Knowledge, Attitude and Practice Regarding Vitamin D Among Primary Health Care Physicians in Riyadh City, Saudi Arabia, 2015
World Journal of Food Science and Technology
Volume 1, Issue 2, September 2017, Pages: 47-55
Received: Apr. 26, 2017;
Accepted: May 19, 2017;
Published: Jul. 11, 2017
Views 1856 Downloads 156
Fahad Al-Amri, Deputy Ministry for Public Health, Assistant Deputy for Primary Health Care, Riyadh, KSA
Ashry Gad, Family and Community Medicine Department, King Saud University, Riyadh, KSA
Dina Al-Habib, Family and Community Medicine Department, King Saud University, Riyadh, KSA
Ahmed Khair Ibrahim, Public Health & Community Medicine School, Faculty of Medicine, Assiut University, Asyut, Egypt
Vitamin D deficiency has been recognized as a worldwide epidemic, affecting even healthy population. The awareness and practices of primary health care physicians regarding vitamin D needs to be highlighted, as improving the knowledge of physicians will improve the knowledge of the public as a whole. This study aimed to address the knowledge, attitude and practice of primary health care physicians regarding vitamin D in Riyadh city, KSA. A cross-sectional study was conducted using a self-administered questionnaire among primary care physicians; currently working in Riyadh city, KSA. Descriptive statistics: mean, standard deviation, frequencies, percentage were calculated. Of the 158 eligible participants, there were 43.7% male. The mean participant's age of was 40.7 ± 9.6 years. Of all the participants; 51.3% showed good knowledge regarding vitamin D, while 48.7% showed poor knowledge; 55.1% had positive attitude. Participants were asked about patient features that would alert them to vitamin D status. Fatigue was shown to alert more male than female physicians participants (75.4% vs. 58.4%, p = 0.026). Participants were asked about ways of managing vitamin D deficiency. Nutrition advice was mostly given by older physicians (p = 0.044) and non-Saudis (p = 0.003). In conclusion, this survey identified a gap in knowledge and practice among Primary Health Care physicians. The confusion could be partly attributed to different guidelines and sources of information. This study showed that continuous medical education and online sources were the most common sources of information about vitamin D among physicians.
Ahmed Khair Ibrahim,
Knowledge, Attitude and Practice Regarding Vitamin D Among Primary Health Care Physicians in Riyadh City, Saudi Arabia, 2015, World Journal of Food Science and Technology.
Vol. 1, No. 2,
2017, pp. 47-55.
Holick MF, Chen TC. Vitamin D deficiency: a worldwide problem with health consequences. The American journal of clinical nutrition. 2008; 87 (4): 1080S-6S.
Forrest KY, Stuhldreher WL. Prevalence and correlates of vitamin D deficiency in US adults. Nutrition research (New York, NY). 2011; 31 (1): 48-54.
G R, Gupta A. Vitamin D deficiency in India: prevalence, causalities and interventions. Nutrients. 2014; 6 (2): 729-75.
Abiaka C, Delghandi M, Kaur M, Al-Saleh M. Vitamin d status and anthropometric indices of an omani study population. Sultan Qaboos University medical journal. 2013; 13 (2): 224-31.
Al-Mogbel ES. Vitamin D status among Adult Saudi Females visiting Primary Health Care Clinics. International journal of health sciences. 2012; 6 (2): 116-26.
Kanan RM, Al Saleh YM, Fakhoury HM, Adham M, Aljaser S, Tamimi W. Year-round vitamin D deficiency among Saudi female out-patients. Public health nutrition. 2013; 16 (3): 544-51.
Sadat-Ali M, AlElq A, Al-Turki H, Al-Mulhim F, Al-Ali A. Vitamin D levels in healthy men in eastern Saudi Arabia. Annals of Saudi medicine. 2009; 29 (5): 378-82.
Alfawaz H, Tamim H, Alharbi S, Aljaser S, Tamimi W. Vitamin D status among patients visiting a tertiary care center in Riyadh, Saudi Arabia: a retrospective review of 3475 cases. BMC public health. 2014; 14: 159.
Ardawi MS, Sibiany AM, Bakhsh TM, Qari MH, Maimani AA. High prevalence of vitamin D deficiency among healthy Saudi Arabian men: relationship to bone mineral density, parathyroid hormone, bone turnover markers, and lifestyle factors. Osteoporos Int. 2012; 23 (2): 675-86.
Mansour MM, Alhadidi KM. Vitamin D deficiency in children living in Jeddah, Saudi Arabia. Indian journal of endocrinology and metabolism. 2012; 16 (2): 263-9.
Holick MF. Vitamin D Deficiency. New England Journal of Medicine. 2007; 357 (3): 266-74.
Dawson-Hughes B. Vitamin D deficiency in adults: Definition, clinical manifestations, and treatment. Up To Date2014 [updated March, 13 2014; cited June, 11 2014]; Available from: http://www.uptodate.com/contents/vitamin-d-deficiency-in-adults-definition-clinical-manifestations-and-treatment.
Lips P, Hosking D, Lippuner K, Norquist JM, Wehren L, Maalouf G, et al. The prevalence of vitamin D inadequacy amongst women with osteoporosis: an international epidemiological investigation. Journal of internal medicine. 2006; 260 (3): 245-54.
Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. The Journal of clinical endocrinology and metabolism. 2011; 96 (7): 1911-30.
Dietary Reference Intakes for Calcium and Vitamin D. Ross AC, Taylor CL, Yaktine AL, Valle HBD, editors: The National Academies Press; 2011.
