Vitamin D prescribed for fragility fractures by 66 percent of Canadian doctors, huge range in dose size

The Prescription of Vitamin D to Fracture Patients: A Lack of Consensus and Evidence.

Journal of Orthopaedic Trauma:. Post Acceptance: September 12, 2015, doi: 10.1097/BOT.0000000000000451

Sprague, Sheila PhD; Bhandari, Mohit MD, PhD, FRCSC; Scott, Taryn MSW; Petrisor, Brad MD, MSc, FRCSC; McKay, Paula BSc; Slobogean, Gerard MD, MPH, FRCSC

Objectives: We conducted a survey to explore practice patterns regarding the assessment of hypovitaminosis D and the prescription of vitamin D in acute fracture patients. Our secondary objective was to determine if practice patterns differed between fragility and non-fragility fracture patients.

Design: Cross-sectional survey.

Setting: All surveys were completed using SurveyMonkey(R).

Patients/Participants: We surveyed surgeon members of the Canadian Orthopaedic Association and the Orthopaedic Trauma Association.

Intervention: Survey.

Main Outcome Measurements: The proportion of surgeons who routinely prescribe vitamin D to fracture patients.

Results: 397 surveys were completed. 65.8% of surgeons indicated that they routinely prescribe vitamin D to fragility fracture patients and 25.7% routinely prescribe vitamin D non-fragility fracture patients. We identified considerable variability in dosing regimens as 45 different dosing regimens were prescribed in fragility fracture patients and 29 in non-fragility fracture patients. They ranged from daily doses of 400 IU to loading doses of 600,000 IU .

The most frequently prescribed doses were

• 1,000 IU daily (14.6%),

• 2,000 IU daily (13.4%), and

• 50,000 IU weekly (8.7%).

Respondents indicated that they heavily relied upon clinical experience to guide their decisions to prescribe vitamin D to fracture patients.

Conclusions: The results of this survey demonstrate multiple areas of uncertainty and a lack of consensus in the prescription of vitamin D to fracture patients . Fragility patients frequently receive vitamin D supplementation, whereas, the majority of surgeons do not prescribe vitamin D to young fracture patients. High-quality clinical research is needed to determine if vitamin D supplementation is beneficial to fracture patients.

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See also VitaminDWiki

• Overview Fractures and Falls and Vitamin D vitamin D both PREVENTS and TREATS fractures

• Bone fractures in children requiring surgery were 55X more likely with low vitamin D – June 2015

• Hip fractures reduced 2X to 6X with just 10 minutes of sunlight daily – RCT 2003-2010

  Pages listed in BOTH the categories Falls/Fracture and Meta-analysis

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Falls/Fracture Intervention trials (give Vitamin D and see what happens)

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