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In the systematic review by Jolliffe et al. patients with Vitamin D deficiency benefitted most from supplementation. The hypothesis is put forward that exacerbations in the Vitamin D deficient groups are driven largely by Vitamin D deficiency. It may be that strategies aimed at reducing the prevalence of Vitamin D deficiency in the COPD population are the most effective. A population health perspective may be sensible. The Scientific Advisory Committee on Nutrition recommends a daily Vitamin D dietary intake of 10 micrograms for everyone 4 years and over. A pragmatic change to our practice could be to encourage, advocate and remind these patients to take a dietary supplement bought from their pharmacy. This advice can be imparted by clinicians during routine reviews and exacerbations both in Primary and Secondary care.
1. Jolliffe DA, Greenberg L, Hooper RL, et al, Vitamin D to prevent exacerbations of COPD: systematic review and meta-analysis of individual participant data from randomised controlled trials. Thorax 2019;74:337-345.
2. Vitamin D and Health Report, Scientific Advisory Committee on Nutrition , 2016