Skip to main content Accessibility help
×
Home
Hostname: page-component-dc8c957cd-k7f5t Total loading time: 0.362 Render date: 2022-01-28T20:30:17.751Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": true, "newCiteModal": false, "newCitedByModal": true, "newEcommerce": true, "newUsageEvents": true }

Vitamin D retesting by general practitioners: a factor and cost analysis

Published online by Cambridge University Press:  17 August 2021

H. Scully
Affiliation:
Mercer's Institute for Research on Ageing, St. James's Hospital, Dublin, Ireland
M. Healy
Affiliation:
Department of Biochemistry, St James's Hospital, Dublin, Ireland
J.B. Walsh
Affiliation:
Mercer's Institute for Research on Ageing, St. James's Hospital, Dublin, Ireland
V. Crowley
Affiliation:
Department of Biochemistry, St James's Hospital, Dublin, Ireland
K. McCarroll
Affiliation:
Mercer's Institute for Research on Ageing, St. James's Hospital, Dublin, Ireland
E. Laird
Affiliation:
Mercer's Institute for Research on Ageing, St. James's Hospital, Dublin, Ireland School of Medicine, Trinity College Dublin, Dublin, Ireland
Rights & Permissions[Opens in a new window]

Abstract

Type
Abstract
Copyright
Copyright © The Authors 2021

Vitamin D testing by Primary Care doctors is increasing as are the associated costs(Reference Sattar, Welsh and Panarelli1). This places an increased workload on laboratories and healthcare systems though there is little data on vitamin D testing patterns in Ireland. This study aims to investigate the factors associated with vitamin D testing by Irish General Practitioners (GPs) including age, gender and location and resulting costs.

This is a retrospective analysis over 5 years (2014–2018) of GP requested 25-hydroxyvitamin D (25(OH)D) results in 36,458 patients at a major city hospital in Dublin, Ireland. Those with one test were compared with individuals who had follow up testing (retested). Retest samples were categorised to determine changes in status with increasing number of tests.One in four patients (n = 8,305) were retested though all retests accounted for 27.2% of all vitamin D requests. When compared to those not retested, positive predictors of retesting were female gender (p < 0.001), age (60–69yrs, p < 0.001), location (Co. Kildare, p < 0.001) and initial deficiency (<30 nmol/L, p < 0.001) or insufficiency (30–49.9 nmol/L, p < 0.001). Vitamin D status improved on retesting, halving deficiency on first retest (9% vs. 18%, p < 0.001) and dropping to 6% on further retests. 12.2% of retests were done within 3 months, one third (29%) had >2 retests within 1 year and 57% were in those who were initially vitamin D replete (>50 nmol/L). One third (29%) had two or more retests within 1 year. The annual approximate cost of inappropriate testing was estimated at €61,976.

Vitamin D retesting accounted for more than a quarter all requests, varying by age, gender and patient location. One in ten retests were inappropriately early (<3months), a third were too frequent and over half were in replete individuals, incurring significant costs. Clear guidance for GP's on retesting and laboratory ordering systems limiting requests using pre-defined criteria are needed. Population based strategies to reduce deficiency may be more effective than widespread testing.

Acknowledgements

Financial Support: This research is partially funded by Mercers’ Institute and Glanbia PLC. Glanbia has no role in study design, data collection and analysis, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

References

Sattar, N, Welsh, P, Panarelli, M, et al. (2012) The Lancet 379, 95.10.1016/S0140-6736(11)61816-3CrossRefGoogle Scholar
You have Access

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Vitamin D retesting by general practitioners: a factor and cost analysis
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

Vitamin D retesting by general practitioners: a factor and cost analysis
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

Vitamin D retesting by general practitioners: a factor and cost analysis
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *