Rapid priority setting exercise on faecal incontinence for Cochrane Incontinence

BMJ Open Gastroenterol. 2022 May;9(1):e000847. doi: 10.1136/bmjgast-2021-000847.

Abstract

Objective: This rapid priority setting exercise aimed to identify, expand, prioritise and explore stakeholder (patients, carers and healthcare practitioners) topic uncertainties on faecal incontinence (FI).

Design: An evidence gap map (EGM) was produced to give a visual overview of emerging trial evidence; existing systematic review-level evidence and FI stakeholder topic uncertainties derived from a survey. This EGM was used in a knowledge exchange workshop that promoted group discussions leading to the prioritisation and exploration of FI stakeholder identified topic uncertainties.

Results: Overall, a mismatch between the existing and emerging evidence and key FI stakeholder topic uncertainties was found. The prioritised topic uncertainties identified in the workshop were as follows: psychological support; lifestyle interventions; long-term effects of living with FI; education; constipation and the cultural impact of FI. When these six prioritised topic uncertainties were explored in more depth, the following themes were identified: education; impact and burden of living with FI; psychological support; healthcare service improvements and inconsistencies; the stigma of FI; treatments and management; culturally appropriate management and technology and its accessibility.

Conclusions: Topic uncertainties identified were broad and wide ranging even after prioritisation. More research is required to unpick the themes emerging from the in-depth discussion and explore these further to achieve a consensus on deliverable research questions.

Keywords: anal incontinence; faecal incontinence; fecal incontinence.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Caregivers
  • Consensus
  • Fecal Incontinence* / therapy
  • Humans
  • Surveys and Questionnaires
  • Uncertainty