555 Improving Adherence to NICE Guidance on the Assessment and Replacement of Vitamin D in Cutaneous Malignant Melanoma - June 2025
British Journal of Surgery, Volume 112, Issue Supplement_10, June 2025, znaf128.516, https://doi.org/10.1093/bjs/znaf128.516 Poster
M Gowell , G Coleman , M Maher
Aim
In melanoma patients, low serum vitamin D levels are linked to higher Breslow thickness tumours at presentation and poorer clinical outcomes, while optimal levels improve surgical wound healing.
Based on this, NICE recommends measuring vitamin D levels and providing supplementation education for all new melanoma diagnoses.
We conducted a quality improvement project in a UK tertiary centre to assess and improve compliance with these guidelines.
Method
Patient records for all new melanoma referrals from primary care were audited from September-December 2023 for the first cycle (n=30), and August-November 2024 for the second cycle (n=26) after intervention. Data on demographics, serum vitamin D levels, and patient education were collected. In June 2024, our intervention entailed streamlining the referral pathway by informing all members of the skin MDT about the importance of measuring serum vitamin D levels. This was achieved through in-person and email reminders alongside posters in clinic rooms.
Results
The mean age at melanoma diagnosis was 61.7 years with a male-to-female ratio of 1:1.5. All patients received information leaflets on vitamin D supplementation in both audit cycles. Initially, only 30% of patients had vitamin D levels measured, increasing to 60% after intervention. Of those patients who had vitamin D levels measured 52% were deficient, consistent with general population rates in the UK.
Conclusions
This project improved adherence to NICE guidelines on vitamin D assessment in melanoma patients. Identifying serum vitamin D deficiencies enables clinicians to guide supplementation, potentially improving outcomes. Further efforts should aim for full compliance to optimise patient care.
NICE Melanoma and Vitamin D test recommentations were made in 2015
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