1.Summary of the 2023 Thai Menopause Society Clinical Practice Guideline on Menopausal Hormone Therapy
Sukanya CHAIKITTISILPA ; Nalina ORPRAYOON ; Orawin VALLIBHAKARA ; Sakda Arj-Ong VALLIBHAKARA ; Prasong TANMAHASAMUT ; Woraluk SOMBOONPORN ; Manee RATTANACHAIYANONT ; Kitirat TECHATRAISAK ; Unnop JAISAMRARN
Journal of Menopausal Medicine 2024;30(1):24-36
The Thai Menopause Society is an academic organization consisting of healthcare professionals engaged in menopause medicine. The position statement was first issued in 1994 and updated in 2003 and 2023. Herein, we reviewed the important updates of the 2023 position statement on menopausal hormone therapy (MHT) as an international reference for healthcare professionals in Thailand. An advisory panel of clinicians and research experts in the field of menopause reviewed the recommendation of published International Consensus Statements and updated the evidence using the MEDLINE database through PubMed. The evidence-based information and relevant publications were assessed, and a consensus on recommendations was subsequently achieved using the level of evidence to determine the recommendation strength and evidence quality. MHT remains the most effective treatment for vasomotor symptoms and genitourinary syndromes of menopause even after 20 years. Additionally, it is effective in preventing bone loss and fractures in postmenopausal women. The cardiovascular risk of MHT increased in women who initiated MHT after 60 years of age. Hormone therapy should be individualized following the hormone type, dose, administration route, use duration, and progestogen inclusion. The necessary pretreatment evaluation and appropriate follow-up recommendations were added for improved MHT standard care. The updated 2023 Clinical Practice Guideline on MHT is useful for gynecologists, general physicians, endocrinologists, and other healthcare professionals in treating menopausal women receiving hormone therapy in Thailand.
2.Summary of the Thai Osteoporosis Foundation (TOPF) Clinical Practice Guideline on the diagnosis and management of osteoporosis 2021
Natthinee CHARATCHAROENWITTHAYA ; Unnop JAISAMRARN ; Thawee SONGPATANASILP ; Vilai KUPTNIRATSAIKUL ; Aasis UNNANUNTANA ; Chanika SRITARA ; Hataikarn NIMITPHONG ; Lalita WATTANACHANYA ; Pojchong CHOTIYARNWONG ; Tanawat AMPHANSAP ; Ong-Art PHRUETTHIPHAT ; Thanut VALLEENUKUL ; Sumapa CHAIAMNUAY ; Aisawan PETCHLORLIAN ; Varalak SRINONPRASERT ; Sirakarn TEJAVANIJA ; Wasuwat KITISOMPRAYOONKUL ; Piyapat DAJPRATHAM ; Sukanya CHAIKITTISILPA ; Woraluk SOMBOONPORN
Osteoporosis and Sarcopenia 2023;9(2):45-52
Objectives:
The Thai Osteoporosis Foundation (TOPF) is an academic organization that consists of a multidisciplinary group of healthcare professionals managing osteoporosis. The first clinical practice guideline for diagnosing and managing osteoporosis in Thailand was published by the TOPF in 2010, then updated in 2016 and 2021. This paper presents important updates of the guideline for the diagnosis and management of osteoporosis in Thailand.
Methods:
A panel of experts in the field of osteoporosis was recruited by the TOPF to review and update the TOPF position statement from 2016. Evidence was searched using the MEDLINE database through PubMed. Primary writers submitted their first drafts, which were reviewed, discussed, and integrated into the final document. Recommendations are based on reviews of the clinical evidence and experts' opinions. The recommendations are classified using the Grading of Recommendations, Assessment, Development, and Evaluation classification system.
Results:
The updated guideline comprises 90 recommendations divided into 12 main topics. This paper summarizes the recommendations focused on 4 main topics: the diagnosis and evaluation of osteoporosis, fracture risk assessment and indications for bone mineral density measurement, fracture risk categorization, management according to fracture risk, and pharmacological management of osteoporosis.
Conclusions
This updated clinical practice guideline is a practical tool to assist healthcare professionals in diagnosing, evaluating, and managing osteoporosis in Thailand.