Implementation of an integral health program for diabetic foot ulcer patients by using Heberprot-P at the primary health attention level in the municipality of Playa, in Havana, Cuba
Abstract
A model was introduced within the Program of Integral Attention to the Diabetic Patient (PIADP), in each policlinic of the Playa municipality in Havana, Cuba, and implemented under the integral treatment of patients with less complicated diabetic foot ulcers (DFU) and by using Heberprot-P to accelerate wound granulation and healing in an ambulatory manner. Since January of 2010, a strategy was developed in the primary health attention (PHA) of that municipality, constituted by three stages and including organizational elements such as: the elaboration of a Situational Room of the municipality, the qualification theoretical-practice of the human resources, the logistic securing, the redispensarization of diabetic patients, the programmed investigation in consultations and domiciliary visits; as well as elements of implementation: action of communitary promotion and mass media use. The application of the Heberprot-P started with the characterization of patient with DFU in the municipality and the selection of the human resources that would execute the treatment. All the 33 health professionals were prepared at each area, in the PIADP room, a system of filter for a suitable classification of the DFU was implemented. To date, 233 patients were treated, 28 of them (12.1%) requiring treatment with Heberprot-P, and their data being registered in pharmacovigilance models; 65 (27.8%) were sent to the secondary level of health, with complicated DFU and other vascular affections (60.1%). All except two of those patients, who completed treatment at the hospital, completed treatment at the PHA. The feasibility of the model by using Heberprot-P was demonstrated and an integral approach was established under intensive pharmacovigilance.