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G469(P) Effectiveness of a novel pathway to reduce vitamin d deficiency in a high risk population
  1. A Briscoe,
  2. E Leith,
  3. F Katz
  1. Making Our Services All Integrated in Camden (MOSAIC), Kentish Town Health Centre, London, UK

Abstract

Aim To evaluate whether we have been successful in reducing Vitamin D deficiency in non–ambulant children in a Special School

Background Vitamin D is derived from exposure to UVB light, and from dietary sources, it plays a vital role in calcium homeostasis. Consequences of vitamin D deficiency include; osteopenia, rickets, poor growth and muscle weakness. There is also the risk of not achieving maximal bone mineral density, with subsequent long–term consequences for adult bone health.

We investigated a group of children attending a special educational needs school; with a diagnosis of cerebral palsy or neuromuscular disorder.

These children are categorised as high risk for vitamin D deficiency. The aim was to assess vitamin D status and determine whether levels improved with supplementation.

Method 25– Hydroxyvitamin D levels were analysed from blood tests for 52 children collected from 2010 – 2014.

Standards Optimal >75nmol/L

Normal >50nmol/L

Insufficient 25 >50 nmol/L

Deficient <25 nmol/L

Results 44 children had >1 vitamin D blood test result available. 20––35% of children had insufficient or deficient levels detected during screening.

Deficient vitamin D levels None remained deficient on final blood testing

50% improved to normal/optimal levels with supplementation.

Insufficient vitamin D levels 77% remained insufficient on final blood test.

23% improved to normal or optimal.

Of the 44 children: 45% had optimal/normal vitamin D levels throughout.

Conclusion In a cohort of 44 children undergoing surveillance for vitamin D levels, 55% had insufficient or deficient levels during the screening process.

All of the children diagnosed with Vitamin D Deficiency had increased levels on subsequent screening, 50% improved to normal or optimal levels.

However 77% of children with insufficient Vitamin D levels on screening remained insufficient.

From our experience lack of compliance in supplementation was evident in the ‘Insufficient’ group. This subgroup of at risk children and their caregivers require further information regarding the benefits of normal/optimal vitamin D levels and subsequent bone health. We are offering alternative supplementation regimes to try and improve compliance.

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