Introduction
We evaluated the knowledge of non-steroidal antiinflammatorydrugs (NSAIDs) including their dosage, side effects,contraindications, and drug interactions among the patients in anoutpatient rheumatology clinic.
Methods
Patients in a rheumatology clinic completed a short surveyassessing their knowledge of over-the-counter NSAIDs.
Results
The survey was provided to 400 participants and 275(68.5%) were using over-the-counter (OTC) NSAIDs. The majorityof the participants identified their commonly used NSAID. Almost athird were unaware of the contraindication of NSAIDs such as pepticulcer disease, chronic kidney disease, and hypertension. Nearly 53.9%participants denied having any discussion of OTC medications withtheir providers. Two-thirds of the respondents reported seeing onlythe medication packaging for the dose determination (67.8%).
Conclusions
The gap in patient knowledge of the potential sideeffects and the lack of discussion of OTC medications by the providersmay be predisposing the patients to preventable side effects fromNSAIDs.
Purpose
This work aims to conduct a geospatial analysis of recent ultrasound access and usage within the United States, with a particular focus on disparities between rural and urban areas.
Methods/Materials
Multiple public datasets were merged on a county level, including US Department of Agriculture economic metrics and Centers for Medicare Services data using the most recent years available (2015-2019). From these databases, 39 total variables encompassing the socioeconomic, health, and ultrasound characteristics of each county were obtained. Current Procedural Terminology (CPT) codes incorporated included ultrasound-guided procedures and diagnostic exams. Three thousand eleven counties were included. The combined dataset was then exported to GeoDa for network-based analysis and to produce map visualizations. To identify statistically significant (p < 0.05) hotspots and coldspots in point-of-care ultrasound (POCUS) prevalence, Moran’s I was used. Choropleth maps were created for visualization. ANOVA was run across the four Moran’s I groups for each of 39 variables of interest.
Results
A total of 30,135,085 ultrasound-related CPT codes were billed to Medicare over 2015-2019, with 26.55% of codes being ultrasound-guided procedures and 73.45% being diagnostic exams. 38.84% of rural counties had access to POC ultrasound compared to 88.56% of metropolitan counties and 74.19% of counties overall. Hotspots of POCUS were in Southern California and the Eastern US (average of 1,441 per 10,000 Medicare members per year). Coldspot areas were seen in the Great Plains and Midwest (average of 7.43 per 10k Medicare members per year). Hotspot clusters, when compared to coldspot clusters, were significantly (p < 0.001) more dense (703.6 to 14.9 people per square mile), more urbanized (3.5 to 7.1 Rural-Urban Continuum (RUC)), more college-educated (25.1% to 20.0%), more likely to have an Emergency Department (ED) visit (725.8 to 616.9 visits per 1,000 Medicare members), more likely to be obese (19.0% to 12.9%), less likely to be uninsured (10.1% to 13.0%), had more Black representation (8.5% to 3.4%), and less Hispanic representation (2.6% to 5.5%).
Conclusions
Ultrasound access and usage demonstrate significant geospatial trends across the United States. Hotspot and coldspot counties differ on several key sociodemographic and economic variables.
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