{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T17:51:11Z","timestamp":1789753871140,"version":"4.0.1"},"reference-count":32,"publisher":"Royal College of General Practitioners","issue":"725","license":[{"start":{"date-parts":[[2019,2,12]],"date-time":"2019-02-12T00:00:00Z","timestamp":1549929600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Gen Pract"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Individuals with vitamin B12 deficiency (including pernicious anaemia) often report being \u2018let down\u2019 or stigmatised by general practice systems and policy, and choose instead to self-medicate via injection; the association between this and perceptions of safe primary care in this group of people is unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To examine the association between self-medication for vitamin B12 deficiency and patient-reported safety in primary care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design and setting<\/jats:title><jats:p>A UK cross-sectional online survey.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>The survey consisted of the three components: demographics; the validated Primary Care Patient Measure of Safety; and questions about self-medication for vitamin B12 deficiency. Multivariable logistic regression analyses and thematic synthesis were undertaken.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Responses from 1297 participants indicated 508 (39.2%) self-medicated via injection. Perceived primary care safety was low. Those who self-medicated via injection reported a significantly lower level of patient safety in primary care including adverse patient-related factors (odds ratio 0.82, 95% confidence interval = 0.73 to 0.92), and patients &gt;34 years of age were significantly more likely to self-medicate via injection. Many reported that treatment under the guidance of a clinician was preferable to self-medication, but felt they had no other choice to regain quality of life. Almost half felt that the doctor did not always consider what they wanted for their care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>To the authors\u2019 knowledge, this is the largest study to date examining patient safety and vitamin B12 deficiency. It found that four out of 10 patients with B12 deficiency self-medicate via injection. Patients who self-medicated perceived primary care as less safe. Providing patient-centred care and treating these patients with dignity and respect is a policy priority to reduce unsafe health behaviours.<\/jats:p><\/jats:sec>","DOI":"10.3399\/bjgp.2021.0711","type":"journal-article","created":{"date-parts":[[2022,6,20]],"date-time":"2022-06-20T13:10:25Z","timestamp":1655730625000},"page":"e891-e898","source":"Crossref","is-referenced-by-count":10,"title":["Patient safety, self-injection, and B12 deficiency: a UK cross-sectional survey"],"prefix":"10.3399","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8257-1090","authenticated-orcid":false,"given":"Natasha","family":"Tyler","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2063-0977","authenticated-orcid":false,"given":"Alexander","family":"Hodkinson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naeem","family":"Ahlam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1623-6029","authenticated-orcid":false,"given":"Sally","family":"Giles","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7153-5745","authenticated-orcid":false,"given":"Maria","family":"Panagioti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1987","published-online":{"date-parts":[[2022,6,20]]},"reference":[{"key":"2024012510253112000_72.725.e891.1","unstructured":"National Institute for Health and Care Excellence (2015) Active B12 assay for diagnosing vitamin B12 deficiency (NICE, London) https:\/\/www.nice.org.uk\/advice\/mib40\/chapter\/Introduction (accessed 8 Sep 2022)."},{"key":"2024012510253112000_72.725.e891.2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g5226"},{"key":"2024012510253112000_72.725.e891.3","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.12959"},{"key":"2024012510253112000_72.725.e891.4","doi-asserted-by":"crossref","first-page":"97","DOI":"10.2147\/JBM.S25620","article-title":"Optimal management of pernicious anemia","volume":"3","author":"Andres","year":"2012","journal-title":"J Blood Med"},{"key":"2024012510253112000_72.725.e891.5","doi-asserted-by":"crossref","first-page":"766","DOI":"10.1177\/2374373519883497","article-title":"Receiving a diagnosis of pernicious anemia: exploring experiences of relationships with health professionals","volume":"7","author":"Seage","year":"2019","journal-title":"J Patient Exp"},{"key":"2024012510253112000_72.725.e891.6","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m2380"},{"key":"2024012510253112000_72.725.e891.7","doi-asserted-by":"publisher","DOI":"10.9734\/ARRB\/2016\/31711"},{"key":"2024012510253112000_72.725.e891.8","doi-asserted-by":"publisher","DOI":"10.2174\/157488610792245966"},{"key":"2024012510253112000_72.725.e891.9","first-page":"1","article-title":"How do patients receiving prescribed B12 injections for the treatment of PA perceive changes in treatment during the COVID-19 pandemic? 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