Establishing a community pharmacist-led vitamin D point-of-care testing service

Abstract

Introduction: Growing recognition of the role of Vitamin D augmented the demand for a point-of- care testing (POCT) framework, unveiling a niche for development of a novel service.

Objectives: Review available Vitamin D POCT devices and validate Vitamin D POCT; Develop and validate framework for Vitamin D POCT; Conduct pilot study for pharmacist-led Vitamin D POCT framework in community pharmacy.

Methods: Vitamin D POCT devices were appraised by considering specifications and the identified Vitamin D POCT kit was validated by comparing results with gold standard method in 20 participants, employing Cohen’s Kappa coefficient. A framework consisting of a Data Collection Sheet, a standard operating procedure and Action Plan record for pharmacist-led Vitamin D POCT was developed and validated. The framework was piloted in a community pharmacy with 80 participants and patient data was correlated with POCT result. Data was analysed using the chi-square test.

Results: The appraisal identified a semi-quantitative POCT which conforms with European Union (EU) regulations. Concordance between POCT and gold standard was observed (κ = 0.84, p < 0.001). Of the 80 participants, 49 had insufficient; 8 had deficient Vitamin D levels. The framework developed was practical to be applied in the community pharmacy setting. Participants suffering from chronic conditions are more likely to have their Vitamin D levels tested (p = 0.042), those suffering from metabolic disorders being more likely to have deficient/insufficient Vitamin D levels (p = 0.026).

Conclusion: The study identified a POCT device for use within a framework for community pharmacist-led assessment of Vitamin D in the context of collaborative care. A high incidence of Vitamin D insufficiency was observed, indicating the value of providing access to this service at primary care level. An accessible Vitamin D testing service to participants, supported by community pharmacist professional advice, facilitates early detection of Vitamin D insufficiency and management.