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Prescription of vitamin D among Swiss pediatricians
Maristella Santi1, Marco Janner1, Giacomo D Simonetti2
1Department of Pediatrics, University Children's Hospital of Bern, Inselspital, Bern, Switzerland.
Insights
Swiss pediatricians frequently prescribe vitamin D for infants but rarely for children over three years old. Oily preparations are most common. Guidelines need better implementation for older children and those with risk factors.
Area of Science:
- Pediatrics
- Nutritional Science
- Public Health
Background:
- Vitamin D supplementation is recommended for Swiss children up to three years old and during winter for older children.
- Current guidelines in Switzerland extend vitamin D recommendations beyond infancy.
- Availability of both alcoholic and oily vitamin D preparations exists.
Purpose of the Study:
- To investigate current vitamin D prescription practices among Swiss pediatricians.
- To identify prescribing patterns for different age groups and health conditions.
- To understand the preferred vitamin D formulations and regimens.
Main Methods:
- A closed-ended questionnaire was distributed to 1530 Swiss board-certified pediatricians.
- Response rate was 52%, with 795 pediatricians participating.
- Data collected between December 2016 and March 2017.
Main Results:
- Routine vitamin D supplementation is common for infants up to one year old.
- Prescription of vitamin D is infrequent for children aged three years and older.
- Oily vitamin D preparations are most frequently prescribed, typically once daily.
Conclusions:
- A significant gap exists between vitamin D guidelines and pediatricians' prescribing habits for older children.
- Few pediatricians prescribe vitamin D for children over three years or those with conditions increasing deficiency risk.
- Enhanced collaboration between policymakers and healthcare professionals is needed to align practice with recommendations.
Abstract:
The traditional recommendation that Swiss children receive vitamin D during the first year of life was recently extended to the second and third year of life and during winter for older children. The aim of the study was to identify how Swiss pediatricians prescribe vitamin D. Between December 2016 and March 2017, 795 (52%) of 1530 invited Swiss board-certified pediatricians answered a closed-ended questionnaire. Respondents routinely prescribe vitamin D supplements in infants ≤ 1 year of age, but infrequently in children ≥ 3 years of age. Only a minority of them prescribe vitamin D in children with conditions that predispose to poor vitamin D status. Oily vitamin D preparations are the most popular and are usually prescribed in a once-a-day regimen. In situations like intake of drugs interfering with vitamin D metabolism, intestinal malabsorption, and diabetes mellitus, Swiss pediatricians often seek the advice of a subspecialist. In cases with clinical suspicion of poor vitamin D status, the diagnosis is confirmed by the determination of 25-hydroxyvitamin D.Conclusion: Few pediatricians prescribe a vitamin D supplementation in children ≥ 3 years of age. Collaboration between policymakers and health care professionals is required to fill the gap between guidelines and clinical practice. What is Known: • In Switzerland, vitamin D supplementation is recommended during the first, second, and third year of life as well as during winter for older children. • Both alcoholic and oily preparations are currently available. What is New: • Swiss pediatricians routinely prescribe vitamin D in infants ≤ 1 year of age, but infrequently in children ≥ 3 years of age. • Oily vitamin D preparations are the most popular and are usually prescribed in a once-a-day regimen.
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