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

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 analyzed 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 (kappa = 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.