[Is cobalamin measurement overprescribed by physicians? Results of an eight-year single academic centre survey]

Abstract

Introduction: Cobalamin (Cb) blood level is widely measured among inpatients, while relevant indications for ordering this assay in clinical practice are limited and tended to decline in the recent years. We evaluated retrospectively, in a single academic centre, changes in volume of Cb measurement in an eight-year period.

Results: The annual number of Cb assays has doubled between 2005 and 2012, from 3049 to 6158, in the medical departments of our hospital. The proportion of patients in which Cb was measured increased to 84% in the same period. The increase was of 36% in the internal medicine department. In this department, 30% of the 1753 patients admitted in 2012 had Cb measurement.

Conclusion: The significant changes in the volume of Cb assay in recent years are not justified by any new scientific data about new indications for ordering Cb measurement. It seems necessary to establish robust national and international guidelines for inpatient Cb measurement.

Keywords: Cobalamin; Internal medicine; Médecine interne; Prescription; Vitamine B12.