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      Vitamin, micronutrients and supplement prescribing patterns in a group of ambulatory colombian patients, 2016 Translated title: Patrones de prescripción de vitaminas y suplementos nutricionales en un grupo de pacientes de Colombia

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          Abstract

          Abstract Introduction: Vitamins and micronutrients are essential organic substances in the metabolic processes of living things, and supplementation is only recommended in conditions of nutritional deficits. Objective: To determine the prescription patterns of vitamins and supplements in a group of patients enrolled in the Colombian Health System in 2016. Methodology: This was a cross-sectional study based on a population database. Vitamin-prescribed patients of both sexes and all ages were selected for 3 consecutive months. A database was designed using the dispensing records. SPSS 23.0 was used for the univariate, bivariate and multivariate analyses. A p-value <0.05 was considered statistically significant. Results: In total, 9998 patients receiving vitamin supplementation were identified. A female predominance was observed (n=8341, 83.4%). The mean age was 57.7±18.7 years. The most commonly formulated vitamins and micronutrients were vitamin D (58.0%), calcium (55.0%) and folic acid (25.0%). Overall, 60.8% of patients were prescribed more than one vitamin. The most frequent multiple-nutrient association was between calcium and vitamin D (n=5505); 77.3% received concurrent treatment with other medications to manage comorbidities. The probability of comedication in the multivariate analysis was higher for folic acid (OR:3.10, 95%CI 2.69-3.59), thiamine (OR:2.75, 95%CI:2.15-3.5) and calcium + vitamin D (OR:1.61, 95%CI: 1.42-1.82) and for those individuals older than 65 years (OR:1.24, 95%CI:1.02-1.51). Conclusions: Vitamins are widely used in the Colombian population. The results of this study elucidate the patterns of use of these supplements and offer proposed strategies to the future and to evaluate and minimize prescriptions that are potentially inappropriate or of little therapeutic value. MÉD.UIS. 2020;33(2):41-8.

          Translated abstract

          Resumen Introducción: Las vitaminas y micronutrientes son sustancias orgánicas esenciales en los procesos metabólicos de los seres vivos y solo se recomienda suplementación en condiciones con déficits nutricionales. Objetivo: Determinar los patrones de prescripción de vitaminas y suplementos en un grupo de pacientes afiliados al Sistema de Salud en Colombia, en el año 2016. Métodos: Estudio de corte transversal a partir de una base de datos poblacional. Se seleccionaron pacientes con prescripción de vitaminas por 3 meses consecutivos de ambos sexos y todas las edades. Se diseñó una base de datos con los registros de dispensación. Se usó SPSS 23.0 para análisis univariados, bivariados y multivariados. Se consideró estadísticamente significativo un valor de p<0,05. Resultados: Se hallaron 9998 pacientes con prescripción de suplementos vitamínicos. Se halló un predominio femenino (n=8341; 83,4%). La edad media fue de 57,7±18,7 años, las vitaminas y micronutrientes más formulados fueron: vitamina D (58,0%), calcio (55,0%) y ácido fólico (25,0%). El 60,8% de pacientes tenía más de un suplemento prescrito. La asociación más frecuente fue calcio y vitamina D (n=5505), y el 77,3% recibía tratamiento simultáneo con otros medicamentos para el control de comorbilidades. La probabilidad de comedicacion en el análisis multivariado fue mayor en formulados con ácido fólico (OR:3,10; IC95%:2,69-3,59), tiamina (OR:2,75; IC95%:2,15-3,50), calcio+vitamina D (OR:1,61; IC95%:1,42-1,82) y los mayores de 65 años (OR:1,24; IC95%:1,02-1,51). Conclusiones: Las vitaminas son ampliamente usadas en la población colombiana, los hallazgos de este estudio permiten conocer un estado de los patrones de uso de estos suplementos, así como plantear estrategias para racionalizar las prescripciones potencialmente inapropiadas o de poco valor terapéutico. MÉD.UIS. 2020;33(2):41-8.

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          Trends in Dietary Supplement Use Among US Adults From 1999-2012.

