Resultados de Búsqueda
The USPSTF recommends screening for unhealthy alcohol use in primary care settings in adults 18 years or older, including pregnant women, and providing persons engaged in risky or hazardous drinking ...
U.S. Preventive Services Task Force A and B recommendations
U.S. Preventive Services Task Force
Recommendation grade B
ver más ... 2018It is not recommended to refer axial lower lumbar back pain for spinal fusion surgery.
Choosing Wisely Australia
Faculty of Pain Medicine, Australian and New Zealand College of Anaesthetists
Chronic low back pain (CLBP) that is not due to underlying disease (infection, cancer) and is not associated with neurological signs is a common problem that is difficult to treat. Historically, lumbar spinal fusion was used for the treatment of demonstrated spinal instability following trauma or cancer. More recently, lumbar spinal fusion has been used for leg pain attributed to an underlying structural change such as spinal stenosis or spondylolisthesis. Spinal fusion has been proposed as a ...
ver más ... 2018It is not recommended to prescribe benzodiazepines for low back pain.
Choosing Wisely Australia
Faculty of Pain Medicine, Australian and New Zealand College of Anaesthetists
Lifetime prevalence of low back pain in Australia is reported to be as high as 80% with one in ten experiencing significant activity limitation. Although benzodiazepines continue to be commonly prescribed as ‘muscle relaxants’ for low back pain (LBP), there is an absolute lack of evidence of benefit for this indication. Only one RCT has been conducted on diazepam in acute LBP during the last 40 years, and it showed no additional benefit when added to NSAID therapy alone. A recent systematic ...
ver más ... 2018It is not recommended to prescribe pregabalin and gabapentin for pain which does not fulfil the criteria for neuropathic pain.
Choosing Wisely Australia
Faculty of Pain Medicine, Australian and New Zealand College of Anaesthetists
The IASP definition of neuropathic pain (2011) requires demonstration of a lesion or disease of the somatosensory system. In effect, that means demonstration of neurological signs. Descriptors that may suggest the pain may be neuropathic, such as burning, painful cold, electric shock-like etc., on their own do not meet this criterion. Pregabalin has a restricted PBS authority for ‘neuropathic pain’. Although the definition being applied is not stated in the PBS Authority listing, use of the ...
ver más ... 2018It is not recommended to continue opioid prescription for chronic non-cancer pain (CNCP) without ongoing demonstration of functional benefit, periodic attempts at dose reduction and screening for ...
Choosing Wisely Australia
Faculty of Pain Medicine, Australian and New Zealand College of Anaesthetists
Comprehensive assessment of patients with CNCP is essential before prescribing an opioid. An opioid ‘contract’ should describe the purpose of the prescription and would include agreed criteria for functional improvement, risks and side-effects of opioid analgesics, and ground rules regarding their use and cessation. There should be a single prescriber (and a deputy) to take responsibility for opioid prescription, in accordance with the regulatory requirements of the relevant jurisdiction.
ver más ... 2018