Article Text
Abstract
Background With the well-documented rise of Vitamin D deficiency (VDD) in the paediatric population, the Chief Medical Officer recently published advice on Vitamin D for at-risk groups and this was followed by the RCPCH Position statement on Vitamin D.
Aims We evaluated the awareness, knowledge and practice of Vitamin D deficiency amongst health care professionals (HCP).
Methods We surveyed a total of 130 HCP in four groups across primary and secondary care in Northwest London including 24 General Practitioners, 39 Paediatricians, 15 Health Visitors and 52 Midwives via an electronic questionnaire, developed and piloted for purpose. Questions included length of practice, self- rated knowledge about vitamin D, assessment of both general and specific knowledge of Vitamin D and usual practice. For doctors, we additionally included case histories to gauge prescribing and follow up practice.
Results The respondents in all four HCP groups were mainly experienced (5–10 years) and thought their self-rated knowledge was good. 79–100% correctly identified the most common risk factors for VDD with Paediatricians being most likely to also identify extra-skeletal symptoms and signs of VDD. The reported incidence of VDD was high with appropriate referrals to secondary care. 75–100% gave advice about vitamin D to high risk groups with the main barriers being time and knowledge. Patients were largely advised to obtain Vitamin D over the counter. Doctors had the most difficulty in correctly identifying eligibility criteria for Healthy Start vitamins compared with health visitors and midwives. On average, 75% of Paediatricians and 65% of GPs were able to correctly identify the maintenance and treatment doses of vitamin D. However, ambiguous cases showed more variability in dosing. All groups highlighted the lack of standardised guidelines for managing VDD.
Conclusions Primary and secondary HCP in Northwest London had good knowledge of VDD, identified high risk groups as well as signs and symptoms. Education is required about the role of diet in VDD and the eligibility criteria for Healthy Start vitamins. There was a call for further raising awareness of VDD amongst HCP and for standardised guidelines to diagnose, investigate and treat VDD. Knowledge and prescribing practice will be re-evaluated following RCPCH guidance on Vitamin D.