Between June and September 1984, district nurses who worked in Coventry were asked to submit returns giving details of the patients for whom they administered vitamin B12 injections. Of 492 patients identified, 382 (78%) were receiving injections more frequently than the recommended three monthly dose of hydroxy-cobalamin. An extra 3751 injections are being administered a year. Four hundred and thirty (88%) of these patients have conditions for which the drug is of proven benefit, so the increased frequency of injections accounts for most of the observed excess. A total of 2000 hours a year of district nurse time is spent with these patients. The nursing service is under increasing strain. Changes in vitamin B12 prescribing alone could make between 600 and 1470 hours available for other patient needs
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