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Implementation of an intervention to reduce population-based screening for vitamin D deficiency: a cross-sectional study.


ABSTRACT:

Background

We describe the implementation of an intervention in Alberta in support of the Choosing Wisely Canada recommendation against population screening for vitamin D deficiency (as determined by serum total 25-hydroxyvitamin D testing). We hypothesized that the introduction of a specialized requisition for vitamin D testing would reduce the annual number of vitamin D tests performed.

Methods

We performed a cross-sectional observational study that included all vitamin D tests ordered in Alberta between Apr. 1, 2015, and Mar. 31, 2016. There were no exclusion criteria. A special requisition for ordering vitamin D tests in Alberta was introduced on Apr. 1, 2015. Using an interrupted time series model, we compared predicted versus observed vitamin D test volumes for the 12-month period following the introduction of the new requisition. The sole outcome measure was the monthly change in volume of vitamin D testing. In addition, we calculated any cost savings as a result of reduced testing.

Results

Over the first 12 months of the intervention, there was a reduction in the number of tests ordered from a predicted 342?477 tests to 29?525 tests (91.4% reduction). This decrease represented a direct spending decrease of Can$938?856-$1?564?760 per year in Alberta.

Interpretation

A provincially led implementation of a Choosing Wisely Canada recommendation resulted in a large and sustained reduction in serum total 25-hydroxyvitamin D testing in Alberta. This study shows that provincially led interventions based on Choosing Wisely Canada recommendations can result in substantial reductions in laboratory tests.

SUBMITTER: Naugler C 

PROVIDER: S-EPMC5378529 | biostudies-literature | 2017 Jan-Mar

REPOSITORIES: biostudies-literature

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Implementation of an intervention to reduce population-based screening for vitamin D deficiency: a cross-sectional study.

Naugler Christopher C   Hemmelgarn Brenda B   Quan Hude H   Clement Fiona F   Sajobi Tolulope T   Thomas Roger R   Turin Tanvir C TC   Hnydyk William W   Chin Alex A   Wesenberg James J  

CMAJ open 20170117 1


<h4>Background</h4>We describe the implementation of an intervention in Alberta in support of the Choosing Wisely Canada recommendation against population screening for vitamin D deficiency (as determined by serum total 25-hydroxyvitamin D testing). We hypothesized that the introduction of a specialized requisition for vitamin D testing would reduce the annual number of vitamin D tests performed.<h4>Methods</h4>We performed a cross-sectional observational study that included all vitamin D tests  ...[more]

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