Factors correlating to the propensity of general practitioners to substitute borderline vitamin B12 deficiency

Figures & data

Table 1. Responses to statements on borderline B12 deficiency.

Survey Statements	n	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree
I commonly see patients with vitamin B12 deficiency	128	6	23	19	69	11
By discussion or through patient notes, I observe how colleagues manage cases of vitamin B12 deficiency and imitate them	126	9	34	33	46	4
Patient demands influence my management of borderline vitamin B12 deficiency	128	9	40	38	37	4
There is currently an overuse of vitamin B12 in Australia	127	3	17	54	38	15
I advocate injections over oral therapy in patients who require vitamin B12 treatment and have known malabsorption	128	3	8	9	67	41
I often request for complementary biomarkers (methylmalonic acid, homocysteine) prior to diagnosing and treating for vitamin B12 deficiency	128	20	64	23	15	6

Table 2. Responses to hypothetical case of borderline B12 deficiency.

Survey Statements	n	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree
Request complementary biomarkers	123	16	38	29	35	5
Recommend or initiate vitamin B12 supplementation	117	8	25	24	54	6
Provide further dietary recommendations	123	3	12	11	79	18
Retest in 3 – 12 months	123	3	7	4	88	21

Table 3. Factors correlating to the propensity to prescribe B12 supplementation.

	Univariate (unadjusted) logistic regression			Step-wise multivariate (adjusted) logistic regression (n = 114)
	n	p value	OR (95% CI)	p value	OR (95% CI)
Increasing age of GP (decades)	115	0.88	0.97 (0.70 – 1.4)
Male Gender	115	0.11	0.55 (0.26 – 1.1)
GP Trainee	109	0.21	1.7 (0.75 – 3.7)
Commonly sees B12 deficiency	117	0.24	1.6 (0.73 – 3.3)
Influenced by colleagues	115	0.45	1.3 (0.63 – 2.8)
Influenced by patients	117	0.052	2.2 (0.99 – 4.8)	0.037	2.4 (1.1 – 5.7)
Perceives overuse	116	0.029	0.43 (0.20 – 0.92)	0.019	0.39 (0.18 – 0.86)
Advocates injections	117	0.53	1.4 (0.50 – 3.8)
Requests biomarkers	117	0.69	1.2 (0.45 – 3.4)
Last B12 education <3 years ago	115	0.75	1.1 (0.54 – 2.4)

Table 4. Factors correlating to the propensity to request complementary biomarkers.

	Univariate (unadjusted) logistic regression			Step-wise multivariate (adjusted) logistic regression (n = 112)
	n	p value	OR (95% CI)	p value	OR (95% CI)
Increasing age of GP (decades)	121	0.19	1.3 (0.90 – 1.8)	0.070	1.4 (0.97 – 2.1)
Male Gender	121	0.72	1.1 (0.53 – 2.5)
GP Trainee	114	0.15	0.51 (0.21 – 1.3)
Commonly sees B12 deficiency	123	0.11	0.53 (0.25 – 1.2)	0.045	0.41 (0.17 – 0.98)
Influenced by colleagues	121	0.66	1.2 (0.55 – 2.6)
Influenced by patients	123	0.68	1.2 (0.53 – 2.6)
Perceives overuse	122	0.25	1.6 (0.73 – 3.3)
Advocates injections	123	0.53	0.72 (0.26 – 2.0)
Last B12 education <3 years ago	121	0.57	1.3 (0.58 – 2.7)