{
  "abstract": "Aim Children undergoing cancer treatment are at high risk of vitamin D deficiency due to reduced sunlight exposure from prolonged hospital admissions, restricted intake secondary to nausea, vomiting or mucositis, and gastrointestinal malabsorption. Additionally, medications such as corticosteroids, antacids, and antiepileptics further increase deficiency risk. A new trust guideline has been implemented for vitamin D testing and prescribing in paediatric haematology, oncology, and bone marrow transplant (BMT) patients. 1 This audit evaluated adherence to this guideline.Method A retrospective audit was conducted on paediatric oncology, haematology, and BMT patients discharged between 1st May and 22nd June 2025. Ethics approval was not required. Patients were included if considered high risk as per guideline criteria: malignant haematology, solid oncology receiving high-dose steroids, darker skin pigmentation, obesity (>98th centile BMI), low/no sunlight exposure, restricted diet, or significant malabsorption. The audit assessed whether vitamin D levels were measured at diagnosis or within one month (unless deferred for CRP >40 mg/L), whether prescribing aligned with guideline recommendations, and if discharge documentation included duration of loading regimens, plans for re-testing, or advice on over-the-counter supplementation.Results Out of the 65 discharges, 30 high-risk patients were included. 35 discharges were excluded as patients were not considered to be high risk or had been re-admitted. Vitamin D levels were checked within the recommended timeframe in 50% of cases. Of the 15 patients not tested, 14 patients had no documented reason for omission, whilst one patient had a CRP >40 mg/L, justifying deferral. Among patients tested, discharge documentation included appropriate recommendations for seven of the patients.Conclusion Compliance with the vitamin D guideline was suboptimal. Half of patients were tested within the recommended timeframe, and fewer than half had appropriate discharge recommendations documented. These findings highlight the need for improved awareness and education among medical and pharmacy teams to ensure timely testing, appropriate treatment, and clear discharge communication. Targeted teaching sessions for doctors and pharmacists are planned to address these gaps, with a re-audit to be conducted following implementation to assess the impact of these interventions.Reference Say G, Wilkinson K, Sealy L. Vitamin D supplementation in paediatric haematology, oncology and Bone Marrow Transplant (BMT) patients. Internal Trust guideline. 2025.",
  "authors": [
    {
      "affiliations": [
        "Bristol Royal Hospital for Children, University Hospitals Bristol and Weston NHS Foundation Trust UK"
      ],
      "name": "Mariam Gebahi"
    },
    {
      "affiliations": [
        "Bristol Royal Hospital for Children, University Hospitals Bristol and Weston NHS Foundation Trust UK"
      ],
      "name": "Sam Whiting"
    }
  ],
  "title": "P33 Vitamin D supplementation in paediatric oncology, haematology and bone marrow transplant patients",
  "uid": "8694a58f-952d-537f-8ed8-63b9b5c71754"
}