ECONOMIC EVALUATION AND IMPLEMENTATION OF A CONTEXTUALLY APPROPRIATE INTERVENTION FOR FOOT CARE OF PEOPLE WITH DIABETES IN PRIMARY CARE - FOCAIN

• Grant number: 25/16045-0
• Support Opportunities: Scholarships in Brazil - Post-Doctoral
• Start date: September 01, 2025
• End date: August 31, 2027
• Field of knowledge: Health Sciences - Physiotherapy and Occupational Therapy
• Principal Investigator: Isabel de Camargo Neves Sacco
• Grantee: Ronaldo Henrique Cruvinel Júnior
• Host Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil
• Associated research grant: 23/09860-4 - IMPLEMENTING A CONTEXTUALLY APPROPRIATE INTERVENTION STRATEGY IN PRIMARY CARE FOR THE FOOT OF PEOPLE WITH DIABETES - FOCAIN, AP.PP

Abstract

Diabetes mellitus is one of the leading causes of chronic diseases, with a growing global impact, affecting millions of people and generating significant economic costs. In Brazil, the prevalence of the disease increases annually, with high rates of complications, including diabetic peripheral neuropathy (DPN), which impairs mobility and foot health, raising the risk of ulcers and amputations. The intervention proposed by the FOCAIN study aims to prevent these complications through a foot and ankle exercise program combined with educational strategies. The initiative is already underway in Limeira/SP, within the Brazilian Public Healthcare Unified System (Sistema Único de Saúde; SUS). FOCAIN seeks to address a gap in public health policy by integrating an exercise program to prevent foot complications in people with diabetes. However, the financial feasibility and sustainability of implementing the program in SUS have not yet been analyzed. An economic study is urgently needed to determine its cost-effectiveness and provide data for efficient resource allocation within SUS. The hypothesis is that implementing the intervention will be cost-effective, offering clinical benefits at a relatively low cost to SUS. Previous evidence indicates that exercise programs for people with diabetes have shown benefits in preventing complications, such as plantar ulcers, with favorable cost-effectiveness ratios. The study will employ a rigorous methodology to perform an economic evaluation from the perspectives of SUS and society. The analysis will include direct and indirect costs and assess cost-effectiveness based on outcomes such as symptoms and severity of DPN, as well as improvements in functionality and patient quality of life. This approach will provide essential data to support sustainable public policies for treating DPN, ensuring the continuity and expansion of the program to other regions of the country.