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Vitamin B12 in primary health care and geriatrics - attitudes, knowledge, competence.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
Umeå University, Faculty of Medicine, Department of Medical Biosciences, Clinical chemistry.
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2001 (English)In: International Journal of Geriatric Psychiatry, ISSN 0885-6230, E-ISSN 1099-1166, Vol. 16, no 10, 987-992 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: The objective of the study was to test attitudes, knowledge and competence of Swedish general practitioners and geriatricians concerning B12-associated problems in 1998. METHODS: Postal questionnaires were sent to a random sample of 485 GPs and a total sample of 613 geriatricians. The response rates were 70% in the GP group and 69% in the geriatrician group. The questionnaire contained 24 statements to be evaluated by a visuo-analogue scale. RESULTS: There were small numerical differences between the two physician groups. The geriatricians were more aware of risk groups for B12 deficiency. GPs were less categorical concerning low hit rate in the laboratory testing of clinical conclusions. There were statistical differences in both directions for statements on pitfalls in laboratory diagnostics. GPs were somewhat less prone to give risk groups prophylactic B12 therapy. CONCLUSIONS: GPs and geriatricians appeared to be familiar with the current debate on B12-associated problems, suggesting that health care quality will be unaffected by patient transfer from hospital care to primary health care. Copyright 2001 John Wiley & Sons, Ltd.

Place, publisher, year, edition, pages
2001. Vol. 16, no 10, 987-992 p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:umu:diva-4357DOI: 10.1002/gps.455PubMedID: 11607944OAI: diva2:143408
Available from: 2005-01-18 Created: 2005-01-18 Last updated: 2016-03-03
In thesis
1. Cobalamin communication in Sweden 1990 – 2000: views, knowledge and practice among Swedish physicians
Open this publication in new window or tab >>Cobalamin communication in Sweden 1990 – 2000: views, knowledge and practice among Swedish physicians
2005 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Cobalamin (vitamin B12) is one of several essential micronutrients needed by the human organism. Other important micronutritients, which interplay with vitamin B12, are folate and iron. During the last ten years, the attention has been drawn to different forms of neurological disorders supposed to be caused by vitamin B12 deficiency. Vitamin B12 deficiency states are common among elderly patients in primary health care and sometimes in hospital care, especially in geriatric practice.

This is a study to define the cobalamin treatment traditions, among Swedish physicians in the period 1990 – 2000. The period was distinguished by an intense debate on the issue by the physicians, an increase of cobalamin consumption, and a shift from parenteral therapy towards oral high-dose therapy.

It had been known that symptoms of cobalamin deficiency could start in the nervous system. This knowledge was reinforced by the application of homocysteine and methyl-malonic acid (MMA) in deficiency diagnosis. Introduction of homocysteine and MMA in deficiency diagnosis changed the view on deficiency prevalence, by identifying persons at risk to develop B12 deficiency prior to established symptoms.

In this study, Swedish physicians are regarded mainly as receivers of communication about the markers homocysteine and MMA, and deficiency states of cobalamin and folate. The main senders were scientists from North America, Norway, Denmark, and Sweden.

This study sets the senders and the receivers of cobalamin communication on a collegial level and quantifies and evaluates the feed-back from the receivers. The receivers, gen¬eral practitioners and geriatricians, appeared to be familiar with old knowledge and frontier concepts in the field. Thus, it is suggested that the increase of B12 prescriptions in Sweden 1990 – 2000 reflected an increased awareness of B12-associated clinical problems among the physicians managing the majority of deficiency patients, although a possible overconsumption of pharmaceutical drugs must be kept in mind.

Place, publisher, year, edition, pages
Umeå: Folkhälsa och klinisk medicin, 2005. 66 p.
Umeå University medical dissertations, ISSN 0346-6612 ; 940
Medicine, Cobalamin, folate, iron, homocysteine, MMA, vitamin B12 deficiency, therapy tradition, drug epidemiology, communication, receivers, senders, Medicin
National Category
Dermatology and Venereal Diseases
Research subject
urn:nbn:se:umu:diva-416 (URN)91-7305-803-3 (ISBN)
Public defence
2005-01-28, 933, Byggnad 3a 9 trappor, Norrlands Universitetssjukhus, Umeå, 13:00 (English)
Available from: 2005-01-18 Created: 2005-01-18 Last updated: 2009-11-25Bibliographically approved

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