Aims: This study evaluated the 10‐year consumption and economic patterns of classical analgesics, adjuvants and opioids in Portugal (2012‐2022), and conducted a comparative analysis between Portugal, Spain and Denmark to explore the consumption patterns among these countries for 2022.Methods: Data on sales and national health service (NHS) costs were obtained from the Portuguese National Authority of Medicines and Health Products. Sales data were converted to defined daily dose (DDD) per 1000 inhabitants per day according to the Anatomical Therapeutic Chemical (ATC) classification/DDD methodology, while comparisons between Spain and Denmark were evaluated with the chi‐square test, when appropriate.Results: The findings reveal that classical analgesics use in Portugal remained stable during the period 2012‐2022, with ibuprofen being the most consumed. Adjuvants, specifically gabapentinoids, experienced an 84% increase in use, primarily attributed to pregabalin. Weak opioids, led by tramadol, witnessed a 117% rise in use, while strong opioid use, led by tapentadol, increased by 618%. Portugal presented the lowest overall opioid consumption when compared to Denmark and Spain in 2022. Economic trends indicated a heightened NHS expenditure on analgesics, primarily driven by increased opioid use. Notwithstanding, there was no significant burden on relative expenditure over the 10‐year period.Conclusions: Portugal presented a major increase in both weak and strong opioid prescriptions, aligning with the trends for Spain and Denmark. The development and approval of generic medicines and vigilant market monitoring are imperative strategies for managing the escalated costs resulting from heightened consumption, particularly concerning opioids.

BACKGROUND: Whey protein is consumed worldwide by athletes due to its alleged benefits on muscle mass and strength. Because of its rich branched chain amino acids content, namely leucine, whey appears to favor muscle protein synthesis through the mTOR pathway in combination with resistance training, when taken after exercise in sufficient amounts. METHODS: In the present study resistance trained (>= 3 months) participants (men and women) between the age of 18 and 30 years old were randomized in a blinded fashion to whey protein isolate (N.=4) and an isocaloric placebo (N.=4) groups. Both groups were subjected to a 12-week RT protocol designed to increase muscle mass and strength. Muscle thickness of the biceps brachii (BB) at 67% of its length and quadriceps muscles, vastus lateralis (VL); vastus intermidius (VI) and rectus femoris (R.F.) at 30% and 50% of its length were assessed using ultrasound technique. Muscle strength was assessed using an isokinetic protocol at angular velocities of 60 degrees.s(-1) (5 repetitions) and 180 degrees.s(-1) (10 repetitions) with a range of motion of 0 degrees to 100 degrees on a dynamometer to determine peak torque (PT). Lean body mass (LBM) and body fat percentage (%BF) were assessed using a body composition analyzer through segmental multi-frequency bioelectrical impedance method. All variables were assessed before and after interventions. RESULTS: Results show an increase in muscle thickness of all muscles from RT except for V.L. and RF at 30% (P>0.05) with an increase in VI at 50% (P=0.045) and a trend in VI at 30% (P=0.075) related to whey protein intake. PT increased with RT for all knee flexors/extensors (P<0.05) and for elbow flexors/extensors at 60 degrees extension and 180 degrees flexion (P0.05). No interactions were found between training and supplementation. CONCLUSIONS: Supplementation with whey protein, combined with RT can increase muscle mass with no effects on muscle strength. Whey protein supplementation may alter body composition in favor of additional fat free mass with no significant changes in body fat.

Chronic pain is a complex condition that benefits from a multidisciplinary approach. This pilot parallel-group single-blinded randomized controlled study evaluated the feasibility, acceptability and adherence by patients and physicians of pharmacist-led medication review on chronic pain patients. Trends in pain intensity, quality of life and patient satisfaction were examined. Twenty adults were recruited from two primary care units in Porto, Portugal, and randomly assigned to either the medication review (MR) group, (n = 10) using the Dader method, or the usual care (UC) group, (n = 10) and given general advice, for 16-weeks. Pain intensity decreased by 2.07 (MR group) and increased by 0.52 (UC group), yielding an adjusted mean difference of 2.77 (95% CI, -4.93 to -0.62; p = 0.008). Pain relief was reported by 62.5% in the MR group versus 37.5% in UC (p = 0.357). The MR group showed significant improvement in physical functioning (p = 0.019) and higher treatment satisfaction (p = 0.029). The acceptance rate of MR interventions was 71%, which resolved 63% of negative medication outcomes. Acceptability was high (> 90% of planned interviews). Conducting pharmacist-led MR for chronic pain management in primary care is feasible and well accepted by patients and physicians. Observed trends toward improved pain and QoL warrant confirmation in a larger trial. This pilot trial was registered in clinicaltrials.gov (NCT06997861).