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Study highlights need to treat female nursing-home patients for vitamin D deficiency
The majority of older women in nursing homes are likely to be deficient in vitamin D during winter months, and those with the lowest levels are at a significantly increased risk of death, according to a study published online February 8, in the Journal of Clinical Endocrinology.
The majority of older women in nursing homes are likely to be deficient in vitamin D during winter months, and those with the lowest levels are at a significantly increased risk of death, according to a study published online February 8, in the Journal of Clinical Endocrinology & Metabolism.
Vitamin D deficiency is extraordinarily high among nursing-home residents, stated lead investigator Stefan Pilz, of the Department of Internal Medicine, Division of Endocrinology and Metabolism, Medical University of Graz, Graz, Austria, and colleagues.
“Limited sunlight access in concert with impaired vitamin D synthesis of the aging skin as well as nutritional deficits may likewise contribute to this high prevalence of vitamin D deficiency,” the authors said.
And, although 25-hydroxyvitamin D (25[OH]D) concentrations are associated with an increased risk of death in the general population, there is only 1 study looking at the measurement for nursing-home patients. As a result, the researchers conducted a prospective cohort study to evaluate whether 25(OH)D concentrations are associated with mortality in elderly female nursing-home patients.
The researchers examined 961 female patients from 95 nursing homes in Austria and found 92.8% had 25(OH)D levels below the recommended level of 50 nmol/L. After a mean follow-up time of 27 months, the researchers noted 264 patient deaths (30% of the study cohort). These results, they said, are in line with previous studies, suggesting that although well known, there have been no strategies put in place to prevent and treat vitamin D deficiency in this population.
“In view of these findings and the existing literature on adverse effects of vitamin D deficiency, there exists now an urgent need for effective strategies to improve vitamin D status in older institutionalized patients,” the authors concluded. And, although they acknowledge limitations of the study, they stated that it would be reasonable to initiate supplementation in this population.
Coalition promotes important acetaminophen dosing reminders
November 18th 2014It may come as a surprise that each year Americans catch approximately 1 billion colds, and the Centers for Disease Control and Prevention estimates that as many as 20% get the flu. This cold and flu season, 7 in 10 patients will reach for an over-the-counter (OTC) medicine to treat their coughs, stuffy noses, and sniffles. It’s an important time of the year to remind patients to double check their medicine labels so they don’t double up on medicines containing acetaminophen.
Support consumer access to specialty medications through value-based insurance design
June 30th 2014The driving force behind consumer cost-sharing provisions for specialty medications is the acquisition cost and not clinical value. This appears to be true for almost all public and private health plans, says a new report from researchers at the University of Michigan Center for Value-Based Insurance Design (V-BID Center) and the National Pharmaceutical Council (NPC).
Management of antipsychotic medication polypharmacy
June 13th 2013Within our healthcare-driven society, the increase in the identification and diagnosis of mental illnesses has led to a proportional increase in the prescribing of psychotropic medications. The prevalence of mental illnesses and subsequent treatment approaches may employ monotherapy as first-line treatment, but in many cases the use of combination of therapy can occur, leading to polypharmacy.1 Polypharmacy can be defined in several ways but it generally recognized as the use of multiple medications by one patient and the most common definition is the concurrent use of five more medications. The presence of polyharmacy has the potential to contribute to non-compliance, drug-drug interactions, medication errors, adverse events, or poor quality of life.
Medical innovation improves outcomes
June 12th 2013I have been diagnosed with stage 4 cancer of the pancreas, a disease that’s long been considered not just incurable, but almost impossible to treat-a recalcitrant disease that some practitioners feel has given oncology a bad name. I was told my life would be measured in weeks.
