Utilization of Corticosteroid Injections in a Student-Run Free Clinic Setting

Niket Todi; Sonia Sajja

Niket Todi Eastern Virginia Medical School
Sonia Sajja Eastern Virginia Medical School

Abstract

Uninsured patients face obstacles when attempting to treat orthopedic chronic pain conditions. The implementation of a corticosteroid injection program offers pain relief to the uninsured patients seen at the Orthopedics Clinic of Eastern Virginia Medical Schoolâ€™s H.O.P.E.S. (Health Outreach Partnership of EVMS Students) Clinic. Though surgery is often necessary to cure these patientsâ€™ pain, the injections help improve the patientsâ€™ quality of life. Additionally, this program provides students a unique learning opportunity to thoroughly evaluate these patients and to better their clinical skills. The implementation of this program demonstrates the role that student-run free clinics can play in helping manage chronic pain and can serve as a model for other clinics.

Author Biographies

Niket Todi, Eastern Virginia Medical School

Niket Todi is a member of the Eastern Virginia Medical School Class of 2018. He graduated from the University of Virginia with a B.S. in Chemistry with a specialization in Biochemistry and a B.A. in Political and Social Thought. During his college career, he studied acute myeloid leukemia as well as type II diabetes at the University of Virginia Medical School. In medical school, he participates actively in community medicine programs and was the Orthopedics Clinic Coordinator of the H.O.P.E.S. clinic. He is also on the executive board for the EVMS Orthopedics Interest Club. After obtaining his M.D., he plans to pursue a career in orthopedics.

Sonia Sajja, Eastern Virginia Medical School

Sonia Sajja is a member of the Eastern Virginia Medical School Class of 2018. She graduated from University of California, Berkeley with a B.S. in Molecular Environmental Biology. During this time, she worked in a developmental biology lab studying Drosophila. At EVMS, she served as one of the Co-Directors of the EVMS student-run free clinic HOPES. She also served as the Co-Director for Beyond Clinic Walls, a community service program providing compassionate care for aging seniors. Her medical interests include geriatrics and internal medicine.

References

Relieving Pain In America, A Blueprint for Transforming Prevention, Care, Education and Research. Washington, D.C.: National Academies Press; 2011.

Wilson K, Eriksson M, D'Eon J, Mikail S, Emery P. Major Depression and Insomnia in Chronic Pain. The Clinical Journal of Pain. 2002;18(2):77-83. doi:10.1097/00002508-200203000-00002.

Mcilvane J. Disentangling the effects of race and SES on arthritis-related symptoms, coping, and well-being in African American and White women. Aging & Mental Health. 2007;11(5):556-569. doi:10.1080/13607860601086520.

Hadley J. Comparison of uninsured and privately insured hospital patients. Condition on admission, resource use, and outcome. JAMA: The Journal of the American Medical Association. 1991;265(3):374-379. doi:10.1001/jama.265.3.374.

Upshur, CC, Luckmann, RS, Savageau JA. Primary care provider concerns about management of chronic pain in community clinic populations. Journal of General Internal Medicine. 2006; 21(6): 652-655.

Lanes SF, Lanza LL, Radensky PW, et al. Resource utilization and cost of care for rheumatoid arthritis and osteoarthritis in a managed care setting: the importance of drug and surgery costs. Arthritis Rheum. 1997;40(8):1475-81.

Arroll B. Corticosteroid injections for osteoarthritis of the knee: meta-analysis. BMJ. 2004;328(7444):869-0. doi:10.1136/bmj.38039.573970.7c.

Bellamy N, Campbell J, Robinson V, Gee T, Bourne R, Wells G. Viscosupplementation for the treatment of osteoarthritis of the knee. The Cochrane Library. 2006.

Gross C, Dhawan A, Harwood D, Gochanour E, Romeo A. Glenohumeral joint injections: a review. Sports Health: A Multidisciplinary Approach. 2012: 1941738112459706.

Hepper C, Halvorson J, Duncan S, M. Gregory A, Dunn W, Spindler K. The Efficacy and Duration of Intra-articular Corticosteroid Injection for Knee Osteoarthritis: A Systematic Review of Level I Studies. Journal of the American Academy of Orthopaedic Surgeons. 2009;17(10):638-646. doi:10.5435/00124635-200910000-00006.