          Dietary supplements are commonly used by US adults; yet, little is known about recent trends in supplement use.
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            The nonskeletal effects of vitamin D: an Endocrine Society scientific statement.

            Significant controversy has emerged over the last decade concerning the effects of vitamin D on skeletal and nonskeletal tissues. The demonstration that the vitamin D receptor is expressed in virtually all cells of the body and the growing body of observational data supporting a relationship of serum 25-hydroxyvitamin D to chronic metabolic, cardiovascular, and neoplastic diseases have led to widespread utilization of vitamin D supplementation for the prevention and treatment of numerous disorders. In this paper, we review both the basic and clinical aspects of vitamin D in relation to nonskeletal organ systems. We begin by focusing on the molecular aspects of vitamin D, primarily by examining the structure and function of the vitamin D receptor. This is followed by a systematic review according to tissue type of the inherent biological plausibility, the strength of the observational data, and the levels of evidence that support or refute an association between vitamin D levels or supplementation and maternal/child health as well as various disease states. Although observational studies support a strong case for an association between vitamin D and musculoskeletal, cardiovascular, neoplastic, and metabolic disorders, there remains a paucity of large-scale and long-term randomized clinical trials. Thus, at this time, more studies are needed to definitively conclude that vitamin D can offer preventive and therapeutic benefits across a wide range of physiological states and chronic nonskeletal disorders.
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              Why US adults use dietary supplements.

              Dietary supplements are used by more than half of adults, although to our knowledge, the reasons motivating use have not been previously examined in US adults using nationally representative data. The purpose of this analysis was to examine motivations for dietary supplement use, characterize the types of products used for the most commonly reported motivations, and to examine the role of physicians and health care practitioners in guiding choices about dietary supplements. Data from adults (≥20 years; n = 11 956) were examined in the 2007-2010 National Health and Nutrition Examination Survey, a nationally representative, cross-sectional, population-based survey. The most commonly reported reasons for using supplements were to "improve" (45%) or "maintain" (33%) overall health. Women used calcium products for "bone health" (36%), whereas men were more likely to report supplement use for "heart health or to lower cholesterol" (18%). Older adults (≥60 years) were more likely than younger individuals to report motivations related to site-specific reasons like heart, bone and joint, and eye health. Only 23% of products were used based on recommendations of a health care provider. Multivitamin-mineral products were the most frequently reported type of supplement taken, followed by calcium and ω-3 or fish oil supplements. Supplement users are more likely to report very good or excellent health, have health insurance, use alcohol moderately, eschew cigarette smoking, and exercise more frequently than nonusers. Supplement users reported motivations related to overall health more commonly than for supplementing nutrients from food intakes. Use of supplements was related to more favorable health and lifestyle choices. Less than a quarter of supplements used by adults were recommended by a physician or health care provider.
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                Author and article information

                Journal
                muis
                Medicas UIS
                Medicas UIS
                Universidad Industrial de Santander (Bucaramanga, Santander, Colombia )
                0121-0319
                1794-5240
                August 2020
                : 33
                : 2
                : 41-48
                Affiliations
                [1] orgnameFundación Universitaria Autónoma de las Américas orgdiv1Grupo Biomedicina Colombia
                [2] orgnameFundación Universitaria Autónoma de las Américas orgdiv1Grupo Biomedicina Colombia
                [3] Risaralda orgnameUniversidad Tecnológica de Pereira orgdiv1Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia Colombia machado@ 123456utp.edu.co
                Article
                S0121-03192020000200005 S0121-0319(20)03300200005
                10.18273/revmed.v33n2-2020005
                c2e53b77-d12e-4a3a-aa1e-5d83d6bc4f53

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 04 November 2018
                : 10 August 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 33, Pages: 8
                Product

                SciELO Colombia

                Categories
                Original Articles

                Colombia,Vitaminas,Suplementos dietéticos,Prescripciones de medicamentos,Prescripción inadecuada,Farmacoepidemiología,Vitamins,Dietary supplements,Drug prescriptions,Prescription Drug Misuse,Pharmacoepidemiology

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