ABSTRACT
Low levels of vitamin D are common in older adults and associated with a variety of negative health outcomes. Studies have found associations between low levels of vitamin D and mortality — all-cause and cardiovascular disease (CVD) —, and type 2 diabetes, dementia, cancer, heart failure, and respiratory tract infections. Since low levels of vitamin D are reversible, vitamin D supplementation may have a potential role in the prevention and/or treatment of conditions associated with low levels of vitamin D. The main function of vitamin D is to enhance the intestinal absorption of calcium and phosphorous. Vitamin D can be obtained from dietary sources and is also produced by the skin after exposure to UV light. Vitamin D deficiency can result from reduced sunlight exposure or a limited dietary intake of vitamin D. Aging reduces the skin's ability to produce vitamin D. When exposed to the same amount of sunlight, the capacity of the skin to produce vitamin D in adults aged 65 years has been estimated to be about 25% of that as compared to adults aged 20 to 30 years. This may be a contributing factor to the low levels of vitamin D that are commonly seen in older adults. In Canada, more than 90% of long-term care residents were found to consume amounts of vitamins D, E, K, magnesium, and potassium below the estimated average requirement/adequate intake. Vitamin D supplements were shown to resolve inadequate intakes for 50% to 70% of participants. Vitamin D has an established role in bone health and vitamin D supplementation is recommended to prevent fractures in long-term care residents. However, the role of vitamin D supplementation in the prevention and/or treatment of other conditions in long-term care residents remains unclear. A summary of the available literature could help decision-makers to determine the appropriate use of vitamin D supplementation in long-term care facilities. This report is part of a series of 3 CADTH reports on the use of vitamin D supplementation in residents of long-term care facilities. One of the reports aimed to summarize the effectiveness and guidelines of vitamin D supplementation for the prevention and/or treatment of COVID-19 in long-term care residents. The other report is an update to a 2019 CADTH report on the clinical effectiveness, cost-effectiveness, and evidence-based guidelines on the use of vitamin D supplementation for the prevention of falls and fractures in long-term care residents. The aim of the current report is to summarize the evidence regarding the clinical effectiveness and evidence-based guidelines of vitamin D supplementation for the prevention and/or treatment of CVD, cancer, and other conditions in elderly patients residing in long-term care facilities.
ABSTRACT
This workshop will provide health science librarians and information professionals at any level/context with an overview of the best practices in finding and identifying the best scientific evidence during novel public health emergencies. Attendees will be presented with an overview of a best practices statement developed by the Librarian Reserve Corps. Attendees will then apply the recommendations from the best practices statement in designing a plan to respond to real-life case study/information request during a public health emergency. A discussion period will follow on how to apply the best practices in other contexts, environments, and cultures. Attendees will also be invited to share their own experiences and best practices during the discussion session. Through hands-on learning and discussion, librarians and information professionals at any level/context will develop strategies to find and critically appraise the best evidence in any novel public health emergency situation. Introduction: To inform the design of a consumer health strategy for a provincial health library system, the library sought to understand patient challenges and barriers in accessing quality sources of health information. Description: Over a period of three months in the winter of 2020-2021, the library engaged in semi-structured interviews with relevant clinical and corporate stakeholders. Program leads were asked about their role in consumer health information provision and support, and where they saw gaps and opportunities within the organization. Answers were themed and analyzed, and an internal report was produced to guide next steps in developing a consumer health strategy. Outcomes: The environmental scan showed that there are clear challenges and barriers for patients in accessing quality health information. Barriers include the duration of interaction with a healthcare practitioner;the specificity of patient information needs;and the organizational emphasis on a single enterprise-wide patient information resource. More significant challenges include language;lack of health information literacy skills;and low digital literacy among certain populations. Discussion: The environmental scan results provided strong rationale for developing a cohesive consumer health strategy for the library. They highlighted valuable but disjointed resources and programs throughout the organization. A Consumer Health Framework was drafted to guide the library in setting achievable goals and leveraging existing supports. Due to the Covid-19 pandemic it was not possible to engage directly with patients for the initial scan, however consultation with patient advisory groups is now being planned to check and validate the library’s direction.