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Essencial: Afegint valor a la pràctica clínica [Essencial: Adding value to the clinical practice]

Generalitat de Catalunya

Valproic acid, approved for the treatment of certain types of epilepsy and bipolar disorder, is teratogenic. Babies born to women treated with the drug have an increased risk of neurodevelopmental disorders or congenital malformations. Clinical practice guidelines, drug agencies, and consensus documents are aligned in the recommendation to avoid prescribing valproate in women with the capacity to conceive, unless the conditions of the pregnancy prevention program are met. When the woman is ...

Choosing Wisely ® : Things we do for no reason

Choosing Wisely: Things we do for no reason

Quantitative studies of effectiveness usually involve experiences at single centers and are without adequate control groups. BAs were created as a tool for safety, a mechanism through which clinical teams may anticipate and take action to mitigate risk. However, this type of communication facilitates prejudice towards patients. While intended to alter provider behavior to promote safety indiscriminately in the workplace, there is little evidence that BAs actually reduce incidents of violence. ...

NICE

NICE

If a person develops mania or hypomania and is not taking an antipsychotic or mood stabiliser, offer haloperidol, olanzapine, quetiapine or risperidone, taking into account any advance statements, the person's preference and clinical context If an alternative antipsychotic is not sufficiently effective at the maximum licensed dose, consider adding lithium. the first antipsychotic is poorly tolerated at any dose (including rapid weight gain) or ineffective at the maximum licensed dose, offer an ...

Choosing Wisely ® : Things we do for no reason

Choosing Wisely ®: Things we do for no reason

Hospital discharge should include effective patient education and care coordination. To optimize patients' understanding of their current medication, don't miss the opportunity to counsel patients on medication adherence. Many studies reveal that patients adhere less frequently to new medications after discharge. Emphasize that inpatient blood pressure may not reflect its baseline value and that overtreatment may be harmful.

NICE

NICE

High risk of breast cancer (not proven but greater than 30% probability of being a TP53 carrier): surveillance recommendations reflect the fact that women who at first evaluation had a 30% probability of being TP53 carriers or older and reach 50 years of age without developing breast cancer or any other type of cancer. TP53-related malignancies will now have a carrier probability of less than 30% and should no longer be offered MRI surveillance. The recommendations in this guide apply to women ...