LAUSR

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. 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. 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. 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.