Ensuring universal assessment and management of vitamin D status in melanoma patients at secondary care level: a service improvement project

Br J Hosp Med (Lond). 2020 Oct 2;81(10):1-5. doi: 10.12968/hmed.2020.0128. Epub 2020 Oct 16.

Abstract

Background/aims: Melanoma is the most aggressive skin malignancy with an ever-increasing caseload, especially in the western world. Recently developed immunotherapeutic modalities have substantially improved the prognosis of advanced melanoma. The association between serum levels of vitamin D and prognosis of melanoma has been a focus of ongoing research, with some evidence of vitamin D's potential as an adjunctive modality to immunotherapy. The National Institute for Health and Care Excellence guidelines clearly recommend that assessment of vitamin D levels and relevant advice should be an inherent aspect of the management of patients with melanoma at the secondary care level.

Method: A service improvement project was conducted to ensure full compliance of practice in the authors' skin unit with the current National Institute for Health and Care Excellence guidelines on the management of vitamin D status in patients with melanoma.

Results: After two reaudits the unit's practice complied with National Institute for Health and Care Excellence guidelines by using a multidisciplinary team approach.

Conclusions: The authors propose that the simple and reliable pathway used to achieve and sustain the results could be easily adopted to ensure universal adherence to these guidelines.

Keywords: Melanoma; National Institute for Health and Care Excellence guidelines; Vitamin D.

MeSH terms

  • Clinical Audit
  • Guideline Adherence
  • Humans
  • Melanoma* / diagnosis
  • Melanoma* / therapy
  • Secondary Care
  • Skin Neoplasms* / diagnosis
  • Skin Neoplasms* / therapy
  • Vitamin D / blood*
  • Vitamins

Substances

  • Vitamins
  • Vitamin D