This new tabular display format follows closely that of the Ministry of Health (MOH) website CPG section at http://www.moh.gov.my
| Standards & Guidance | Date | CPG | QR | TM | PIL |
|---|---|---|---|---|---|
| Management of Systemic Lupus Erythematosus | 2023 | 6.23 MB | 1.89 MB | ||
| Management of Osteoporosis (3rd Edition) | 2022 | 4.54 MB | |||
| Management of Gout (2nd Edition) | 2021 | 5.79 MB | 2.42 MB | 23.1 MB | |
| Management of Rheumatoid Arthritis | 2019 | 4.11 MB | 1.34 MB | 22.8 MB | |
| Management of Osteoarthritis (2nd Edition) | 2013 | 12.8 MB | 4.25 MB | 21.5 MB |
Inflammatory Arthritis
2018 APLAR Axial Spondyloarthritis Treatment Recommendations
2018 APLAR axial spondyloarthritis treatment recommendations.
Read more:
https://onlinelibrary.wiley.com/doi/full/10.1111/1756-185X.13510
2018 Update of the APLAR Recommendations for Treatment of Rheumatoid Arthritis
2018 update of the APLAR recommendations for treatment of rheumatoid arthritis.
Read more:
https://onlinelibrary.wiley.com/doi/full/10.1111/1756-185X.13513
Development of an ASAS-endorsed recommendation for the early referral of patients with a suspicion of axial spondyloarthritis
The aim of this work was to develop a consensual recommendation under the auspices of the Assessment of SpondyloArthritis international Society (ASAS) for early referral of patients with a suspicion of axial spondyloarthritis by non-rheumatologists.
The development of a referral recommendation consisted of four phases:
(1) systematic literature review,
(2) the first Delphi round aiming at identification of unmet needs and development of a candidate list of referral parameters,
(3) the second Delphi round aiming at identification of the most useful combination of referral parameters and
(4) final discussion and formal endorsement by ASAS membership. The following consensus on a referral recommendation was achieved as a result of the Delphi processes and final voting:
Download the Recommendation below:
Inflammatory Arthritis and Biologic Therapy - Malaysian Consensus
Chronic inflammatory arthritis such as Rheumatoid Arthritis (RA), Psoriatic Arthritis (PsA) and Ankylosing Spondylitis (AS) are associated with significant morbidity and disability. These may result in decreased quality of life, loss of productivity and increased health cost. According to Malaysian data on the burden of disease published in 2004, musculoskeletal disorders ranked 3rd among diseases in females.
The total drug expenditure in 2005 for the treatment of inflammatory and rheumatic diseases is RM 50.7 million, ranking 5th as the most prescribed group of drugs and forms 7.8% of the top 40 prescribed drugs in Malaysia(1).
The introduction of biologics spawned a new therapeutic era in rheumatology. It has provided another treatment option in controlling disease activity, thus improving patients’ functional status and attenuating structural damage. This will result in potential long term benefits such as improved quality of life and increased prospect of remaining in work.
Management of Gout
Objective:
- Education and Awareness on the proper way to diagnose, assess and investigate gout.
- Evidence based guidance on the management of gout
Clinical Questions:
- What are the current best practices in the management of gout and its complications
- What is the evidence to treat asymptomatic hyperuricaema?
Target Population
- This guideline is to be applied to adults above 16 years old with gout
Download the CPG below:
e-CPG Management of Gout (Second Edition)
Quick Reference – Management of Gout (Second Edition)
Management of Rheumatoid Arthritis
Objectives
The objectives of the CPG are to provide evidence-based recommendations on rheumatoid arthritis (RA) on the following aspects:
• diagnosis
• investigations
• treatment (non-pharmacological and pharmacological)
• special considerations
• referral and follow-up
Download CPG below:
New Guidelines for Spondyloarthritis Imaging Issued by EULAR
EULAR recommendations for the use of imaging in the diagnosis and management of spondyloarthritis in clinical practice.
Download CPG below:
Inflammatory Back Pain Referral Algorithm
Inflammatory Back Pain Referral Algorithm.
Download:
Inflammatory Back Pain Referral Algorithm in Malaysia- Aug 2020
Osteoarthritis
Clinical Practice Guidelines On The Management Of Osteoarthritis (2nd Edition), 2014
The Launch of the Management of Osteoarthritis (Second Edition) Clinical Practice Guideline, 28th May 2014
Osteoarthritis is a progressive mechanical failure of the joint, associated with severe pain, disability and poor quality of life. Recently, the Ministry of Health, Malaysia and the Malaysian Society of Rheumatology took the initiative to produce an updated edition of the Management of Osteoarthritis Clinical Practice Guideline.
On the 28th May 2014, Datuk Dr Jeyaindran A/L Tan Sri Sinnadurai, Timbalan Ketua Pengarah Kesihatan (Perubatan) Malaysia, launched the guidelines at Selayang Hospital. An overview of the guidelines was presented by Dr Azmillah Rosman, Chairperson of the Clinical Practice Guideline Development Group, followed by the delivery of the guideline packages to representatives from Jabatan Kesihatan Negeri and Faculties of Medicine of local universities.
To facilitate access to the guideline, documents such as Quick Reference and Training Module are made available in the Ministry of Health and the Malaysian Society of Rheumatology web portals.
CPG_Management_of_Osteoarthritis_3nd_Edition
QR_Management_of_Osteoarthritis_2nd_Edition
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Osteoporosis
Clinical Guidance on Management of Osteoporosis 2012 - Second Edition (2015)
This Clinical Guidance is not intended to serve as a standard of medical care. Standards of medical care are determined on the basis of all clinical data available for an individual case and are subject to change as scientific knowledge advances and patterns of care evolve.
