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

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The combination of opioids and gabapentinoids (gabapentin and pregabalin) increases the risk of respiratory depression. In Catalonia, an estimated 34.9% of patients with chronic non-cancer pain who use strong opioids also take gabapentinoids. Clinical guidelines warn against the co-prescription of opioids and gabapentinoids in patients with chronic non-cancer pain (CNCP). The evidence is inconclusive as to whether the combination offers greater efficacy than monotherapy with either drug. ...

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

Essencial Salut

Headache is one of the most common and disabling neurological symptoms. Ninety percent of headaches are primary, where the headache "is the disease itself." Routine imaging tests (computed tomography and magnetic resonance imaging) should be avoided in people with primary headaches or without warning signs and symptoms. Neuroimaging tests are recommended when secondary headaches are suspected, based on warning signs or atypical presentation. In most cases, the cause and type of headache can be ...

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

Essencial Salut

In the management of dyspnea, treatment must be individualized based on the underlying cause. In cases of respiratory failure, oxygen therapy can prolong the patient's life, improve exercise tolerance, and prevent clinical deterioration. Administration of continuous home oxygen therapy (>15 hours per day) increases survival in patients with chronic obstructive pulmonary disease and chronic respiratory failure at rest. In patients without respiratory failure, studies have not shown an ...

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

Essencial Salut

Nonsteroidal anti-inflammatory drugs (NSAIDs) are medications that possess analgesic, antipyretic, and anti-inflammatory properties. NSAIDs are associated with a broad profile of side effects that are associated with considerable morbidity and mortality. There are safer alternatives to NSAIDs in patients with cardiovascular disease, chronic kidney disease, or liver failure. In cases where NSAIDs are considered essential, their use should be restricted to the lowest effective doses and for the ...

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

Essencial Salut

Prescribing a proton pump inhibitor (PPI) for drug-induced gastropathy in people without an increased risk of gastrointestinal bleeding has no proven benefit. On the contrary, it can cause adverse events and contribute to polypharmacy. PPIs are associated with potentially serious adverse events, such as kidney damage, osteoporotic fractures, and an increased risk of enteric and pulmonary infections, among others. In primary care in Catalonia, between October 2023 and September 2024, 48.7% of ...