RT Journal Article
SR Electronic
T1 Implementation of an intervention to reduce population-based screening for vitamin D deficiency: a cross-sectional study
JF CMAJ Open
FD Canadian Medical Association
SP E36
OP E39
DO 10.9778/cmajo.20160073
VO 5
IS 1
A1 Christopher Naugler
A1 Brenda Hemmelgarn
A1 Hude Quan
A1 Fiona Clement
A1 Tolulope Sajobi
A1 Roger Thomas
A1 Tanvir C. Turin
A1 William Hnydyk
A1 Alex Chin
A1 James Wesenberg
YR 2017
UL http://www.cmajopen.ca/content/5/1/E36.abstract
AB 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.