Awareness of investigations and treatment of faecal incontinence among the general practitioners: a postal questionnaire survey

Abstract

Objective: Faecal incontinence is a distressing condition that can result in significant embarrassment and limitation of routine activities. General practitioners (GP) are the primary carers of such patients. There are recent developments in the surgical treatment options for this under-reported condition. Awareness of these changes is required to make the best use of them. To the best knowledge of the authors, no studies have examined the awareness of investigations and treatment options for faecal incontinence amongst GPs. This is the focus of our study.

Method: A confidential questionnaire was posted to GPs in the Yorkshire region. The questionnaire was designed to assess: first, the basic knowledge of GPs with regard to prevalence, investigations and treatment modalities of faecal incontinence and secondly, the patterns of consultations and referrals of patients with faecal incontinence.

Results: One thousand and one hundred questionnaires were posted. Five hundred and four were returned giving a response rate of 48.5% (n = 504). The prevalence assessed by the GPs is similar to that by population based surveys. Only 32% (n = 162) of GPs were aware of at least one investigation. Similarly only 32% of the GP's were aware of at least one form of surgical treatment. The knowledge of UK centres where these facilities are available was limited (60% not aware). Only one quarter of the GPs referred the patients to the surgical specialties. Surprisingly, there was no significant difference in the level of knowledge of investigation and treatments between the GPs who see patients with faecal incontinence more frequently compared with those who see such patients infrequently (P-values 0.298 and 0.432 respectively).

Conclusion: The level of awareness of investigation modalities and treatment options for faecal incontinence is limited among GPs. Knowledge of the existence of diagnostic tests and surgical treatment options for faecal incontinence and the centres with these facilities is needed for the best utilization of the technical resources and expertise. Further studies are needed to assess the impact of this lack of knowledge on the quality of patient care. Better communication between referral centres and GPs, combined with continuing medical education programmes, may be useful tools to improve appropriate patient management.