{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T15:18:17Z","timestamp":1788535097422,"version":"build-2803163510"},"reference-count":35,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T00:00:00Z","timestamp":1776038400000},"content-version":"unspecified","delay-in-days":12,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,3,18]]},"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Multivitamins and minerals (MVMs) are readily available dietary supplements that help prevent nutritional deficiencies and boost energy. This study examined the prescribing and consultation practices of healthcare professionals (HCPs) related to MVM supplements in Pakistan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional study used a web-based structured questionnaire to collect data from HCPs from February 2021 to January 2022. The study link, which included a consent form and questionnaire, was circulated on social media platforms, and all individuals who provided consent and completed the forms were included in the study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 524 HCPs participated in the study, with the majority being males, holding MBBS or Fellow of the College of Physicians and Surgeons qualifications, and working in urban settings. Findings revealed that HCPs prescribe MVMs for varied reasons. We assessed differences based on various factors like gender, education level, area of practice and specialty. Most of the differences observed were not statistically significant, except for a few related to area of practice and education level that were found significant. The primary conditions prompting MVM prescriptions included osteoporosis and bone pain (80% for vitamin D and calcium), fatigue and weakness (over 70% for iron) and numbness\/tingling (more than half for folate and vitamin B\n                      <jats:sub>12<\/jats:sub>\n                      ). Regarding biospecimen analysis before prescribing MVMs, 46% of HCPs required laboratory investigations before prescribing vitamin D and calcium and 60% for iron prescriptions. Common formulations prescribed include cholecalciferol for vitamin D deficiency (62%) and ferrous sulfate for iron deficiency (76%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our study findings highlight that the prescribing practices of MVMs by HCPs are primarily in line with the known physiological roles of these supplements. However, a few identified gaps in practices highlight the need for standardised guidelines to ensure patients\u2019 health and well-being.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-111121","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T16:50:20Z","timestamp":1776099020000},"page":"e111121","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Prescribing practices of healthcare professionals regarding multivitamins and mineral supplements in Pakistan: a cross-sectional study"],"prefix":"10.1136","volume":"16","author":[{"given":"Maira","family":"Mubashir","sequence":"first","affiliation":[{"name":"Department of Community Health Sciences, The Aga Khan University, Karachi, Sindh, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4448-0061","authenticated-orcid":false,"given":"Sabahat","family":"Naz","sequence":"additional","affiliation":[{"name":"Department of Community Health Sciences, The Aga Khan University, Karachi, Sindh, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustafa","family":"Shabbir","sequence":"additional","affiliation":[{"name":"Department of Community Health Sciences, The Aga Khan University, Karachi, Sindh, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nawazish","family":"Zehra","sequence":"additional","affiliation":[{"name":"Department of Oncology, The Aga Khan University, Karachi, Sindh, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7506-7988","authenticated-orcid":false,"given":"Hafsa","family":"Majid","sequence":"additional","affiliation":[{"name":"Department of Pathology & Laboratory Medicine, The Aga Khan University, Karachi, Sindh, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lena","family":"Jafri","sequence":"additional","affiliation":[{"name":"Department of Pathology & Laboratory Medicine, The Aga Khan University, Karachi, Sindh, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aysha","family":"Habib","sequence":"additional","affiliation":[{"name":"Department of Pathology & Laboratory Medicine, The Aga Khan University, Karachi, Sindh, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5364-4366","authenticated-orcid":false,"given":"Romaina","family":"Iqbal","sequence":"additional","affiliation":[{"name":"Department