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

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.