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Vitamin B12 supplementation post-gastrectomy: a service closed-loop audit at St. James's Hospital, Dublin.
Temperley, Hugo C; Gaule, Richard; Murray, Cian; Carey, James; O'Sullivan, Niall J; Davey, Matthew G; Fanning, Michelle; Bolger, Jarlath C; Ravi, Narayanasamy; Reynolds, John V; Donohoe, Claire L.
Afiliação
  • Temperley HC; Department of Surgery, Trinity Centre for Health Sciences, St. James's Hospital and Trinity College Dublin, Dublin 8, Ireland. temperlh@tcd.ie.
  • Gaule R; Department of Surgery, Trinity Centre for Health Sciences, St. James's Hospital and Trinity College Dublin, Dublin 8, Ireland.
  • Murray C; Department of Surgery, Trinity Centre for Health Sciences, St. James's Hospital and Trinity College Dublin, Dublin 8, Ireland.
  • Carey J; Department of Surgery, Trinity Centre for Health Sciences, St. James's Hospital and Trinity College Dublin, Dublin 8, Ireland.
  • O'Sullivan NJ; Department of Surgery, Tallaght University Hospital, Dublin 24, Ireland.
  • Davey MG; Discipline of Surgery, National University of Ireland, Galway, Ireland.
  • Fanning M; Department of Clinical Nutrition, St James's Hospital, Dublin, Ireland.
  • Bolger JC; Department of Surgery, Trinity Centre for Health Sciences, St. James's Hospital and Trinity College Dublin, Dublin 8, Ireland.
  • Ravi N; Department of Surgery, Toronto General Hospital/University Health Network, Toronto, ON, Canada.
  • Reynolds JV; Department of Surgery, Trinity Centre for Health Sciences, St. James's Hospital and Trinity College Dublin, Dublin 8, Ireland.
  • Donohoe CL; Department of Surgery, Trinity Centre for Health Sciences, St. James's Hospital and Trinity College Dublin, Dublin 8, Ireland.
Ir J Med Sci ; 192(3): 1051-1057, 2023 Jun.
Article em En | MEDLINE | ID: mdl-35965306
BACKGROUND: Vitamin B12 (VB12) deficiency is a well-described complication post-gastrectomy. It is caused by the loss of parietal cell mass leading to megaloblastic anaemia. This closed-loop audit assesses patient understanding of and adherence with VB12 supplementation guidelines post-gastrectomy. METHODS: A closed-loop audit cycle was performed. After the first cycle, an educational intervention was actioned prior to re-audit. One hundred twenty-five patients who underwent gastrectomy between 2010 and 2020 were available for study (86 total gastrectomies (TG), 39 subtotal gastrectomies (STG)). Twenty-nine patients who had not been adherent with VB12 supplementation/surveillance were eligible for re-audit. RESULTS: 91.9% (79/86) of TG patients reported adherence in regular parenteral VB12 supplementation. Adherence was significantly lower for STG for checking (and/or replacing) their VB12, with only 53.8% (21/39) checking their VB12 levels. 67/125 (53.6%) of the patients stated that they knew it was important to supplement B12 post-gastrectomy. 37.8% (43/113) of participants could explain why this was important, and 14.4% (18/125) had any knowledge of the complications of VB12 deficiency. Following re-audit, 5/8 (57.5%) of TG patients who had not been adherent with VB12 supplementation in the first cycle were now adherent with VB12 supplementation following our educational intervention. 7/17 (41.2%) of the STG group had received VB12 or made arrangements to receive supplemental VB12 if it was indicated. CONCLUSION: This study demonstrates good adherence in those undergoing TG. Patient understanding correlates with adherence, suggesting that patient education and knowledge reinforcement may be key to adherence with VB12 supplementation. A simple educational intervention can improve adherence with VB12 supplementation in patients undergoing gastrectomy.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Vitamina B 12 / Deficiência de Vitamina B 12 Idioma: En Revista: Ir J Med Sci Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Irlanda

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Vitamina B 12 / Deficiência de Vitamina B 12 Idioma: En Revista: Ir J Med Sci Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Irlanda