ASH, ABHH, ACHO, Grupo CAHT, Grupo  CLAHT, SAH, SBHH, SHU, SOCHIHEM, SOMETH, Sociedad Panameña de Hematología, SPH, and SVH 2021 guidelines for management of venous thromboembolism in Latin America

Abstract

Background: Venous thromboembolism (VTE) is a common disease in Latin American settings. Implementing international guidelinn Aes in Latimerican settings requires additional considerations. Objective: The purpose of our study was to provide evidence-based guidelines about managing VTE for Latin American patients, clinicians, and decision makers. Methods: We used the Grading of Recommendations, Assessment, Development and Evaluation (GRADE)-ADOLOPMENT method to adapt recommendations from 2 American Society of Hematology (ASH) VTE guidelines (Treatment of VTE and Anticoagulation Therapy). ASH and local hematology societies formed a guideline panel comprised of medical professionals from 10 countries in Latin America. Panelists prioritized 18 questions relevant for the Latin American context. A knowledge synthesis team updated evidence reviews of health effects conducted for the original ASH guidelines and summarized information about factors specific to the Latin American context (ie, values and preferences, resources, accessibility, feasibility, and impact on health equity). Results: The panel agreed on 17 recommendations. Compared with the original guideline, 4 recommendations changed direction and 1 changed strength. Conclusions: This guideline adolopment project highlighted the importance of contextualization of recommendations suggested by the changes to the original recommendations. The panel also identified 2 implementation priorities for the region: expanding the availability of home treatment and increasing the availability of direct oral anticoagulants (DOACs). The guideline panel made a conditional recommendation in favor of home treatment for individuals with deep venous thrombosis and a conditional recommendation for either home or hospital treatment for individuals with pulmonary embolism. In addition, a conditional recommendation was made in favor of DOACs over vitamin K antagonists for several populations.

Direct Oral Anticoagulants for Anticoagulation after Initial Management of Venous Thromboembolism

“…심부정맥 혈전증과 폐동맥색전증은 정맥 혈전색전증의 주 된 형태로, 최근 들어 빠르게 증가하고 있으며, 지역사회와 병 원 내 환자에서 상당한 사망률을 나타낸다 (1)(2)(3). 주된 치료는 항응고요법이며, 목적은 진단 이후 3∼6개월 이내에 가장 높 은 혈전증의 재발, 색전증 등의 합병증 및 사망을 막고자 함이 다.…”

“…주된 치료는 항응고요법이며, 목적은 진단 이후 3∼6개월 이내에 가장 높 은 혈전증의 재발, 색전증 등의 합병증 및 사망을 막고자 함이 다. 정맥 혈전색전증으로 진단받고 첫 5∼10일간의 항응고제 사용 후 보다 장기간의 항응고제 유지치료가 필요한데, 여러 연구지침에서 권고하고, 최근 많이 사용되는 direct oral anticoagulants (DOACs)에 대해 정리해 보고자 한다 (2)(3)(4)(5)(6).…”

Review of an international pilot project to adapt the Canadian Adult Obesity Clinical Practice Guideline

“…Organizations and individuals in several countries immediately expressed an interest in endorsing and/or adapting the guideline for use in their jurisdictions given the extensive human, financial and technical resources required to create a de novo CPG. However, while guidelines in other chronic disease spaces such as lung cancer, psychosis, and rheumatology [ [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] ] have successfully demonstrated adaptation from one country to another, an adaptation of an obesity CPG had, to our knowledge, never been implemented.…”

American Society of Hematology, ABHH, ACHO, Grupo CAHT, Grupo CLAHT, SAH, SBHH, SHU, SOCHIHEM, SOMETH, Sociedad Panamena de Hematología, Sociedad Peruana de Hematología, and SVH 2023 guidelines for diagnosis of venous thromboembolism and for its management in special populations in Latin America

“…The recommendations included in this document complement the previously published guidelines about management of VTE in adults, and its prevention in surgical and medical patients, as well in long-distance travelers. 4 This manuscript refers to the adaptation of the following ASH guidelines: Diagnosis of VTE, 5 Management of VTE in pregnant women 6 and management of VTE in children. 7…”

“…The recommendations included in this document complement the previously published guidelines about the management of VTE in adults and its prevention in surgical and medical patients, as well as in long-distance travelers. 4 …”