Italian guidelines for the management of adult individuals with post-surgical hypoparathyroidism

Aim: These guidelines (GLs) aim to improve and standardize the management of post-surgical hypoparathyroidism (hypoPTH) and to ensure that all patients receive the best possible care nationwide. Target population: Adults with post-surgical hypoPTH. Excluded population: The GLs do not address individuals under 18 years of age or those with familial, genetic, or autoimmune forms of hypoPTH. Patients with advanced renal failure are also excluded. Methods: Direct costs and resource utilization were evaluated over time to implement appropriate management within the National Health Service. Recommendations were formulated based on an analysis of literature evidence according to the GRADE methodology. Patient preferences were collected and verified through targeted bibliographic research and the active participation of two patients within the GLs' development group. Results: The present GLs provide four formal graded recommendations and 34 ungraded good clinical practice indications. A high level of agreement was consistently achieved among panel members. Conclusions: These GLs provide operational recommendations-based on the best available evidence -for the treatment of adult patients with post-surgical hypoPTH. The expected benefits of disseminating and implementing these GLs include improved quality of care, national standardization, and the rationalization of healthcare expenditure, while respecting patient preferences.