Inappropriate vitamin D supplementation among multimorbid older patients: a multicountry analysis.

IF 3.8 2区医学 Q2 GERIATRICS & GERONTOLOGY

BMC Geriatrics Pub Date : 2025-07-19 DOI:10.1186/s12877-025-06189-w

Elisavet Moutzouri, Shanthi Beglinger, Martin Feller, Anne Eichenberger, Olivia Dalleur, Wilma Knol, Marielle Emmelot-Vonk, Denis O'Mahony, Benoit Boland, Carole E Aubert, Patricia O Chocano-Bedoya, Drahomir Aujesky, Anne Spinewine, Nicolas Rodondi

{"title":"Inappropriate vitamin D supplementation among multimorbid older patients: a multicountry analysis.","authors":"Elisavet Moutzouri, Shanthi Beglinger, Martin Feller, Anne Eichenberger, Olivia Dalleur, Wilma Knol, Marielle Emmelot-Vonk, Denis O'Mahony, Benoit Boland, Carole E Aubert, Patricia O Chocano-Bedoya, Drahomir Aujesky, Anne Spinewine, Nicolas Rodondi","doi":"10.1186/s12877-025-06189-w","DOIUrl":null,"url":null,"abstract":"Background: The prevalence of vitamin D supplementation and the percentage of participants with a lack of appropriate vitamin D supplementation (\"potential underuse\") or potentially inappropriate vitamin D supplementation (\"potential overuse\") and risk factors for these are currently unclear.Methods: Cross-sectional analysis from the OPERAM study, a multicenter cluster randomized controlled trial in four European countries (Belgium, Ireland, The Netherlands, Switzerland) including multimorbid (≥ 3 chronic conditions) older patients, with polypharmacy (≥ 5 chronic medications). For the definition of potential underuse and overuse we used high-risk conditions, which were defined according to the START criteria (version 2) for potential prescribing omissions in older people i.e., E2) long-term systemic corticosteroid therapy, known osteoporosis or osteopenia, E3) previous fragility fractures, and E5) housebound/in nursing homes or experiencing falls. We used mixed effect logistic regression to identify factors associated with underuse and overuse.Results: 2008 patients (79.4y, SD 6.3, 45% female) were included. 825/2008 (41.1%) were supplemented with vitamin D. We identified 681 participants with potential underuse (33.9% of all participants, 69.7% of non-vitamin D users) and 204 with potential overuse (10.2% of all participants, 24.7% of vitamin D users). In the multivariable logistic regression analysis increasing age and being male were associated with underuse, while the number of baseline medications and previous hospitalizations were associated with both underuse and overuse. Specifically, underuse decreased with an increasing number of medications (OR: 0.93, 95% CI: 0.90-0.95), while overuse increased (OR: 1.08, 95% CI: 1.04-1.12). Previous hospitalizations were linked to underuse (OR: 1.08, 95% CI: 1.00-1.17) and inversely associated with overuse (OR: 0.88, 95% CI: 0.77-0.99).Conclusions: One-third of multimorbid older adults experienced potential underuse, while up to 10% potential overuse of vitamin D supplementation. Polypharmacy, previous hospitalizations, increasing age and being male are factors associated with inappropriate use of vitamin D. A better targeted vitamin D supplementation is warranted.Trial registration: NCT02986425, Registration date 2016-10-21.","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"541"},"PeriodicalIF":3.8000,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275266/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Geriatrics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12877-025-06189-w","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: The prevalence of vitamin D supplementation and the percentage of participants with a lack of appropriate vitamin D supplementation ("potential underuse") or potentially inappropriate vitamin D supplementation ("potential overuse") and risk factors for these are currently unclear.

Methods: Cross-sectional analysis from the OPERAM study, a multicenter cluster randomized controlled trial in four European countries (Belgium, Ireland, The Netherlands, Switzerland) including multimorbid (≥ 3 chronic conditions) older patients, with polypharmacy (≥ 5 chronic medications). For the definition of potential underuse and overuse we used high-risk conditions, which were defined according to the START criteria (version 2) for potential prescribing omissions in older people i.e., E2) long-term systemic corticosteroid therapy, known osteoporosis or osteopenia, E3) previous fragility fractures, and E5) housebound/in nursing homes or experiencing falls. We used mixed effect logistic regression to identify factors associated with underuse and overuse.

