E. Bernabeu Mira1, S. Aebischer Perone2, Y. Sidler3, C. Barth3, L. Angama-Mueller3, S. Du Mortier2, A. Bourgeois Hadir4, A. Benyaich5
1International Committee of the Red Cross (ICRC), Physical Rehabilitation Program (PRP), Niamey, Niger, 2International Committee of the Red Cross (ICRC), Health, Geneva, Switzerland, 3International Committee of the Red Cross (ICRC), Physical Rehabilitation Program (PRP), Health, Geneva, Switzerland, 4International Committee of the Red Cross (ICRC), Physical Rehabilitation Program (PRP), Geneva, Switzerland, 5International Committee of the Red Cross (ICRC), Physical Rehabilitation Program (PRP), Beirut, Lebanon

Background: Prevalence of diabetes doubled since 1980 with 422 million people estimated to be living with diabetes in 2020 (1) and is growing in low and middle-income countries (2). Worldwide about 6% of patients with diabetes are suffering from foot problems (3).  
In many conflict and post conflict settings, the number of persons amputated due to diabetes seen at the International Committee of Red Cross (ICRC) supported Physical Rehabilitation Centers is high. A lack of access to comprehensive diabetes management lead to the development of diabetic foot ulcer with high risk of subsequent amputation. 
World Physiotherapy released a statement on Non-Communicable Diseases (NCDs) (4) advocating for the effectiveness of physical therapy in preventing and managing NCDs and risk factors. Physiotherapists (alongside other health practitioners) should be involved in both prevention and management of diabetic foot complications. In ICRC’s contexts this is an increasing need, but often capacity and resources to address it are missing.
This abstract will describe the initial process of developing a training of interprofessional diabetic foot care teams at the ICRC and humanitarian and LMIC contexts.

Purpose: Strengthen and improve interprofessional care of people with diabetic foot complications by developing training that promotes an integrated biopsychosocial, clinical and rehabilitation approach and empower health staff to work on the continuum of care.

Methods: Our approach towards an interprofessional training started at the design stage, where we set up three work coordinated by a Core group. The groups functioned collaboratively to design, adapt to ICRC contexts and pilot an interprofessional training programme. 
The working groups: 
  • physiotherapists and ortho-prosthetists of ICRC field operations;
  • representatives ICRC’s different health programs (primary care, mental health, hospital care, physical rehabilitation, learning and development) 
  • external international experts in the field of diabetic foot and diabetes management in LMIC and humanitarian settings

Results: Four main outputs so far:
  • Consultation and commitment of five “expert institutions” to contribute to the course (D-Foot, Geneva University Hospitals, Human Study, MSF, ICRC)
  • Creation and deployment of a training needs analysis that has been answered by 29 field ICRC health staff.
  • Development of a blended training concept with different training levels and methods 
  • Creation of training objectives and content that will guide the course development

Conclusion(s): The engagement and commitment of all actors (physiotherapists, ortho-prosthetists, nurses, doctors, psychologists, trainers…) at all levels, from the field to the international experts, has provided a robust body of evidence that permitted the development of the training needs analysis, concept, and the training objective. Regular Core group meetings were central to the harmonization of aims, goals and ideas to coordinate and align the different professionals  leading to the development and planning of the interprofessional training program.

Implications: By strengthening the capacities of health care providers both on technical side and on interprofessional collaboration, we expect to see an improvement on foot ulcers care, prevention of new ulcers and effectively reduce the complications in diabetic patients thanks to an active participation/contribution of physiotherapists in the interprofessional teams.

Funding, acknowledgements: None

Keywords: NCDs, interdisciplinary, training

Topic: Non-communicable diseases (NCDs) & risk factors

Did this work require ethics approval? No
Institution: Swiss Association of Research Ethics Committees
Committee: Commission Cantonale d'Ethique de la Recherche (CCER)
Reason: not working directly with health data from persons

All authors, affiliations and abstracts have been published as submitted.

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