Abstract Body

BACKGROUND and PURPOSE: CRPS is a chronic pain condition accompanied by autonomic, inflammatory, sensory, and vasomotor symptoms. CRPS type II involves peripheral nerve injury. Diagnosis is based on the Budapest Criteria, however, its pathophysiology and treatment are not fully defined. The objective of this report is to raise awareness to the correct diagnosis and to the possibility of conservative treatment.

METHODS: Information about patient’s clinical data was obtained through consultation of clinical records. Complementary information was collected by researching databases on this matter.

RESULTS: A 76-year man, diagnosed with Herpes Zoster five months before, presented with swelling, stiffness, erythema, paraesthesia and pain 10/10 of the 2^nd finger of the left hand. The symptoms had been present for several weeks. Daily activities such as buttoning buttons were difficult. On examination, left hand was globally swollen, with emphasis on his 2^nd finger. There was allodynic and hyperalgesic pain response to any palpation. He revealed global mobility loss, with restriction of active and passive movement and tremor. Investigation was performed, no leucocytosis was found, and C-reactive protein (CRP) and sedimentation rate (SR) were negative. The hand X-ray evidenced osteoarthrosis of interphalangeal joints and the ultrasound edema as well as hyperecogeneity of the subcutaneous adipose tissue. Budapest criteria were fulfilled and the diagnose of CRPS was made. He started gabapentin 900mg/day, amitriptyline 10mg/day and physical therapy.

CONCLUSIONS: Chronic pain is among the top complaints in patients who visit primary care. Fast diagnosis, rehabilitation and maximizing quality of life are essential to family doctors’ practice.

Abstract Body

WHO announced in 2017 its third global patient safety challenge, which focuses on improving medication safety. Its main goal is to reduce the level of severe, avoidable medication-associated harm by 50% over the next 5 years. Although there is no consensual definition for polypharmacy, the most used refers to the use of five or more medications.

Portugal is the third country with the highest aging rate in the European Union; elderly represents 21.3% of the population. Prescribing is a complex act, which involves dealing with multimorbidity and a greater risk of adverse reactions, side effects and drug interactions.

De-prescribing is the planned and supervised process of reducing the dose or stopping the medication that may be causing harm or no longer bringing benefits.

Primary health care professionals are in a privileged position to facilitate de-prescribing since they have access to the patient’s complete medical history and an established relationship with the patient that supports shared decision-making.

This workshop is targeted at all health professionals. Its objective is to equip family doctors with appropriate knowledge and practical tools, as well as to raise awareness to this common and challenging problem.

I will make a brief theoretical presentation, which aims to present tools that can be used daily in clinical practice, followed by discussion of clinical cases, and role-playing in groups of 5/6 people with a total maximum of 20 participants.

At last, participants are expected to be able to update their patients’ medication list, according to their life expectancy and comorbidities.

Abstract Body

BACKGROUND and PURPOSE: CRPS is a chronic pain condition accompanied by autonomic, inflammatory, sensory, and vasomotor symptoms. CRPS type II involves peripheral nerve injury. Diagnosis is based on the Budapest Criteria, however, its pathophysiology and treatment are not fully defined. The objective of this report is to raise awareness to the correct diagnosis and to the possibility of conservative treatment.

METHODS: Information about patient’s clinical data was obtained through consultation of clinical records. Complementary information was collected by researching databases on this matter.

RESULTS: A 76-year man, diagnosed with Herpes Zoster five months before, presented with swelling, stiffness, erythema, paraesthesia and pain 10/10 of the 2^nd finger of the left hand. The symptoms had been present for several weeks. Daily activities such as buttoning buttons were difficult. On examination, left hand was globally swollen, with emphasis on his 2^nd finger. There was allodynic and hyperalgesic pain response to any palpation. He revealed global mobility loss, with restriction of active and passive movement and tremor. Investigation was performed, no leucocytosis was found, and C-reactive protein (CRP) and sedimentation rate (SR) were negative. The hand X-ray evidenced osteoarthrosis of interphalangeal joints and the ultrasound edema as well as hyperecogeneity of the subcutaneous adipose tissue. Budapest criteria were fulfilled and the diagnose of CRPS was made. He started gabapentin 900mg/day, amitriptyline 10mg/day and physical therapy.

CONCLUSIONS: Chronic pain is among the top complaints in patients who visit primary care. Fast diagnosis, rehabilitation and maximizing quality of life are essential to family doctors’ practice.

Abstract Body

WHO announced in 2017 its third global patient safety challenge, which focuses on improving medication safety. Its main goal is to reduce the level of severe, avoidable medication-associated harm by 50% over the next 5 years. Although there is no consensual definition for polypharmacy, the most used refers to the use of five or more medications.

Portugal is the third country with the highest aging rate in the European Union; elderly represents 21.3% of the population. Prescribing is a complex act, which involves dealing with multimorbidity and a greater risk of adverse reactions, side effects and drug interactions.

De-prescribing is the planned and supervised process of reducing the dose or stopping the medication that may be causing harm or no longer bringing benefits.

Primary health care professionals are in a privileged position to facilitate de-prescribing since they have access to the patient’s complete medical history and an established relationship with the patient that supports shared decision-making.

This workshop is targeted at all health professionals. Its objective is to equip family doctors with appropriate knowledge and practical tools, as well as to raise awareness to this common and challenging problem.

I will make a brief theoretical presentation, which aims to present tools that can be used daily in clinical practice, followed by discussion of clinical cases, and role-playing in groups of 5/6 people with a total maximum of 20 participants.

At last, participants are expected to be able to update their patients’ medication list, according to their life expectancy and comorbidities.