Frequency of clinical conditions suitable for point-of-care ultrasound and comparison of patient management plans among ultrasound users and non-users in Danish general practice.

Abstract

BACKGROUND: The prevalence of clinical conditions where point-of-care ultrasound (POCUS) can be useful in general practice and the impact of POCUS on patient management is not well studied. OBJECTIVE: The aim of this study was to investigate the frequency of 29 pre-specified clinical conditions that could be explored further using POCUS and compare the management of these conditions in a group of POCUS-users and non-users. METHODS: In a prospective registration study, 91 office-based general practitioners (GPs) (31 POCUS-users and 60 non-users), registered the total number of clinical patient encounters, the number of encounters with at least one of 29 clinical conditions suited for POCUS, and the management plan following these 29 clinical conditions during a one-month period. RESULTS: The median registration period was 18 [IQR = 16–20] days. A total of 2430 registrations were made in 26,839 consultations corresponding to an incidence of the 29 clinical conditions of 9.1%. The most common conditions were pneumonia (11.1%), shoulder pain (10.8%), joint swelling (9.5%) and residual urine (7.5%). POCUS-users referred significantly fewer patients to specialists (9.3% vs. 17.4%; p < 0.001) and imaging (7.4% vs. 11.9%; p < 0.001) than non-users. POCUS-users finished treatment and did follow-up for more patients compared to non-users (59.2% vs. 42.2%; p < 0.001). CONCLUSION: Clinical conditions that can be further explored using POCUS are commonly encountered in general practice. Use of POCUS seems to have a significant impact on patient care, as POCUS-users referred fewer patients and concluded treatment more often than non-users.