The contents of this publication are a guide to clinical practice, based on the best available evidence at the time of development. Adherence to this guide may not acceptable methods of care.
Each physician is ultimately responsible for the management of his/her unique patient in the light of clinical data presented by the patient and the diagnostic and treatment options available.
Download CPG below:
Connective Tissue Diseases
Clinical Practice Guidelines: Management of Pulmonary Arterial Hypertension (PAH)
To provide evidence-based guidance in the diagnosis and management of PAH in adults and pediatric patients.
SPECIFIC OBJECTIVES
- To guide early diagnosis of PAH in adults and pediatric patients so as to enable referral of PAH cases for prompt specialist care
- To guide in assessment of patients with suspected PAH
- To provide guidance on appropriate and timely PAH management
- To guide on monitoring response to treatment
- To guide on specific aspects of managing PAH in congenital heart disease
CLINICAL QUESTIONS
1. What is the definition of PAH?
2. What is the epidemiology and natural history of PAH?
3. How is PAH diagnosis made?
4. What are the investigations to evaluate PAH?
5. How to manage patients with PAH?
6. What are the conventional and PAH specific therapies available?
7. How to evaluate response to treatment?
8. What are the key issues in managing PAH in congenital heart disease?
TARGET POPULATION
Adult and paediatric patients with PAH as defined in the updated clinical classification of Pulmonary Hypertension (PHT) from Dana Point, 2008. The inclusion criteria are idiopathic PAH, heritable PAH, Connective Tissue Disease associated PAH and Congenital Heart Disease associated PAH. The other types of PAH are excluded.
TARGET GROUP/USER
These guidelines are applicable to physicians, cardiologists (paediatric and adult), pulmonologists, rheumatologists, critical care providers and primary care doctors involved in treating patients with PAH.
Download CPG below:
Others
Acupuncture As A Complementary Therapy For Musculoskeletal Pain
Background
Musculoskeletal pain syndromes are a common health problem. The causes of musculoskeletal pain are varied starting from trauma up to musculoskeletal diseases such as low back pain, Osteoarthritis and etc. Nowadays there are many ways to treat musculoskeletal pain depending on the severity of the condition. Pharmacologic and non pharmacologic therapies such as acupuncture and physiotherapy can be used to manage patient with musculoskeletal pain. Understanding the physiology of pain transmission, modulation, and perception is crucial for effective management.
Nowadays acupuncture has grown in popularity among alternative therapies and it is estimated that 2% of adults in the UK use it each year for a variety of conditions. It was claimed to have many benefits and advantages especially reducing pain in various diseases and improve quality of life.
This technology review was conducted following a request from Director of Traditional and Complementary Medical (T&CM) Division, Ministry of Health (MOH) Malaysia to provide the best available evidence in ensuring T&CM practice in Malaysia is safe and conforms to acceptable standards for the benefits of the public, and in line with requirement of the Traditional and Complementary Medicine Act 2013.
Download CPG below:
Deep Tissue Massage As A Complementary Therapy For Musculoskeletal Pain
Background
Musculoskeletal pain is the pain that affects the muscles, ligaments, tendons, and bones. Musculoskeletal pain has tremendous socioeconomic impact through direct and indirect effects on health. Despite its high prevalence, musculoskeletal pain remains poorly understood and insufficiently treated. Musculoskeletal pain significantly impinges on the psychosocial status of affected people as well as their families and carers.
Musculoskeletal conditions encompass a spectrum of conditions, from those of acute onset and short duration to lifelong disorders; including osteoarthritis, rheumatoid arthritis, osteoporosis, and low back pain. In surveys carried out in Canada, the United States of America (USA) and Western Europe, the prevalence of physical disabilities caused by a musculoskeletal condition has been estimated at 4% to 5% of the adult population. It increases distinctly with age, and many are influenced by lifestyle factors, such as obesity and lack of physical activity.
Musculoskeletal pain is best treated by treating its cause. Treatment for musculoskeletal pain includes analgesics such as acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDs) and opiods. Many forms of complementary therapies exist, such as massage therapy, acupuncture and chiropractic manipulation. Massage therapy, in particular, has grown in popularity. In Malaysia, Malay massage using the concept of deep tissue massage technique has been used as a complementary therapy for musculoskeletal pain.
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Additional Links to Guidelines and Recommendations
EULAR Recommendations: Recommendations and Initiatives
EULAR Recommendations: Recommendations and initiatives.
Read more:
https://www.eular.org/recommendations-home
ACR Clinical Practice Guidelines
ACR Clinical Practice Guidelines
Read more:
https://www.rheumatology.org/Practice-Quality/Clinical-Support/Clinical-Practice-Guidelines
BSR Guidelines
BSR Guidelines
Read more:
https://www.rheumatology.org.uk/practice-quality/guidelines/
Consensus on Advanced Therapy for Inflammatory Arthritis (2023 Edition)
Chronic inflammatory arthritis e.g., Rheumatoid Arthritis (RA), Psoriatic Arthritis (PsA) and axial Spondyloarthritis (SpA) including Ankylosing Spondylitis (AS) are associated with significant morbidity and disability. These may result in decreased quality of life, loss of productivity and increased health cost. According to Malaysian data on the burden of disease published in 2004, musculoskeletal disorders are ranked third among diseases in females. The total drug expenditure in 2005 for the treatment of inflammatory and rheumatic diseases is RM50.7 million, ranking fifth as the most prescribed group of drugs and forms 7.8% of the top 40 prescribed drugs in Malaysia.