Carolinas Research Day 2021

Educational Studies

01 Commonly Logged Diagnoses and Treatments in Geriatric Patients During Ambulatory Family Medicine Rotations

Miriam Brown, OMS IV, Kyle Burke, OMS IV, Emma Griffith, OMS IV, Hannah Coulson, DO, FASCP, FCAP, Jaime Foushee, PharmD, BCPS, BCCCP, Harold R. Garner, PhD

Edward Via College of Osteopathic Medicine-Carolinas

Context: Clinical clerkships provide osteopathic medical students the opportunity to diagnose and treat commonly encountered medical conditions. Appropriate management of these conditions may include pharmacotherapy and/or non-pharmacologic interventions, such as osteopathic manipulative treatment (OMT). Opportunities may exist to expand the utilization of OMT in the management of common conditions, particularly for geriatric patients, who are at increased risk for adverse outcomes from inappropriate medication use. Objective: To assess the most common diagnoses and corresponding treatments logged by osteopathic medical students within an ambulatory geriatric population. Methods: Patient encounters logged electronically by osteopathic medical students were retrospectively reviewed to determine the most commonly reported

diagnostic codes and their treatments. Logged interventions were filtered to include patients over the age of 65 seen on family medicine rotations within an ambulatory setting. The top ten diagnoses were sorted and assessed to determine the associated treatments, including medications, procedures, and OMT. Results: Between January 2018 and June 2020, 11,185 primary diagnoses were logged pertaining to the defined patient population. The most frequently documented diagnoses were essential hypertension (n=1420; 12.7%), type 2 diabetes mellitus (n=837; 7.5%), encounter for well exam (n=1389; 12.4%), hyperlipidemia (n=346; 3.1%), chronic obstructive pulmonary disease (n=273; 2.4%), osteoarthritis (n=221; 1.9%), low back pain (n=202; 1.8%), pain in joint (n=187; 1.6%), hypothyroidism (n=163; 1.5%), and atrial fibrillation/flutter (n=152; 1.4%). Three of the top ten logged diagnoses were musculoskeletal

in nature. Pharmacotherapy was reported as the predominant treatment for musculoskeletal conditions, with OMT being logged as a treatment for 10.0% (n=47) of those cases. The most commonly logged medication class in the management of patients with those musculoskeletal conditions was non-steroidal anti-inflammatory agents (n=136; 28.9%), while opioids were the second most frequently documented class of medications (n=63; 13.4%). Conclusions: Musculoskeletal complaints were commonly logged by osteopathic medical students within the studied population. Opioids were documented as a treatment for musculoskeletal conditions more frequently than OMT. As such, opportunities exist to expand the utilization of OMT during clinical clerkships and decrease inappropriate medication-based pain management strategies.

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