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Objective: Identify the impact of COVID-19 lockdown restrictions on the vitamin D status of individuals in the west of Ireland. Design: Cross-sectional study. Setting: Adults who had wintertime serum 25(OH)D analysis completed in Galway University Hospital. Participants: A total of 16,725 participants (2015–2020 (n = 13,449) and 2020–2021 (n = 3276)). Baseline demographics; sex, age, origin of the sample and the date of sample collection. Results: Median serum vitamin D and serum vitamin D3 concentrations were higher in the 5-month period from October–February 2020–2021 (61 nmol/L (± 36–85 nmol/L) and 60 nmol/L (± 34–85 nmol/L)) respectively, than for the corresponding 5-month period (October–February) in 2015–2020 (53 nmol/L (± 32–78 nmol/L) and 51 nmol/L (± 30–77 nmol/L)) respectively. These changes coincided with a decline in the prevalence of deficiency. In the 5-month period October–February 2020–2021, 19.2% of the population were vitamin D deficient (< 30 nmol/L) compared to 22.5% in the corresponding 5-month period in 2015–2020, and 38.1% were vitamin D deficient (< 50 nmol/L) in the 5-month period October–February 2020–2021 compared to 46.6% in the corresponding 5-month period in 2015–2020. Males were more likely to be deficient at both thresholds (p < 0.001). For the total cohort, at the < 30 nmol/L threshold, inpatients (25.5%) and nursing home residents (34.1%) had higher prevalence of deficiency. Conclusions: Vitamin D levels were higher in the 5-month period of October–February 2020–2021, and this precipitated a decline in deficiency at both thresholds, indicating that lockdown coincided with enhanced vitamin D status. We postulate that it may be attributable to changes in diet and/or supplementation, or increased sun exposure, but further confirmatory studies are required. [ABSTRACT FROM AUTHOR]

Background: Adopting the WHO protocol for glucose analysis is arguably impractical in the routine clinical setting. Deviations may develop due to a lack of understanding regarding the impact of glycolysis on the accuracy of results. Aim: We sought to assess the stability of glucose in two different blood collection tubes (BCT), BD Vacutainer® FX 'Fl-Ox' and Greiner Vacuette® FC-Mix 'FC-Mix' stored at room temperature (RT:18–22°C) and 4°C over 8.5 days. Method: Each participant provided venous whole blood collected into 51 BCTs; 'Fl-Ox' (n = 26) and 'FC-Mix' (n = 25). One Fl-Ox sample from each participant was handled according to the WHO recommended method. The remaining BCTs were stored at 4°C/RT prior to analyses at designated study timepoints. Glucose was measured using the hexokinase assay on the Cobas® 8000 platform. Results: Participants (n = 8, Male = 2) were aged 24–56 years. Plasma glucose measured in FI-Ox BCTs according to the WHO sample-handling method had a median concentration of 5.73 mmol/L (Range: 5.39–10.37 mmol/L). Glucose decreased by greater than minimal difference (>0.26 mmol/L) in blood collected into Fl-Ox and stored @4°C/RT within 24 h of phlebotomy. FC-Mix BCT maintained glucose <0.26 mmol/L @4°C over a period of 8.5 days and up to 4 days @RT when compared to the WHO recommended method. Conclusion: Glucose in FC-Mix BCT stored @4°C demonstrated the best agreement with results determined using the WHO specifications. When FC-Mix tubes were stored @RT, glucose was stable for 4 days. These findings suggest that the FC-Mix BCT effectively inhibits glycolysis and should be introduced into routine clinical practice. [ABSTRACT FROM AUTHOR]

Aim: Many challenges exist in determining true rates of adherence to antihypertensive medications among individuals in a clinic setting. For the first time, we aimed to compare patient‐reported antihypertensive adherence with objective evidence using mass spectrometry spot urinalysis in a tertiary referral clinic setting. Methods: A prospective observational single‐centre cohort study was performed in a tertiary referral hypertension clinic, encompassing antihypertensive initiation and persistence. Patients were referred with apparent treatment‐resistant hypertension or for suspected secondary causes. Participants completed a self‐reported assessment of antihypertensive adherence and provided a spot urine sample. The presence of antihypertensive medications and/or their respective metabolites was evaluated using high‐performance liquid chromatography tandem mass spectrometry. Patients were determined to be adherent if they demonstrated both self‐reported adherence and objective mass spectrometry evidence. Results: Of all 105 eligible participants initially recruited, 73 (69.5%) met the eligibility criteria. Only 27.4% (95% confidence interval 0.2‐0.4) of participants demonstrated true adherence to their self‐reported antihypertensives, despite 75.3% (0.6‐0.8) reporting adherence. Greatest medication adherence was achieved with angiotensin II receptor blockers (61%), with calcium‐channel blockers and mineralocorticoid antagonists demonstrating least adherence (38%). Conclusion: In patients attending a tertiary hypertension clinic, the combined use of spot urine mass spectrometry and self‐reporting identifies higher rates of nonadherence when compared to either modality alone. Both techniques should be combined for more accurate detection of medication adherence. [ABSTRACT FROM AUTHOR]

Aims: The purpose of this study was to assess the clinical performance and user acceptance of capillary blood samples prepared remotely using the MiniCollect® capillary blood collection device as an alternative to blood collection by venepuncture for glycated haemoglobin (HbA1c) analysis. Methods: Following written informed consent, a cross‐sectional study was conducted in individuals aged ≥18 years with any type of diabetes who routinely self‐monitor their blood glucose. Eligible participants recruited whilst attending their routine clinical appointments were required to provide a venous blood sample, prepare a capillary blood sample at home (remotely) and complete a bespoke questionnaire. HbA1c in whole blood collected in ethylenediaminetetraacetic acid was determined by capillary electrophoresis on the Sebia Capillary's 3 Tera analyser following standard operating procedure. Results: HbA1c results from both venous and capillary collection demonstrated good agreement. Passing‐Bablok regression: y = 0 + 1x (p = 0.18), Spearman correlation r = 0.986, p < 0.0001. The Bland–Altman difference plot provided a mean difference of 0.3 mmol/mol (2.2%). Over half of the participants found the MiniCollect device easy to use. The majority of participants were in favour of the remote capillary blood collection service and would use it if routinely available. Conclusion: The home collection of capillary blood for HbA1c determination is a valuable and convenient alternative to standard venous blood collection as it provides an opportunity to support routine HbA1c monitoring, whilst mitigating the transmission of SARS‐CoV‐2. This service would additionally allow individuals to attend clinic visits with a HbA1c value, ensuring optimal continuance of patient care for individuals with diabetes. [ABSTRACT FROM AUTHOR]