ODP069 A Clinical audit on the diagnosis and management of Vitamin D Deficiency at Scarborough General Hospital, United Kingdom

INTRODUCTION: A rising problem in the United Kingdom, Vitamin D deficiency is common in the elderly due to inadequate sunlight exposure and poor intake. Vitamin D deficiency is defined as 25-OH Vitamin D levels less than 30nmol/L. OBJECTIVES: The principal aim of this audit was to ascertain how close and efficiently the patients were managed with Vitamin D deficiency at Scarborough General Hospital when compared to the York NHS Trust guidelines. Another goal was to have a consensus with regards to improving our practices in the management of Vitamin D deficiency. METHODOLOGY: Data was collected retrospectively over 12 months (2020 March to 2021 March) on adults attending the General Hospital as outpatients as well as those who were admitted as inpatients. The questionnaire proforma for the audit was based on guidelines recommended by York Trust. A total of 30 cases were randomly chosen and data were sought from case notes and Electronic health care records. Data were analyzed by Microsoft Excel. RESULTS: This audit showed that 64% met the criteria for testing, 3% did not meet it and in 33% of cases it was not documented. Chronic wide spread pain (53%) was the most common factor that prompted vitamin D testing in the group who met the criteria. 67% had a vitamin D level between 20 and 29 nmol/mL while 33% had a level between 10 and 19 nmol/mL. Most of them (80%) were symptomatic; in 17% no symptoms were documented. Serum Calcium was normal in 77% and Serum Phosphate was normal in 73% of cases. The loading dose of Vitamin D was 50,000 IU for 6 weeks in 70% of the patients and in 70% the duration of the loading dose was 6 week. In 57% of the cases, Calcium supplementation was not required. In those who were prescribed with Calcium, 85% had them rechecked in the follow up visits. In the follow up visits, Vitamin D level was checked in only 53% of cases, in 40% cases it was unknown and in 7% cases it was not done. The advice to the GP did not include patient recommendations about regular exposure to sunlight and dietary sources as recommended by the guideline. CONCLUSION: Chronic pain was the single best reason for Vitamin D testing and most of the patients were symptomatic which emphasizes Vitamin D deficiency to be considered especially in the elderly population. In addition to the routine information given to the GP it will be good to reiterate dietary management and regular exposure to sunlight as this helps in augmenting Vitamin D apart from supplementation. As a significant proportion received inadequate follow up it is important to follow up with rechecks including vitamin D levels. Presentation: No date and time listed