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Medical intelligence in Sweden. Vitamin B12: oral compared with parenteral?
Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine.
Umeå University, Faculty of Medicine, Public Health and Clinical Medicine.
Umeå University, Faculty of Medicine, Medical Biosciences, Clinical chemistry.
Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine.
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2005 (English)In: Postgraduate medical journal, ISSN 0032-5473, E-ISSN 1469-0756, Vol. 81, no 953, 191-193 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Sweden is the only country in which oral high dose vitamin B12 has gained widespread use in the treatment of deficiency states. OBJECTIVE: The aim of the study was to describe prescribing patterns and sales statistics of vitamin B12 tablets and injections in Sweden 1990-2000.Design, setting, and sources: Official statistics of cobalamin prescriptions and sales were used. RESULTS: The use of vitamin B12 increased in Sweden 1990-2000, mainly because of an increase in the use of oral high dose vitamin B12 therapy. The experience, in statistical terms a "total investigation", comprised 1,000,000 patient years for tablets and 750,000 patient years for injections. During 2000, 13% of residents aged 70 and over were treated with vitamin B12, two of three with the tablet preparation. Most patients in Sweden requiring vitamin B12 therapy have transferred from parenteral to oral high dose vitamin B12 since 1964, when the oral preparation was introduced. CONCLUSION: The findings suggest that many patients in other post-industrial societies may also be suitable for oral vitamin B12 treatment.

Place, publisher, year, edition, pages
2005. Vol. 81, no 953, 191-193 p.
Keyword [en]
Administration; Oral, Adolescent, Adult, Aged, Child, Child; Preschool, Female, Humans, Infant, Infant; Newborn, Injections; Intramuscular, Male, Middle Aged, Physician's Practice Patterns/trends, Prescriptions; Drug/statistics & numerical data, Sweden, Tablets, Vitamin B 12/*administration & dosage, Vitamin B 12 Deficiency/*drug therapy
Identifiers
URN: urn:nbn:se:umu:diva-14819DOI: 10.1136/pgmj.2004.020057PubMedID: 15749797OAI: oai:DiVA.org:umu-14819DiVA: diva2:154491
Available from: 2008-10-10 Created: 2008-10-10 Last updated: 2017-12-14Bibliographically approved
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.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 940
Keyword
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
Medicine
Identifiers
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)
Opponent
Supervisors
Available from: 2005-01-18 Created: 2005-01-18 Last updated: 2009-11-25Bibliographically approved

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