Vitamin B12 injections: considerable source of work for the district nurse.

Middleton, John; Wells, Winfield J.

doi:10.1136/bmj.290.6477.1254

Cited by 24 publications

(13 citation statements)

References 2 publications

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“…Consequently, this study is the most extensive assessment of the use of vitamin B-12 in general practice yet reported. It has confirmed the findings of previous studies that vitamin B-12 is still used inappropriately 4 5 6 7…”

Section: Changes In the Use Of Vitamin B-12supporting

confidence: 88%

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Use of vitamin B-12 in Leicestershire practices: a single topic audit led by a medical audit advisory group

Fraser

Farooqi²,

Sorrie³

1995

BMJ

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Section: Changes In the Use Of Vitamin B-12supporting

confidence: 88%

“…We also anticipated that most practices could cope with the expected small workload, although some change in clinical behaviour would be required 4 5. The audit would also entail medical, nursing, and clerical members of primary care health teams 6. Finally, a locally developed protocol was already available 7…”

Section: Introductionmentioning

confidence: 99%

Use of vitamin B-12 in Leicestershire practices: a single topic audit led by a medical audit advisory group

Fraser

Farooqi²,

Sorrie³

1995

BMJ

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“…The possibility of taking an oral preparation would also allow patient preferences to be taken into account when deciding on what treatment to prescribe. Oral administration should provide patients with greater autonomy, improve treatment satisfaction, reduce treatment costs, and improve safety in anticoagulated patients [23,25,26,27]. Nyholm et al showed that all patients included in their study found oral therapy to be acceptable or highly acceptable and that 87% preferred oral to intramuscular therapy [23].…”

Section: Discussionmentioning

confidence: 99%

Oral Cyanocobalamin is Effective in the Treatment of Vitamin B12 Deficiency in Crohn’s Disease

et al. 2017

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Cobalamin deficiency is common in patients with Crohn’s disease (CD). Intramuscular cobalamin continues to be the standard therapy for the deficiency and maintenance treatment in these patients, although oral route has been demonstrated to be effective in other pathologies with impaired absorption. Our aims were to evaluate the efficacy of oral therapy in the treatment of cobalamin deficiency and in long-term maintenance in patients with Crohn’s disease. We performed a multicenter retrospective cohort study that included 94 patients with Crohn’s disease and cobalamin deficiency. Seventy-six patients had B12 deficiency and 94.7% of them normalized their cobalamin levels with oral treatment. The most used dose was 1 mg/day, but there were no significant differences in treatment effectiveness depending on the dose used (≥1 mg/24 h vs. <1 mg/24 h). Eighty-two patients had previous documented B12 deficiency and were treated with oral B12 to maintain their correct cobalamin levels. After a mean follow-up of 3 years, the oral route was effective as maintenance treatment in 81.7% of patients. A lack of treatment adherence was admitted by 46.6% of patients in who the oral route failed. In conclusion, our study shows that oral cyanocobalamin provides effective acute and maintenance treatment for vitamin B12 deficiency caused by CD with or without ileum resection.

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“…A 2001 cost study estimated that between $C2.9 and $C17.6 million could be saved over 5 years in the province of Ontario if elderly patients on intramuscular B 12 were switched to oral therapy 17. In addition, a British study estimated that 2000 nursing hours are required to provide 1 year of injections to 492 patients in their homes 18. Across Canada, only Nova Scotia, Northwest Territories, Yukon and the Non-Insured Health Benefits program for First Nations and Inuit consider oral B 12 tablets to be a benefit in their provincial drug formularies, while all provinces and territories cover the injectable product.…”

Section: Introductionmentioning

confidence: 99%

Should vitamin B₁₂tablets be included in more Canadian drug formularies? An economic model of the cost-saving potential from increased utilisation of oral versus intramuscular vitamin B₁₂maintenance therapy for Alberta seniors

2014

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ObjectiveThe aim of this study was to estimate the cost-savings attainable if all patients aged ≥65 years in Alberta, Canada, currently on intramuscular therapy were switched to oral therapy, from the perspective of a provincial ministry of health.SettingPrimary care setting in Alberta, Canada.ParticipantsSeniors of age 65 years and older currently receiving intramuscular vitamin B12 therapy.InterventionOral vitamin B12 therapy at 1000 μg/day versus intramuscular therapy at 1000 μg/month.Primary and secondary outcome measuresCost saving from oral therapy over intramuscular therapy, from the perspective of the Alberta Ministry of Health, including drug costs, dispensing fees, injection administration fees, additional laboratory monitoring and physician visit fees.ResultsOver 5 years, if all Albertans aged 65 years and older who currently receive intramuscular B12 are switched to oral therapy, our model found that $C13 975 883 can be saved. Even if no additional physician visits are billed for among patients receiving intramuscular therapy, $C8 444 346 could be saved from reduced administration costs alone.ConclusionsOral B12 therapy has been shown to be an effective therapeutic option for patients with vitamin B12 deficiency, yet only three provinces and the Non-Insured Health Benefits program include oral tablets on their formulary rather than the parenteral preparation. To ensure judicious use of limited health resources, clinicians and formulary committees are encouraged to adopt oral B12 therapy as a clinically and cost-effective first-line therapy for vitamin B12 deficiency.

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Vitamin B12 injections: considerable source of work for the district nurse.

Cited by 24 publications

References 2 publications

Use of vitamin B-12 in Leicestershire practices: a single topic audit led by a medical audit advisory group

Use of vitamin B-12 in Leicestershire practices: a single topic audit led by a medical audit advisory group

Oral Cyanocobalamin is Effective in the Treatment of Vitamin B12 Deficiency in Crohn’s Disease

Should vitamin B₁₂tablets be included in more Canadian drug formularies? An economic model of the cost-saving potential from increased utilisation of oral versus intramuscular vitamin B₁₂maintenance therapy for Alberta seniors

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Vitamin B12 injections: considerable source of work for the district nurse.

Cited by 24 publications

References 2 publications

Use of vitamin B-12 in Leicestershire practices: a single topic audit led by a medical audit advisory group

Use of vitamin B-12 in Leicestershire practices: a single topic audit led by a medical audit advisory group

Oral Cyanocobalamin is Effective in the Treatment of Vitamin B12 Deficiency in Crohn’s Disease

Should vitamin B12tablets be included in more Canadian drug formularies? An economic model of the cost-saving potential from increased utilisation of oral versus intramuscular vitamin B12maintenance therapy for Alberta seniors

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Product

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About

Should vitamin B₁₂tablets be included in more Canadian drug formularies? An economic model of the cost-saving potential from increased utilisation of oral versus intramuscular vitamin B₁₂maintenance therapy for Alberta seniors