Greater Socioeconomic Disadvantage as Measured by the Area Deprivation Index Is Associated With Failure of Healing Following Arthroscopic Repair of Massive Rotator Cuff Tears but Not With Clinical Outcomes

Ardebol, Javier; Kiliç, Ali Īhsan; Pak, Theresa; Menendez, Mariano E.; Denard, Patrick J.

doi:10.1016/j.arthro.2023.08.074

Cited by 1 publication

(2 citation statements)

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“…Interestingly, while the prevalence of cannabis use was lowest among patients living in the most disadvantaged neighborhoods, risk for CUD was higher among this group. The influence of neighborhood on health outcomes has been well established; however, the influence of neighborhood on substance use and especially cannabis use is limited or conflicting . In this study, the underrepresentation of patients from the most disadvantaged neighborhoods prevents drawing strong conclusions on the specific links with risk of CUD.…”

Section: Discussionmentioning

confidence: 88%

“…The influence of neighborhood on health outcomes has been well established; however, the influence of neighborhood on substance use and especially cannabis use is limited or conflicting. 36 , 37 , 38 In this study, the underrepresentation of patients from the most disadvantaged neighborhoods prevents drawing strong conclusions on the specific links with risk of CUD.…”

Section: Discussionmentioning

confidence: 93%

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Cannabis Use Reported by Patients Receiving Primary Care in a Large Health System

Gelberg,

Beck,

Koerber

et al. 2024

JAMA Netw Open

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ImportanceDespite the changing legal status of cannabis and the potential impact on health, few health systems routinely screen for cannabis use, and data on the epidemiology of cannabis use, and especially medical cannabis use among primary care patients, are limited.ObjectiveTo describe the prevalence of, factors associated with, and reasons for past–3 month cannabis use reported by primary care patients.Design, Setting, and ParticipantsThis cross-sectional study used electronic health record data from patients aged 18 years and older who had an annual wellness visit between January 2021 and May 2023 from a primary care clinic within a university-based health system in Los Angeles, California.ExposuresFactors of interest included age, race and ethnicity, sex, employment status, and neighborhood Area Deprivation Index (ADI).Main Outcomes and MeasuresCannabis use was assessed using the Alcohol Substance Involvement Screening Test (ASSIST). Patients were also asked about reasons for use, symptoms for which they used cannabis, and mode of use.ResultsAmong the 175 734 patients screened, the median (range) age was 47 (18-102) years; 101 657 (58.0%) were female; 25 278 (15.7%) were Asian, 21 971 (13.7%) were Hispanic, and 51 063 (31.7%) were White. Cannabis use was reported by 29 898 (17.0%), with 10 360 (34.7%) having ASSIST scores indicative of moderate to high risk for cannabis use disorder (CUD). Prevalence of cannabis use was higher among male patients than female patients (14 939 [20.0%] vs 14 916 [14.7%]) and younger patients (18-29 years, 7592 [31.0%]; ≥60 years, 4200 [8.5%]), and lower among those who lived in the most disadvantaged neighborhoods (ADI decile 9-10, 189 [13.8%]; ADI decile 1-2, 12 431 [17.4%]). The most common modes of use included edibles (18 201 [61.6%]), smoking (15 256 [51.7%]), and vaporizing (8555 [29.0%]). While 4375 patients who reported using cannabis (15.6%) did so for medical reasons only, 21 986 patients (75.7%) reported using cannabis to manage symptoms including pain (9196 [31.7%]), stress (14 542 [50.2%]), and sleep (16 221 [56.0%]). The median (IQR) number of symptoms managed was 2 (1-4), which was higher among patients who were at moderate to high risk for CUD (4 [2-6] symptoms).Conclusions and RelevanceIn this study, cannabis use and risk of CUD were common, and more than three-quarters of patients who reported any cannabis use reported doing so to manage a health-related symptom. These findings suggest that integration of information regarding cannabis use for symptom management could help provide a crucial point-of-care opportunity for clinicians to understand their patients’ risk for CUD.

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Section: Discussionmentioning

confidence: 88%