Usage Of Cholecalciferol Among Adult Patients in Putrajaya Hospital (HPJ)

Introduction: Vitamin D Deficiency is common in Southeast Asia and South Asia countries in relative to the abundance of sunshine which is essential for the Cholecalciferol production. In Malaysia, increased usage of Cholecalciferol is reported. The purpose of this study was to investigate the secondary causes of Vitamin D deficiency or insufficiency as well as its efficacy in improving vitamin D level and possible association with gender and ethnic populations. Materials and Methods: An observational study design using retrospective clinical data was performed among adult patients treated with Cholecalciferol in Hospital Putrajaya. A total of 138 patients were treated with Cholecalciferol from January 2011 until December 2017 with baseline and post administration Vitamin D level were included in this study. The inclusion criteria are as follows: i) adult patient in HPj aged ≥ 18 years old ii) received treatment as out or in-patient iii) received Cholecalciferol from 2011-2017 iv) had baseline Vitamin D level before treatment started v) adherence to Cholecalciferol based on prescription filling. The exclusion criteria are as follows: i) without the post- Vitamin D level ii) had treatment duration of less than 3 months1 iii) and had normal baseline of Vitamin D >75nmol/L during initiation of the Cholecalciferol. Results: Most of the patients are female (n = 123, 89.1%) and Malays (66.7%, n= 92). The main secondary causes of vitamin D deficiency are thyroid disease (n=43, 31.1%), chronic inflammatory polyarthropathies (n=37, 26.8%), post-menopausal osteoporosis (n=17, 12.3%) and obesity (n=16, 11.6%). The number of patients with Vitamin D deficiency was significantly reduced (p<0.001) after treatment with Cholecalciferol by comparing the pre and post vitamin D level. There were no association between gender (p=0.096) and ethnicity (p=0.584) towards Cholecalciferol supplementation. Discussion/conclusion: The optimal duration for Cholecalciferol supplementation is 6 to 8 weeks of in adults2 and the recommended intake of Cholecalciferol is 800IU to 1000IU daily3. Cholecalciferol has significant and positive effect in raising serum 25-hydroxyvitamin D levels compared with the effect of Ergocalciferol (P= 0.001)4. A double blind placebo study found both male and female groups had increased post serum 25-hydroxyvitamin D levels, showing no significant different (P