An urgent need for improving thalassemia care due to the wide gap in current real-life practice and clinical practice guidelines

Abstract Based on Thalassemia International Federation clinical practice guidelines (CPG) for non-transfusion dependent and transfusion dependent thalassemia, several measures should be routinely implemented such as monitoring and surveillance of thalassemia related complications for early detection...

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Autores principales:	Supachai Ekwattanakit, Chattree Hantaweepant, Archrob Khuhapinant, Noppadol Siritanaratkul, Vip Viprakasit
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/8ed80476dfbc4f1ca5d244243e1b4ea1
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spelling	oai:doaj.org-article:8ed80476dfbc4f1ca5d244243e1b4ea12021-12-02T17:45:03ZAn urgent need for improving thalassemia care due to the wide gap in current real-life practice and clinical practice guidelines10.1038/s41598-021-92715-w2045-2322https://doaj.org/article/8ed80476dfbc4f1ca5d244243e1b4ea12021-06-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-92715-whttps://doaj.org/toc/2045-2322Abstract Based on Thalassemia International Federation clinical practice guidelines (CPG) for non-transfusion dependent and transfusion dependent thalassemia, several measures should be routinely implemented such as monitoring and surveillance of thalassemia related complications for early detection and proper clinical management. To evaluate the prevalence and the performance of routine surveillance for thalassemia related complications during 2 periods; before and after published CPGs (2012–2014 vs 2015–2017), data from 524 adult thalassemia patients attended at Siriraj hospital were compared among different treating physician groups; thalassemia, private hematology, and internal medicine clinics. Three most common complications were osteopenia/osteoporosis (69.8%), gallstones (67.6%) and abnormal vitamin D level (67.6%). Iron overload has been widely evaluated (93.1%) followed by liver function test (82.3%). However, the rate of evaluation for other complications were significantly reduced and < 25% of patients were evaluated in several complications. Comparing among clinics, the surveillance rate has increased significantly for several endocrine complications only in patients treated at thalassemia clinic but not in others. This study was the first study that evaluated real-world practical management of thalassemia patient in terms of complication surveillance. This different clinical practice has called for an immediate policy change to improve and standardize a care for thalassemia patients in Thailand.Supachai EkwattanakitChattree HantaweepantArchrob KhuhapinantNoppadol SiritanaratkulVip ViprakasitNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-6 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Supachai Ekwattanakit Chattree Hantaweepant Archrob Khuhapinant Noppadol Siritanaratkul Vip Viprakasit An urgent need for improving thalassemia care due to the wide gap in current real-life practice and clinical practice guidelines
description	Abstract Based on Thalassemia International Federation clinical practice guidelines (CPG) for non-transfusion dependent and transfusion dependent thalassemia, several measures should be routinely implemented such as monitoring and surveillance of thalassemia related complications for early detection and proper clinical management. To evaluate the prevalence and the performance of routine surveillance for thalassemia related complications during 2 periods; before and after published CPGs (2012–2014 vs 2015–2017), data from 524 adult thalassemia patients attended at Siriraj hospital were compared among different treating physician groups; thalassemia, private hematology, and internal medicine clinics. Three most common complications were osteopenia/osteoporosis (69.8%), gallstones (67.6%) and abnormal vitamin D level (67.6%). Iron overload has been widely evaluated (93.1%) followed by liver function test (82.3%). However, the rate of evaluation for other complications were significantly reduced and < 25% of patients were evaluated in several complications. Comparing among clinics, the surveillance rate has increased significantly for several endocrine complications only in patients treated at thalassemia clinic but not in others. This study was the first study that evaluated real-world practical management of thalassemia patient in terms of complication surveillance. This different clinical practice has called for an immediate policy change to improve and standardize a care for thalassemia patients in Thailand.
format	article
author	Supachai Ekwattanakit Chattree Hantaweepant Archrob Khuhapinant Noppadol Siritanaratkul Vip Viprakasit
author_facet	Supachai Ekwattanakit Chattree Hantaweepant Archrob Khuhapinant Noppadol Siritanaratkul Vip Viprakasit
author_sort	Supachai Ekwattanakit
title	An urgent need for improving thalassemia care due to the wide gap in current real-life practice and clinical practice guidelines
title_short	An urgent need for improving thalassemia care due to the wide gap in current real-life practice and clinical practice guidelines
title_full	An urgent need for improving thalassemia care due to the wide gap in current real-life practice and clinical practice guidelines
title_fullStr	An urgent need for improving thalassemia care due to the wide gap in current real-life practice and clinical practice guidelines
title_full_unstemmed	An urgent need for improving thalassemia care due to the wide gap in current real-life practice and clinical practice guidelines
title_sort	urgent need for improving thalassemia care due to the wide gap in current real-life practice and clinical practice guidelines
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/8ed80476dfbc4f1ca5d244243e1b4ea1
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An urgent need for improving thalassemia care due to the wide gap in current real-life practice and clinical practice guidelines

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