Knowledge and Practice of Pediatricians Regarding Hypovitaminosis D—A Survey across 33 European Countries

Abstract

Hypovitaminosis D has been recognized as a worldwide pandemic, but there are disagreements regarding its diagnosis and treatment. This study aimed to evaluate the knowledge and practice of European pediatricians concerning vitamin D (VD) and hypovitaminosis D and their adherence to relevant guidelines. A cross-sectional study was conducted through an anonymous survey via SurveyMonkey on 304 European pediatricians. Most of the participants were general pediatricians, followed by endocrinologists and neonatologists. ESPGHAN’s and the national guidelines were the most frequently used. VD testing was mostly performed in patients with skeletal, chronic kidney, and autoimmune diseases. Participants predominantly answered the questions regarding the definition of hypovitaminosis D and VD supplementation correctly, especially in children younger than 12 months. They showed the least knowledge regarding the cut off-point for the initiation of the therapy and therapeutic doses used to treat confirmed hypovitaminosis D. Participants’ conflicting answers could be related to the differences between the guidelines. We consider that experts in this field should create uniform guidelines, and that those guidelines should also be promoted by national or local pediatric associations.

Knowledge about Vitamin D among Women in the United Arab Emirates

“…Many answered incorrectly regarding factors that impacted vitamin D synthesis such as latitude, season, time of day, sunscreen application, and skin pigmentation. Inaccurate nutrition knowledge was re-markable regarding red meat as only 13% indicated the right answer about red meat as a source of Vitamin D. In line with our study, several quantitative and qualitative studies at the international, national, and local levels showed a lack of knowledge about vitamin D dietary sources, health benefits, complications related to vitamin D deficiency, and updated vitamin D recommendations [20,32,33,37,[39][40][41]. This points to the need for better targeted educational interventions.…”

“…As this study focused on addressing the areas of knowledge and behavioral patterns toward vitamin D among women in the UAE. We believe the results could incentivize public health professionals and stakeholders to implement interventions focusing on vitamin D education, supplementation, and food fortification strategies as they are considered the most effective ways to prevent vitamin D deficiency [41][42][43][44].…”

Exposure to a Vitamin D Best Practices Toolkit, Model, and E-Tools Increases Knowledge, Confidence, and the Translation of Research to Public Health and Practice

“…In a study of doctors caring for pregnant women, 35% did not assess women for VDD, and 32% only assessed high-risk women [83]. In a study on pediatricians' knowledge of vitamin D best practices, participants were least knowledgeable with respect to when to initiate vitamin D therapy and which dosages should be used to treat low 25(OH)D concentrations [30]. In the same study, the authors noted a discrepancy between guidelines and participants' knowledge, proposing that pediatricians may be fearful of intoxication and unclear between general supplementation guidelines and the therapeutic doses necessary for repletion [30].…”

“…In a study on pediatricians' knowledge of vitamin D best practices, participants were least knowledgeable with respect to when to initiate vitamin D therapy and which dosages should be used to treat low 25(OH)D concentrations [30]. In the same study, the authors noted a discrepancy between guidelines and participants' knowledge, proposing that pediatricians may be fearful of intoxication and unclear between general supplementation guidelines and the therapeutic doses necessary for repletion [30]. In the United States, a 2009-2016 data analysis showed that less than 40% of breastfeeding and non-breastfeeding infants between the ages of 0 and 11 months met the American Academy of Pediatrics guidelines for vitamin D supplementation (≥400 IU) regardless of demographic subgroups [84].…”

“…The development of better clinical guidelines, electronic decision aids, and visual cues has been recommended to aid the ease of moving vitamin D research into practice [17][18][19][20]. Further education and training were also recommended to increase both students' and practicing HCPs' vitamin D knowledge and increase the translation of this knowledge into practice and public health [21][22][23][24][25][26][27][28][29][30]. Research shows that HCP education increases knowledge, results in feelings of enhanced self-efficacy, and increases the sustainability of evidence-based practice (EBP); however, authors have noted that translational methods are needed to sustain a long-term practice change [31].…”