low and white patients were less likely to receive vitamin D treatment than blacks or Hispanics. Interventions to correct the high prevalence of vitamin D deficiency should address the markedly low rate of vitamin D prescribing when 25OHD levels are measured.
Authors: Philip T Liu; Steffen Stenger; Huiying Li; Linda Wenzel; Belinda H Tan; Stephan R Krutzik; Maria Teresa Ochoa; Jürgen Schauber; Kent Wu; Christoph Meinken; Diane L Kamen; Manfred Wagner; Robert Bals; Andreas Steinmeyer; Ulrich Zügel; Richard L Gallo; David Eisenberg; Martin Hewison; Bruce W Hollis; John S Adams; Barry R Bloom; Robert L Modlin Journal: Science Date: 2006-02-23 Impact factor: 47.728
Authors: Andrea B Braun; Fiona K Gibbons; Augusto A Litonjua; Edward Giovannucci; Kenneth B Christopher Journal: Crit Care Med Date: 2012-01 Impact factor: 7.598
Authors: Mario Fabri; Steffen Stenger; Dong-Min Shin; Jae-Min Yuk; Philip T Liu; Susan Realegeno; Hye-Mi Lee; Stephan R Krutzik; Mirjam Schenk; Peter A Sieling; Rosane Teles; Dennis Montoya; Shankar S Iyer; Heiko Bruns; David M Lewinsohn; Bruce W Hollis; Martin Hewison; John S Adams; Andreas Steinmeyer; Ulrich Zügel; Genhong Cheng; Eun-Kyeong Jo; Barry R Bloom; Robert L Modlin Journal: Sci Transl Med Date: 2011-10-12 Impact factor: 17.956
Authors: Shanna Nesby-O'Dell; Kelley S Scanlon; Mary E Cogswell; Cathleen Gillespie; Bruce W Hollis; Anne C Looker; Chris Allen; Cindy Doughertly; Elaine W Gunter; Barbara A Bowman Journal: Am J Clin Nutr Date: 2002-07 Impact factor: 7.045
Authors: Ana P Johnson; Joel L Parlow; Brian Milne; Marlo Whitehead; Jianfeng Xu; Susan Rohland; Joelle B Thorpe Journal: Eur J Health Econ Date: 2016-05-11