Lips P. Vitamin D deficiency and secondary hyperparathyroidism in the elderly: consequences for bone loss and fractures and therapeutic implications. Endocrine reviews. 2001; 22 (4): 477-501.
Gallagher JC, Peacock M, Yalamanchili V, Smith LM. Effects of vitamin D supplementation in older African American women. The Journal of clinical endocrinology and metabolism. 2013; 98 (3): 1137-46.
El-Sonbaty MR, Abdul-Ghaffar NU. Vitamin D deficiency in veiled Kuwaiti women. European journal of clinical nutrition. 1996; 50 (5): 315-8.
Hatun S, Islam O, Cizmecioglu F, Kara B, Babaoglu K, Berk F, et al. Subclinical vitamin D deficiency is increased in adolescent girls who wear concealing clothing. J Nutr. 2005; 135 (2): 218-22.
Al-Ghamdi MA, Lanham-New SA, Kahn JA. Differences in vitamin D status and calcium metabolism in Saudi Arabian boys and girls aged 6 to 18 years: effects of age, gender, extent of veiling and physical activity with concomitant implications for bone health.
Looker AC, Pfeiffer CM, Lacher DA, Schleicher RL, Picciano MF, Yetley EA. Serum 25-hydroxyvitamin D status of the US population: 1988-1994 compared with 2000-2004.
Thomas MK, Lloyd-Jones DM, Thadhani RI, Shaw AC, Deraska DJ, Kitch BT, et al. Hypovitaminosis D in medical inpatients. The New England journal of medicine. 1998; 338 (12): 777-83.
Webb AR, DeCosta BR, Holick MF. Sunlight regulates the cutaneous production of vitamin D3 by causing its photodegradation. The Journal of clinical endocrinology and metabolism. 1989; 68 (5): 882-7.
Lucas R MA, Smith W, Armstrong B. Solar ultraviolet radiation: Global burden of disease from solar ultraviolet radiation. Geneva Switzerland: World Health Organization (WHO Press), 2006.
Siddiqui AM, Kamfar HZ. Prevalence of vitamin D deficiency rickets in adolescent school girls in Western region, Saudi Arabia. Saudi medical journal. 2007; 28 (3): 441-4.
Glerup H, Mikkelsen K, Poulsen L, Hass E, Overbeck S, Thomsen J, et al. Commonly recommended daily intake of vitamin D is not sufficient if sunlight exposure is limited. Journal of internal medicine. 2000; 247 (2): 260-8.
Al-Othman A, Al-Musharaf S, Al-Daghri NM, Krishnaswamy S, Yusuf DS, Alkharfy KM, et al. Effect of physical activity and sun exposure on vitamin D status of Saudi children and adolescents. BMC pediatrics. 2012; 12: 92.
Kaliyaperumal K. Guideline for conducting a knowledge, attitude and practice (KAP) study. AECS Illumination. 2004; 4 (1): 7-9.
Locyer V, Porcellato L, Gee I. Vitamin D deficiency and supplementation: are we failing to prevent the preventable? Community Pract. 2011; 84 (3): 23-6.
Bonevski B, Girgis A, Magin P, Horton G, Brozek I, Armstrong B. Prescribing sunshine: a cross-sectional survey of 500 Australian general practitioners' practices and attitudes about vitamin D. International journal of cancer Journal international du cancer. 2012; 130 (9): 2138-45.
Rubio-Valera M, Pons-Vigues M, Martinez-Andres M, Moreno-Peral P, Berenguera A, Fernandez A. Barriers and facilitators for the implementation of primary prevention and health promotion activities in primary care: a synthesis through meta-ethnography. PloS one. 2014; 9 (2): e89554.
Reeder AI, Jopson JA, Gray AR. "Prescribing sunshine": a national, cross-sectional survey of 1,089 New Zealand general practitioners regarding their sun exposure and vitamin D perceptions, and advice provided to patients. BMC family practice. 2012; 13: 85.
Stoll D, Lamy O, Hans D, Zufferey P, So A, Krieg MA, et al. Changing the awareness of low vitamin D status in a rheumatology population: a pre/post-study. Swiss medical weekly. 2013; 143:w13891.
Al-Daghri NM, Al-Attas OS, Alokail MS, Alkharfy KM, El-Kholie E, Yousef M, et al. Increased vitamin D supplementation recommended during summer season in the gulf region: a counterintuitive seasonal effect in vitamin D levels in adult, overweight and obese Middle Eastern residents. Clin Endocri. 2012; 76 (3): 346-50.
Alamri F, Alshahrani F, Al-Saleh Y, Saeedi M, Almalki M, Al-Daghri N, et al. Optimum Sun Exposure Times for Vitamin D Status Correction in Saudi Arabia. European Journal of Preventive Medicine 2015; 3 (5): 147-154.
Chen TC, Chimeh F, Lu Z, Mathieu J, Person KS, Zhang A, et al. Factors that influence the cutaneous synthesis and dietary sources of vitamin D. Archives of biochemistry and biophysics. 2007; 460 (2): 213-7.
Cancer Incidence Report. Saudi Arabia: Ministry of Health; 2010. Available from: http://www.scr.org.sa/.
Australian Institute of Health and Welfare (AIHW). Australian Cancer Incidence and mortality. http://www.aihw.gov.au/acim-books/.
Cancer: New Registrations and Deaths 2011. Wellington: Ministry of Health2014. Available from: http://www.health.govt.nz/publication/cancer-new-registrations-and-deaths-2011.
Hossein-nezhad A, Holick MF. Vitamin D for health: a global perspective. Mayo Clinic proceedings. 2013; 88 (7): 720-55.