naturalbiologylabs.com Blog

 A new study from the University of Colorado Denver’s School of Pharmacy has found that a simple educational intervention provided by a pharmacist can make a significant impact in the amount of vitamin D intake in geriatric outpatients, resulting in increased serum, or blood levels of this key nutrient. Surprisingly, the study also found that the overall increase in serum levels in the patients who received the intervention were still not in the target range, indicating that current national recommendations for vitamin D intake may be insufficient. The study is published this month in the July/August issue of the Journal of the American Pharmaceutical Association.“The educational intervention was simple to administer and can be reproduced by pharmacists in a variety of settings, including a community pharmacy or a clinical practice site,” said Joseph Vande Griend, PharmD, assistant professor in the Department of Clinical Pharmacy at the UC Denver School of Pharmacy and lead author of the paper. “Geriatric patients are at risk of medical complications from vitamin D insufficiency, including osteoporosis, and pharmacists, physicians, and other point-of-contact health care representatives can make a difference by recognizing vitamin deficiencies in their patients and taking the time to talk about the importance of key nutrients like vitamin D.”The Pharmacist’s Findings and an Educational Intervention Vitamin D concentrations were studied in older adults, ages 65 to 89 years, during clinic visits to the University of Colorado Hospital from December 2005 to January 2006. Eighty patients completed the study and 59 of them, 74 percent, were found to have vitamin D insufficiency. The majority of patients who were vitamin D insufficient consumed more than the recommended 400 to 600 IU per day of vitamin D.

The UC Denver pharmacists practicing in geriatric medicine then created a vitamin D informational sheet that was given to those geriatric outpatients who had insufficient vitamin D intake. A pharmacist reviewed the sheet with the participant during a 15-minute, one-on-one educational session about vitamin D, in which it was recommended the participant consume a total of 1,200 IU per day of vitamin D. A recommendation of 1,200 IU was chosen because the amount was estimated to increase patient serum levels to the study-defined sufficient vitamin D concentration of 32 ng/mL. The 1200 IU per day of vitamin D is also easy to obtain from over-the-counter resources; it is higher than the current Institute of Medicine recommendation (400 IU/day under age 70 and 600 IU/day over age 70) but below the upper daily intake limit (2,000 IU/day).

The handout covered the importance of vitamin D in maintaining good health, provided a listing of food sources with vitamin D, and a listing of over-the-counter supplements containing vitamin D3 along with their general cost. The handout is available online at http://www.japha.org/ .

At the conclusion of the educational session, the clinical pharmacist helped the participant choose which foods and/or supplements to use to increase daily vitamin D intake and provided the participant with a written, personalized plan to consume 1,200 IU per day of vitamin D. No supplements were provided to the study participants.

Two weeks after the educational session, the pharmacist followed-up with participants via telephone. During the call, the importance of vitamin D in maintaining optimal health and the details of the personalized vitamin D plan were reiterated. Participants were then asked whether they had obtained the agreed upon vitamin D product(s) and whether they were actually using the products. If not, the recommendation was reviewed and the participant was encouraged to obtain the product(s) and try to increase vitamin D intake.

The Outcome of the Educational Intervention After 12 weeks, a higher proportion of participants in the educational intervention group (55 percent) achieved the desired vitamin D blood level concentration of 32 ng/mL compared with the nonintervention group (24 percent). The change in dietary and over-the-counter vitamin D intake was also evaluated. Self-reported total vitamin D intake increased by a mean of 647 IU/day in educational intervention participants and 67 IU/day in the nonintervention group. Participants in the educational intervention group reported consuming an average of more than 1,400 IU/day vitamin D.