Periarticular Corticosteroid Injection in the Therapeutic Approach of Musculoskeletal Disease in General Practice: A systematic Review

Detalhes bibliográficos
Autor(a) principal: Trindade, Irene
Data de Publicação: 2015
Tipo de documento: Artigo
Idioma: por
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/6127
Resumo: Introduction: Periarticular corticosteroid injection utilization by General Practitioners treating musculoskeletal disease in primary health care system is internationally acknowledged. This article aims at analyzing this evidence and contributing to the discussion of a potential development of the technique in Portugal.Material and Methods: Qualitative analysis of randomized control trials, cost-effectiveness studies, cross-sectional studies, retrospective cohort studies and observational studies, using PRISMA model. Data Sources: PubMed, Cochrane Library and Essential Evidence Plus. Eligibility criteria: corticosteroid injection mention in the treatment of musculoskeletal disease and an element that indicates primary health care context.Results: Nine randomized control trials, three cost-effectiveness studies, three cross-sectional studies, three descriptive studies and one retrospective cohort study were reviewed. Most success parameters of corticosteroid injections performed by general practitioners showed short term efficacy; at long term they did not outstand other therapeutic options. The balance between the economic burden ascribed to this technique utilization in primary health care context and gain in subject’s quality of life is favorable. The eleven studies assessing security registered only minor side effects and no serious ones.Discussion: The periarticular corticosteroid injection technique performance places it as a therapeutic option treating musculoskeletal disease in Portuguese primary health care. Nevertheless further evidence is required to support its efficacy and safety parameters, namely at national level.Conclusion: Corticosteroid injection utilization in primary health care constitutes an effective and safe option, with the potential to improve primary health care service rendering in an economically sustainable way.
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spelling Periarticular Corticosteroid Injection in the Therapeutic Approach of Musculoskeletal Disease in General Practice: A systematic ReviewInfiltração Peri-Articular de Corticosteróides na Abordagem da Patologia Músculo- Esquelética em Medicina Geral e Familiar: Uma Revisão SistemáticaAdrenal Cortex HormonesGeneral PracticeInjectionsPrimary Health Care.CorticosteróidesCuidados de Saúde PrimáriosInfiltraçõesMedicina Geral e Familiar.Introduction: Periarticular corticosteroid injection utilization by General Practitioners treating musculoskeletal disease in primary health care system is internationally acknowledged. This article aims at analyzing this evidence and contributing to the discussion of a potential development of the technique in Portugal.Material and Methods: Qualitative analysis of randomized control trials, cost-effectiveness studies, cross-sectional studies, retrospective cohort studies and observational studies, using PRISMA model. Data Sources: PubMed, Cochrane Library and Essential Evidence Plus. Eligibility criteria: corticosteroid injection mention in the treatment of musculoskeletal disease and an element that indicates primary health care context.Results: Nine randomized control trials, three cost-effectiveness studies, three cross-sectional studies, three descriptive studies and one retrospective cohort study were reviewed. Most success parameters of corticosteroid injections performed by general practitioners showed short term efficacy; at long term they did not outstand other therapeutic options. The balance between the economic burden ascribed to this technique utilization in primary health care context and gain in subject’s quality of life is favorable. The eleven studies assessing security registered only minor side effects and no serious ones.Discussion: The periarticular corticosteroid injection technique performance places it as a therapeutic option treating musculoskeletal disease in Portuguese primary health care. Nevertheless further evidence is required to support its efficacy and safety parameters, namely at national level.Conclusion: Corticosteroid injection utilization in primary health care constitutes an effective and safe option, with the potential to improve primary health care service rendering in an economically sustainable way.Introdução: Internacionalmente constata-se o tratamento de patologia músculo-esquelética em cuidados de saúde primários através de técnicas de infiltração peri-articular de corticosteróides. Este artigo procede à análise da evidência existente, com o objectivo de contribuir para a discussão do desenvolvimento dessa prática, ainda diminuta, em Portugal.Material e Métodos: Análise qualitativa de estudos controlados aleatorizados, custo-efectividade, transversais e coorte restrospectivo, recorrendo ao modelo PRISMA. Fontes de dados: PubMed, Cochrane Library, Essential Evidence Plus. Critérios de elegibilidade: infiltrações de corticosteróides no tratamento de patologia músculo-esquelética e indicação de contexto em cuidados de saúde primários.Resultados: Foram incluídos nove estudos controlados aleatorizados, três estudos de custo-efectividade, três estudos transversais, três estudos descritivos e um estudo coorte retrospectivo. A maioria dos indicadores de sucesso da utilização de infiltrações de corticosteróides por médicos de medicina geral e familiar mostrou eficácia a curto prazo; a longo prazo não mostrou superioridade comparativamenteàs intervenções alternativas. O balanço entre os encargos económicos e o aumento da qualidade de vida é favorávelà utilização desta técnica em cuidados de saúde primários. Todos os onze estudos que avaliaram a segurança registaram efeitos adversos ligeiros e