Results: 2008 patients (79.4y, SD 6.3, 45% female) were included. 825/2008 (41.1%) were supplemented with vitamin D. We identified 681 participants with potential underuse (33.9% of all participants, 69.7% of non-vitamin D users) and 204 with potential overuse (10.2% of all participants, 24.7% of vitamin D users). In the multivariable logistic regression analysis increasing age and being male were associated with underuse, while the number of baseline medications and previous hospitalizations were associated with both underuse and overuse. Specifically, underuse decreased with an increasing number of medications (OR: 0.93, 95% CI: 0.90-0.95), while overuse increased (OR: 1.08, 95% CI: 1.04-1.12). Previous hospitalizations were linked to underuse (OR: 1.08, 95% CI: 1.00-1.17) and inversely associated with overuse (OR: 0.88, 95% CI: 0.77-0.99).

Conclusions: One-third of multimorbid older adults experienced potential underuse, while up to 10% potential overuse of vitamin D supplementation. Polypharmacy, previous hospitalizations, increasing age and being male are factors associated with inappropriate use of vitamin D. A better targeted vitamin D supplementation is warranted.

Trial registration: NCT02986425, Registration date 2016-10-21.

查看原文本刊更多论文

多病老年患者维生素D补充不当：多国分析

背景：目前尚不清楚维生素D补充的流行程度和缺乏适当维生素D补充（“潜在使用不足”）或潜在不适当维生素D补充（“潜在过度使用”）的参与者的百分比以及这些风险因素。方法：来自OPERAM研究的横断面分析，这是一项在四个欧洲国家（比利时、爱尔兰、荷兰、瑞士）进行的多中心集群随机对照试验，包括多病（≥3种慢性病）老年患者，多药（≥5种慢性药物）。对于潜在使用不足和过度使用的定义，我们使用高风险条件，根据START标准（版本2）对老年人潜在的处方遗漏进行定义，即E2)长期全身性皮质类固醇治疗，已知骨质疏松或骨质减少，E3)既往脆性骨折，E5)足不出屋/在养老院或经历跌倒。我们使用混合效应逻辑回归来确定与使用不足和过度使用相关的因素。结果：纳入2008例患者（79.4岁，SD 6.3，女性45%）。825/2008（41.1%）补充了维生素D。我们确定了681名可能使用不足的参与者（占所有参与者的33.9%，占非维生素D使用者的69.7%）和204名可能过度使用的参与者（占所有参与者的10.2%，占维生素D使用者的24.7%）。在多变量logistic回归分析中，年龄增长和男性与用药不足有关，而基线药物数量和既往住院与用药不足和用药过度均有关。具体来说，药物使用不足随着药物数量的增加而减少（OR: 0.93, 95% CI: 0.90-0.95），而过度使用增加（OR: 1.08, 95% CI: 1.04-1.12）。既往住院与用药不足相关（OR: 1.08, 95% CI: 1.00-1.17），与用药过度相关（OR: 0.88, 95% CI: 0.77-0.99）。结论：三分之一患有多种疾病的老年人可能服用维生素D不足，而高达10%的人可能过量服用维生素D补充剂。多种药物、既往住院、年龄增长和男性是不适当使用维生素D的相关因素，因此需要更好地有针对性地补充维生素D。试验报名：NCT02986425，报名日期2016-10-21。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

BMC Geriatrics GERIATRICS & GERONTOLOGY-

CiteScore

5.70

自引率

7.30%

发文量

873

审稿时长

20 weeks

期刊介绍： BMC Geriatrics is an open access journal publishing original peer-reviewed research articles in all aspects of the health and healthcare of older people, including the effects of healthcare systems and policies. The journal also welcomes research focused on the aging process, including cellular, genetic, and physiological processes and cognitive modifications.