Vitamin D deficiency (defined as 25(OH)-vitamin D serum level \<50 nmol/l) is cured with supplementation by mouth. National guidelines recommend the administration of 800 IU cholecalciferol daily for an effective treatment, especially during the winter (poor sun exposition). Commercially available pharmaceutical forms are liquid in Switzerland (drops) and solid forms in Germany (tablets and capsules). Because therapeutic range of vitamin D3 is wide and toxicity is seldom reached, even after the consumption of 200'000 IU, and because the administration of 8 drops daily is inconvenient, weekly and monthly administrations of the cumulative amount (i.e., 5'600 IU weekly or 24'000 IU monthly) have been investigated. Both administration schedules are therapeutic equivalent. The study aims to investigate which form (liquid or solid) and which schedule (weekly or monthly) procure the highest adherence behavior with outpatients under polypharmacy i.e., with 4 or more medications daily. The investigators will use commercially available Swiss and German products.
Intervention study in patients with serum vitamin D \<50 nmol/l and polypharmacy, defined as ≥4 medicaments/day. Treatment duration: 6 months. Treatment groups are defined as Lm (liquid monthly 24'000 IU); Lw (liquid weekly 5'600 IU); Sm (solid monthly 20'000 IU) and Sw (solid weekly 5'600 IU). Cross-over design with identical form (liquid or solid) and switching frequence, i.e. from weekly to monthly treatment and vice versa, for 3 months each.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
97
Patient will start treatment with weekly schedule, and switch after 3 months to monthly schedule for another 3 months.
Patient will start treatment with monthly schedule, and switch after 3 months to weekly schedule for another 3 months.
Patient will start treatment with weekly schedule, and switch after 3 months to monthly schedule for another 3 months.
Patient will start treatment with monthly schedule, and switch after 3 months to weekly schedule for another 3 months.
Pharmaceutical Care Research Group
Basel, Switzerland
Adherence to medication
Taking adherence: number of dosis taken divided by number of dosis prescribed. Timing adherence: number of dosis taken within a time interval (within 15% of the mean preset intake time) divided by number of dosis prescribed.
Time frame: 3 months of treatment
Serum level of vitamin D
Level of serum vitamin D compared to baseline value.
Time frame: 3 and 6 months
Patients preferences
Questionnaire with 5-point Likert scale (from 1=strongly disagree to 5=strongly agree)
Time frame: 3 months of treatment
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