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To evaluate the prevalence and the performance of routine surveillance for thalassemia related complications during 2 periods; before and after published CPGs (2012\u20132014 vs 2015\u20132017), 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\u2009&lt;\u200925% 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.<\/jats:p>","DOI":"10.1038\/s41598-021-92715-w","type":"journal-article","created":{"date-parts":[[2021,6,24]],"date-time":"2021-06-24T10:02:56Z","timestamp":1624528976000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["An urgent need for improving thalassemia care due to the wide gap in current real-life practice and clinical practice guidelines"],"prefix":"10.1038","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2101-595X","authenticated-orcid":false,"given":"Supachai","family":"Ekwattanakit","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0996-3789","authenticated-orcid":false,"given":"Chattree","family":"Hantaweepant","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Archrob","family":"Khuhapinant","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8624-5516","authenticated-orcid":false,"given":"Noppadol","family":"Siritanaratkul","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3162-1849","authenticated-orcid":false,"given":"Vip","family":"Viprakasit","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,6,24]]},"reference":[{"issue":"8","key":"92715_CR1","first-page":"704","volume":"79","author":"DJ Weatherall","year":"2001","unstructured":"Weatherall, D. 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Guidelines for the Management of Transfusion Dependent Thalassaemia (TDT) (Thalassaemia International Federation, 2014)."},{"key":"92715_CR4","volume-title":"Thailand Clinical Practice Guidelines for Diagnosis and Management of Thalassemia Syndromes","author":"S Fucharoen","year":"2014","unstructured":"Fucharoen, S., Tanphaichitr, V. S., Torcharus, K., Viprakasit, V. & Meekaewkunchorn, A. Thailand Clinical Practice Guidelines for Diagnosis and Management of Thalassemia Syndromes (Queen Sirirkit National Institute of Child Health, 2014)."},{"issue":"4","key":"92715_CR5","doi-asserted-by":"publisher","first-page":"e28109","DOI":"10.1002\/pbc.28109","volume":"67","author":"P Nakavachara","year":"2020","unstructured":"Nakavachara, P., Kajchamaporn, W., Pooliam, J. & Viprakasit, V. Early development of decreased beta-cell insulin secretion in children and adolescents with hemoglobin H disease and its relationship with levels of anemia. Pediatr. 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