NATIONAL CLINICAL PROTOCOLS IN PHTHISIOPULMONOLOGY: EVALUATION AND ENSURING QUALITY AND SAFETY
DOI:
https://doi.org/10.52692/1857-0011.2025.3-83.32Keywords:
phthisiopulmonology, national clinical protocols, patient safety, quality of medical care, medical error, forensic examinationAbstract
In the context of healthcare reform in the Republic of Moldova, national clinical protocols are becoming particularly important. Their main purpose is to standardize diagnosis and treatment, reduce medical risks, improve patient safety, and serve as a guideline for medical and forensic examinations. This study is devoted to the analysis of phthisiopulmonological protocols. It identified the most significant nosologies, assessed the frequency of protocol updates, and examined the medical and legal risks associated with the untimely revision of documents. In the Republic of Moldova, 10 protocols for adults and 14 for children have been approved. They cover diseases and conditions such as tuberculosis, pneumonia, chronic obstructive pulmonary disease, sarcoidosis, idiopathic interstitial pneumonitis, bronchiectasis, obstructive sleep apnea syndrome, smoking cessation, and a number of rare diseases. The average age of the protocols for adults is 5.7 years, which indicates the need for their accelerated revision. A medical-legal analysis has shown that untimely updating of protocols reduces their evidential value and increases the risk of liability for healthcare professionals.
References
Agusti A., Vogelmeier C. F. GOLD 2024: a brief overview of key changes. Jornal Brasileiro de Pneumologia, 2023, vol. 49, nr. 6, e20230369. DOI 0.36416/18063756/e20230369.
Alameeri A., Capraz Yavuz Burcu, Lucca Francesca, Bambir Ivan, Famulska Paulina; Wrobel Folescu Cohen Renata. Cystic fibrosis year in review 2024. Journal of Cystic Fibrosis, 2025, vol. 24, nr. 2, p. 218223. DOI 10.1016/j.jcf.2025.02.012.
Centers for Disease Control and Prevention (CDC). RSV vaccine guidance for adults – interim recommendations. 8 июля 2025 г. https://www.cdc.gov/rsv/recommendations/adults.html.
Choi Hayoung, McShane Pamela J., Aliberti Stefano, Chalmers James D. Bronchiectasis management in adults: state of the art and future directions. European Respiratory Journal, 2024, vol. 63,
Commonwealth of Independent States (CIS). Legislation of 11 countries members of CIS. Moldova [online]. CISLegislation.com. https://cis-legislation.com/search.fwx?countryid=7.
Cottin V. Criteria for Progressive Pulmonary Fibrosis: Getting the Horse Ready for the Cart. American Journal of Respiratory and Critical Care Medicine, 2023, vol. 207, nr. 1, p. 1113.
Global Initiative for Asthma (GINA). COVID19 and asthma – global strategy for asthma management and prevention [online]. 26 апреля 2021 г. https://ginasthma.org/wp-content/uploads/2021/04/200421-25COVID-19-and-Asthma.pdf.
Global Initiative for Asthma (GINA). Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention, 2025. Updated May 2025”. https://ginasthma.org/2025- gina-strategy-report/.
Kashyap Surender, Bhardwaj Manisha. New sarcoidosis guidelines: Are we near to perfection? Lung India, 2022, vol. 39, nr. 3, p. 217219. DOI 10.4103/lungindia.lungindia_159_22.
Kondoh Yasuhiro, Inoue Yoshikazu. Progressive Pulmonary Fibrosis: Current Status in Terminology and Future Directions. Advances in Therapy, 2025 Jul., vol. 42, nr. 7, p. 29883001.
Matthys B., Jafaar L., Ahmed S. et al. Development and implementation of a digital clinical decision support system to improve primary healthcare delivery in a refugee setting in Chad. BMC Primary Care, 2025, vol. 26, article 113.
Migliori Giovanni B., Marx F. M., Ambrosino N. et al. Clinical standards for the assessment, management and rehabilitation of posttuberculosis lung disease. International Journal of Tuberculosis and Lung Disease, 2021, vol. 25, nr. 10, p. 769783.
Ministerul Sănătății al Republicii Moldova. Ghiduri, protocoale, standarde [online]. https://ms.gov.md/legislatie/ghiduri-protocoale-standarde/.
image
Ministerul Sănătății al Republicii Moldova. Metodologia de elaborare și implementare a actelor normative de standardizare a serviciilor de sănătate (Ordinul MS nr. 1024 din 12.12.2024) [online]. https://ms.gov.md/wp-content/uploads/2025/07/Ordinul-MS-nr.-1024-din-12.12.2024-cu-privire-la-aprobarea-Metodologiei-de-elaborare-si-implementare-a-actelor-normative-de-standardizare- a-serviciilor-de-sanatate.pdf.
Republica Moldova. Parlamentul. COD Nr. 985 din 18-04-2002. Codul Penal al Republicii Moldova* Publicat: 14-04-2009 în Monitorul Oficial Nr. 72-74 art. 195. MODIFICAT LP257 din 16.12.20, MO353-357/22.12.20 art.288; în vigoare 01.01.21. https://www.legis.md/cautare/getResults?doc_id=125325&lang=ro
Slowik Jennifer M., Sankari Abdulghani, Collen Jacob
F. Obstructive Sleep Apnea. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; updated 4 March 2025. https://www.ncbi.nlm.nih.gov/books/NBK499876/.
World Health Organization (WHO). Global patient safety action plan 2021–2030: towards eliminating avoidable harm in health care. Geneva: WHO, 2021. ISBN 9789240032705.
World Health Organization (WHO). Post COVID19 condition (long COVID). Fact sheet, 26 February 2025 [online]. https://www.who.int/news-room/fact-sheets/detail/post-covid-19-condition- (long-covid).
World Health Organization (WHO). TB preventive treatment: new recommendations on levofloxacin for contacts of multidrug and rifampicinresistant tu- berculosis. News release, 9 September 2024 [online]. https://www.who.int/news/item/09-09-2024-who-re-leases-updated-guidelines-on-tuberculosis-preven-tive-treatment.
World Health Organization (WHO). WHO clinical treatment guideline for tobacco cessation in adults. Geneva: WHO, 2024. ISBN 9789240096431.
World Health Organization (WHO); Global Initia- tive for Chronic Obstructive Lung Disease (GOLD). Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease (2025 report) [online]. Geneva: GOLD, 15 Nov 2024. https://goldcopd.org/wp-content/uploads/2024/11/GOLD-2025-Report-v1.0-15Nov2024_WMV.pdf.
World Intellectual Property Organization (WIPO). Obstructive Sleep Apnea Treatment: Biological Tendon Tether Technology [online]. https://www.wipo.int/portal/en/index.html.
Downloads
Published
License
Copyright (c) 2026 Bulletin of the Academy of Sciences of Moldova. Medical Sciences
This work is licensed under a Creative Commons Attribution 4.0 International License.
