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ACTION FOR POLICY AND IMPLEMENTATION

In the Australian population, the prevalence of moderate and severe vitamin D deficiency is 6% and 1%, respectively. Yet most women (56%) in the ALSWH 1946-51 cohort had at least one vitamin D test after the new criteria were introduced. Some targeted testing is occurring. However, the high testing rates suggest that screening has become routine. It is clear that over-testing for vitamin D deficiency is happening again and other interventions are necessary to reduce this.

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Dr Louise Wilson

Post Doctoral Research Fellow, NHMRC Centre for Research Excellence on Women and Non-communicable Diseases (CRE-WaND), University of Queensland

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RESEARCH CONTEXT

In the early 2000s, vitamin D testing in Australia increased by a staggering 3,587%. In an attempt to limit costs, the Australian Government introduced new MBS testing criteria in 2014. Researchers from the Centre for Research Excellence on Women and Non-communicable Disease (CRE-WaND) have assessed the effectiveness of these changes.

Using Medicare data, the team reviewed national vitamin D testing trends in Australian women aged 15 years and over, both before and after the MBS testing criteria changed. Although vitamin D testing initially declined after the new criteria was introduced in 2014, the reduction was not sustained. Between 2016 and 2019, vitamin D testing rates in Australian women increased across all age groups.  

To assess which women were more likely to have a vitamin D test under the new criteria, the team analysed MBS data linked with survey data from 7,771 women (born 1946-1951) in the Australian Longitudinal Study on Women’s Health (ALSWH). As expected, they found that women who had had a bone density test and those living in latitudes with less sun exposure were more likely to have a vitamin D test. Other predictors of having a vitamin D test under the new criteria were:

• having had a vitamin D test before the introduction of the new criteria
• visiting a GP more than twice a year (the strongest associations were in women who visited more than 8 times year)

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