nenhum grave.Discussão: O desempenho das técnicas de infiltração peri-articular de corticosteróides permite figurá-las como opção terapêutica no tratamento de patologia músculo-esquelética nos cuidados de saúde primários Portugueses. Importa incentivar estudos, nomeadamente a nível nacional, que suportem tanto os indicadores de eficácia, como de segurança desta técnica.Conclusão: A infiltração peri-articular de corticosteróides constitui uma opção relativamente eficaz, segura e com potencial de melhoria da prestação de cuidados de saúde primários Portugueses de uma forma economicamente sustentável.Ordem dos Médicos2015-09-11info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfapplication/vnd.ms-powerpointimage/jpegapplication/mswordapplication/mswordapplication/mswordhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/6127oai:ojs.www.actamedicaportuguesa.com:article/6127Acta Médica Portuguesa; Vol. 28 No. 5 (2015): September-October; 652-662Acta Médica Portuguesa; Vol. 28 N.º 5 (2015): Setembro-Outubro; 652-6621646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/6127https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/6127/4499https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/6127/7484https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/6127/7485https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/6127/7622https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/6127/7623https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/6127/7948Trindade, Ireneinfo:eu-repo/semantics/openAccess2022-12-20T11:04:44Zoai:ojs.www.actamedicaportuguesa.com:article/6127Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:19:15.956077Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Periarticular Corticosteroid Injection in the Therapeutic Approach of Musculoskeletal Disease in General Practice: A systematic Review
Infiltração Peri-Articular de Corticosteróides na Abordagem da Patologia Músculo- Esquelética em Medicina Geral e Familiar: Uma Revisão Sistemática
title Periarticular Corticosteroid Injection in the Therapeutic Approach of Musculoskeletal Disease in General Practice: A systematic Review
spellingShingle Periarticular Corticosteroid Injection in the Therapeutic Approach of Musculoskeletal Disease in General Practice: A systematic Review
Trindade, Irene
Adrenal Cortex Hormones
General Practice
Injections
Primary Health Care.
Corticosteróides
Cuidados de Saúde Primários
Infiltrações
Medicina Geral e Familiar.
title_short Periarticular Corticosteroid Injection in the Therapeutic Approach of Musculoskeletal Disease in General Practice: A systematic Review
title_full Periarticular Corticosteroid Injection in the Therapeutic Approach of Musculoskeletal Disease in General Practice: A systematic Review
title_fullStr Periarticular Corticosteroid Injection in the Therapeutic Approach of Musculoskeletal Disease in General Practice: A systematic Review
title_full_unstemmed Periarticular Corticosteroid Injection in the Therapeutic Approach of Musculoskeletal Disease in General Practice: A systematic Review
title_sort Periarticular Corticosteroid Injection in the Therapeutic Approach of Musculoskeletal Disease in General Practice: A systematic Review
author Trindade, Irene
author_facet Trindade, Irene
author_role author
dc.contributor.author.fl_str_mv Trindade, Irene
dc.subject.por.fl_str_mv Adrenal Cortex Hormones
General Practice
Injections
Primary Health Care.
Corticosteróides
Cuidados de Saúde Primários
Infiltrações
Medicina Geral e Familiar.
topic Adrenal Cortex Hormones
General Practice
Injections
Primary Health Care.
Corticosteróides
Cuidados de Saúde Primários
Infiltrações
Medicina Geral e Familiar.
description Introduction: Periarticular corticosteroid injection utilization by General Practitioners treating musculoskeletal disease in primary health care system is internationally acknowledged. This article aims at analyzing this evidence and contributing to the discussion of a potential development of the technique in Portugal.Material and Methods: Qualitative analysis of randomized control trials, cost-effectiveness studies, cross-sectional studies, retrospective cohort studies and observational studies, using PRISMA model. Data Sources: PubMed, Cochrane Library and Essential Evidence Plus. Eligibility criteria: corticosteroid injection mention in the treatment of musculoskeletal disease and an element that indicates primary health care context.Results: Nine randomized control trials, three cost-effectiveness studies, three cross-sectional studies, three descriptive studies and one retrospective cohort study were reviewed. Most success parameters of corticosteroid injections performed by general practitioners showed short term efficacy; at long term they did not outstand other therapeutic options. The balance between the economic burden ascribed to this technique utilization in primary health care context and gain in subject’s quality of life is favorable. The eleven studies assessing security registered only minor side effects and no serious ones.Discussion: The periarticular corticosteroid injection technique performance places it as a therapeutic option treating musculoskeletal disease in Portuguese primary health care. Nevertheless further evidence is required to support its efficacy and safety parameters, namely at national level.Conclusion: Corticosteroid injection utilization in primary health care constitutes an effective and safe option, with the potential to improve primary health care service rendering in an economically sustainable way.
publishDate 2015
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dc.publisher.none.fl_str_mv Ordem dos Médicos
publisher.none.fl_str_mv Ordem dos Médicos
dc.source.none.fl_str_mv Acta Médica Portuguesa; Vol. 28 No. 5 (2015): September-October; 652-662
Acta Médica Portuguesa; Vol. 28 N.º 5 (2015): Setembro-Outubro; 652-662
1646-0758
0870-399X
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