Swiss interdisciplinary guidance on good practices for acute and complicated diabetic foot syndromes.

BACKGROUND

Diabetic foot syndromes (DFS) usually have negative outcomes for patients characterised by multiple comorbidities and frailty. In Switzerland, we need a nationwide "quality of care" programme consisting of evidence-based, practical guidance for primary care providers, together with the implementation of a multidisciplinary care system for DFS.

METHODS

Elaboration of interprofessional and comprehensive Swiss practical guidance for the timely management of acute DFS. This guidance will not replace existing recommendations, but will be complementary to them. Before nationwide implementation, three Swiss pilot sites will test the guidance in collaboration with local interprofessional foot-care centres.

RESULTS

Under the umbrella of QualiCCare, and endorsed by the professional societies involved, twenty experts from all relevant professions issued four protocols for various aspects of DFS between March 2018 and January 2020. In addition, they defined criteria for triage and treatment in primary care, as well as the timely referral of patients with DFS to interprofessional foot-care centres. We propose a framework for multidisciplinary, specialised foot-care networks, and interprofessional foot-care centres. The piloting of the proposed concepts is underway. All documents are available on the website www.qualiccare.ch.

CONCLUSIONS

We provide evidence-based tools for Swiss primary care providers and specialists, and increase the accessibility for patients to specialised and timely care of DFS.