of Community Health Sciences, The Aga Khan University, Karachi, Sindh, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,4,13]]},"reference":[{"key":"2026041309501252000_16.4.e111121.1","doi-asserted-by":"publisher","DOI":"10.3329\/jhpn.v31i4.19975"},{"key":"2026041309501252000_16.4.e111121.2","doi-asserted-by":"crossref","DOI":"10.1093\/cdn\/nzz075","article-title":"Public Health Aspects in the Prevention and Control of Vitamin Deficiencies","volume":"3","author":"Darnton-Hill","year":"2019","journal-title":"Curr Dev Nutr"},{"key":"2026041309501252000_16.4.e111121.3","first-page":"E93","article-title":"Main nutritional deficiencies","volume":"63","author":"Kiani","year":"2022","journal-title":"J Prev Med Hyg"},{"key":"2026041309501252000_16.4.e111121.4","unstructured":"National Institutes of Health . Multivitamin\/mineral supplements. 2022. Available: https:\/\/ods.od.nih.gov\/factsheets\/MVMS-HealthProfessional\/#en6"},{"key":"2026041309501252000_16.4.e111121.5","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0236449","article-title":"Prevalence and factors associated with anemia among women of reproductive age in seven South and Southeast Asian countries: Evidence from nationally representative surveys","volume":"15","author":"Sunuwar","year":"2020","journal-title":"PLoS One"},{"key":"2026041309501252000_16.4.e111121.6","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-021-11888-1","article-title":"High prevalence of vitamin D deficiency among the South Asian adults: a systematic review and meta-analysis","volume":"21","author":"Siddiqee","year":"2021","journal-title":"BMC Public Health"},{"key":"2026041309501252000_16.4.e111121.7","unstructured":"Government of Pakistan and UNICEF . National nutrition survey 2018 - key findings report. 2019."},{"key":"2026041309501252000_16.4.e111121.8","article-title":"Rationality of Prescriptions by Rational Use of Medicine Consensus Approach in Common Respiratory and Gastrointestinal Infections: An Outpatient Department Based Cross-Sectional Study from India","volume":"8","author":"Chakraborty","year":"2023","journal-title":"Trop Med Infect Dis"},{"key":"2026041309501252000_16.4.e111121.9","doi-asserted-by":"crossref","DOI":"10.1186\/s40360-017-0176-z","article-title":"Assessment of utilization pattern of fixed dose drug combinations in primary, secondary and tertiary healthcare centers in Nepal: a cross-sectional study","volume":"18","author":"Poudel","year":"2017","journal-title":"BMC Pharmacol Toxicol"},{"key":"2026041309501252000_16.4.e111121.10","first-page":"64","article-title":"Dietary Supplements Use and Associated Determinants Among Adult Population in Southern Bangladesh","volume":"5","author":"Islam","year":"2018","journal-title":"Food Sci Nutr"},{"key":"2026041309501252000_16.4.e111121.11","doi-asserted-by":"crossref","first-page":"S800","DOI":"10.51253\/pafmj.v72iSUPPL-4.9659","article-title":"Prevalence of Multivitamin Supplements use Among General Population of Rawalpindi and Islamabad","volume":"72","author":"Shahzad","year":"2022","journal-title":"Pak Armed Forces Med J"},{"key":"2026041309501252000_16.4.e111121.12","first-page":"462","article-title":"Prescription patterns of general practitioners in Peshawar, Pakistan","volume":"30","author":"Raza","year":"2014","journal-title":"Pak J Med Sci"},{"key":"2026041309501252000_16.4.e111121.13","doi-asserted-by":"publisher","DOI":"10.1016\/0009-8981(83)90096-7"},{"key":"2026041309501252000_16.4.e111121.14","doi-asserted-by":"crossref","DOI":"10.3390\/nu11020443","article-title":"Macronutrient and Micronutrient Intake during Pregnancy: An Overview of Recent Evidence","volume":"11","author":"Mousa","year":"2019","journal-title":"Nutrients"},{"key":"2026041309501252000_16.4.e111121.15","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/85.1.318S"},{"key":"2026041309501252000_16.4.e111121.16","first-page":"436","article-title":"Vitamin-D Toxicity And Other Non-Malignant Causes Of Hypercalcemia: A Retrospective Study At A Tertiary Care Hospital In Pakistan","volume":"29","author":"Khan","year":"2017","journal-title":"J Ayub Med Coll Abbottabad JAMC"},{"key":"2026041309501252000_16.4.e111121.17","doi-asserted-by":"crossref","first-page":"26","DOI":"10.7861\/clinmedicine.5-1-26","article-title":"Rational prescribing: the principles of drug selection and assessment of efficacy","volume":"5","author":"Waller","year":"2005","journal-title":"Clin Med (Northfield)"},{"key":"2026041309501252000_16.4.e111121.18","unstructured":"Otten JJ , Hellwig JP , Meyers LD . 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