Despite Guidelines, Low Proportion of Elderly Hip Fracture Patients Are Consistently Taking Vitamin D Interview with:

Dr. Sheila Sprague, PhD Assistant Professor, Research Methodologist McMaster University

Dr. Sheila Sprague

Dr. Sheila Sprague, PhD
Assistant Professor, Research Methodologist
McMaster University What is the background for this study? What are the main findings?

Response: Previous research has found that daily administration of vitamin D is important for maintaining bone homeostasis. There has been an increased interest among the orthopaedic community regarding vitamin D supplementation and patient outcomes following fractures. Using data from the FAITH trial (NCT01908751), a multicenter randomized controlled trial that compared cancellous screws versus sliding hip screws in patients over the age of 50 with femoral neck fractures, we:

1) determined the proportion of patients consistently taking vitamin D following hip fracture surgery and
2) determined if supplementation was associated with improved health related quality of life and reduced re-operation.

Patients enrolled in the FAITH trial were recruited from 81 clinical sites in 8 countries over a 6-year span. We asked a subset of them about vitamin D supplementation and categorized them as consistent users, inconsistent users, or non-users.

The final analysis included 573 patients and we found that a surprisingly low proportion of elderly hip fracture patients are consistently taking vitamin D (18.7% of patients reported never taking vitamin D, 35.6% reported inconsistent use, and 45.7% reported consistent use). We also found that vitamin D was associated with a statistically (p=0.033), but not clinically, significant improvement in health-related quality of life following a hip fracture. Lastly, supplementation was discovered to not be associated with reduced re-operation (p=0.386). What should readers take away from your report?

Response: Despite guidelines, a low proportion of elderly hip fracture patients are consistently taking vitamin D, suggesting that physician and patient education programs aimed at improving vitamin D supplementation may need to be developed and evaluated as a means of improving compliance within this high-risk patient group. What recommendations do you have for future research as a result of this study?

Response: Given the observational nature of this study, it is possible that the statistically significant increase in physical function seen in patients compliant with vitamin D supplementation may be due to other factors. Therefore, further research is needed to confirm the validity of this finding. Additional research is also needed to determine the optimal dosing regimen of vitamin D supplementation for fracture patients. Is there anything else you would like to add?

Response: The FAITH Study was funded by the Canadian Institutes of Health Research, National Institutes of Health, Stichting NutsOhra, The Netherlands Organisation for Health Research and Development, and Physicians’ Services Incorporated. Funding for the pilot phase of FAITH was supported, in part, by Stryker Inc. Thank you for your contribution to the community.


Vitamin D Use and Health Outcomes Following Hip Fracture Surgery Mohit Bhandari, MD, Hamilton, ON, Canada Earl R. Bogoch, MD, Toronto, ON, Canada Alisha Garibaldi, MSc, Hamilton, ON, Canada Faith Investigators, Hamilton, ON, Canada Nathan N. O’Hara, Baltimore, MD Brad Petrisor, MD, Hamilton, ON, Canada Gerard Slobogean, MD, Baltimore, MD Sheila Sprague, PhD, Hamilton, ON, Canada A low proportion of elderly hip fracture patients consistently take vitamin D. Our study demonstrates that vitamin D following a hip fracture may be associated with improved physical function.

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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