title: Initiative to improve detection of faecal incontinence in primary care: The GIFT Project.
abstract: Faecal incontinence (FI) is a distressing condition with a significant impact on quality of life. The true prevalence of FI is unknown but probably underestimated. Identifying patients affected is of key importance because a significant proportion may improve with conservative treatments, and there are a number of other treatments available.
  
  
  
  The aim of our project was to improve detection of FI in our primary care setting.
  
  
  
  A multidisciplinary working group was created in order to raise awareness and educate health professionals about FI. We designed a simple protocol and organized educational meetings at 7 primary care centres. The usual diagnostic computer-based tools used by nurses were modified, so that FI was systematically asked about. A proactive attitude among doctors and midwives regarding FI was recommended for high-risk patient groups.
  
  
  
  The project was implemented in October 2014. Before the intervention, only 250 (<1%) patients with a diagnosis of FI were identified from the primary care register out of a population over 165000 people. Between October 2014 and February 2016, 17370 patients were questioned about anal continence in routine follow-ups. Of those questioned, 829 (4.8%) disclosed suffering from FI. Mean age was 78.5 ± 14 years (16-104), 565 (68.2%) were females, and 264 (31.8%) were males. The percentage of patients with FI increased with age and was higher in women.
  
  
  
  Our results show that a proactive approach with direct questions on FI may lead to a significant increase in FI detection in primary care.
authors.affiliation: Department of Surgery (Coloproctology), Consorci Sanitari de Terrassa, Terrassa (Barcelona), Spain.
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Ribas
authors.affiliation: Primary Care Nurse, Consorci Sanitari de Terrassa, Terrassa (Barcelona), Spain.
authors.forename: Meritxell
authors.initials: M
authors.lastname: Coll
authors.affiliation: Primary Care Doctor, Consorci Sanitari de Terrassa, Terrassa (Barcelona), Spain.
authors.forename: Avelina
authors.initials: A
authors.lastname: Espina
authors.affiliation: Primary Care Nurse, Consorci Sanitari de Terrassa, Terrassa (Barcelona), Spain.
authors.forename: Concepció
authors.initials: C
authors.lastname: Jiménez
authors.affiliation: Primary Care Nurse, Consorci Sanitari de Terrassa, Terrassa (Barcelona), Spain.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Chicote
authors.affiliation: Primary Care Doctor, Consorci Sanitari de Terrassa, Terrassa (Barcelona), Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Torné
authors.affiliation: Department of Gastroenterology, Consorci Sanitari de Terrassa, Terrassa (Barcelona), Spain.
authors.forename: Ines
authors.initials: I
authors.lastname: Modolell
mesh_terms: D000368:Aged; D005242:Fecal Incontinence / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006282:Health Personnel / Q000193:education; D006801:Humans; D008297:Male; D008403:Mass Screening; D015995:Prevalence; D011320:Primary Health Care; D011788:Quality of Life; D012307:Risk Factors
keywords: Detection; faecal incontinence; improvement; primary care