Aspects of improving clinical protocols for the profile «Adult urology»

Aim of the study . To evaluate the availability of pharmacological treatment and the relevance of recommendations presented in clinical protocols in the field of «Adult Urology» through a comparative analysis of international experience and to identify aspects for improving protocols in this field. Materials and methods . The materials used were current clinical protocols for diagnosis and treatment in the field of «Adult Urology» available on the official website of the National Scientific Center for Healthcare Development, international recommendations of the constantly updated database of guidelines for decision support in clinical practice British Medical Journal Best Practice, guidelines of the European Association of Urologists, guidelines, reviews of the UpToDate resource, providing medical professionals with relevant and evidence-based information. Results and discussion . Urological diseases are often complex, multifactorial conditions; it is impossible to encompass all treatment regimens for every clinical scenario. Nonetheless, it is necessary to broaden the scope of this profile by developing clinical protocols depending on the etiological factor, extent of involvement, and stage of medical intervention. Upon reviewing clinical protocols in the field of «Adult Urology» the following common deviations were identified regarding pharmacotherapy: irrational selection of antibacterial agents, routine use of antifungal prophylaxis, use of medications with low levels of evidence, dosing regimen errors, and the use of trade names in the protocol text, which constitutes a blatant violation of the ethical promotion policy of pharmaceuticals. Antibiotic therapy is recommended only for confirmed bacteriuria with broadspectrum antibiotics. Antifungal prophylaxis is recommended only for patients at risk (secondary or primary immunodeficiency). Conclusions . Currently, 100% of clinical protocols in the field of «Adult Urology» are outdated and require revision. The rapid advancement of science, development, and improvement of pharmaceuticals necessitates ongoing professional development on the part of healthcare personnel, which can be facilitated by regular updating of clinical protocols. The availability of pharmacological therapy for urological patients is quite high: 97.35% medications presented in clinical protocols are available to patients in the Kazakhstani market (registered and included in the Kazakhstani National Drug Formulary), 94.7% medications are reimbursed within the framework of outpatient care, and 90.9% medications are available for procurement by medical organizations through the Single Distributor.