A rapid priority setting exercise on faecal incontinence for Cochrane Incontinence

Faecal incontinence (FI) has a high prevalence in both community and residential settings. Historically, there has been a lack of priority setting recommendations for FI. Our priority setting exercise for Cochrane Incontinence, used an evidence gap map to provide a visual overview of emerging trial evidence; existing systematic review-level evidence and FI stakeholder topic uncertainties derived from a survey. We identified one hundred and fourteen reviews which mainly focused on drugs, surgery or the use of mechanical devices aimed at either preventing, managing, decreasing or eliminating FI. Most of the late-stage clinical trials we found looked at the impact of complementary therapies, pelvic floor muscle training, electrical stimulation (non-implanted), the use of laxatives and sacral nerve stimulation on FI. Prioritised topic uncertainties identified by key stakeholders were mainly focused on the patient experience more holistically, particularly psychological support and education to help individuals learn to live with the condition. Future primary studies should aim to improve management and containment options and examine how best to support patients throughout the care pathway. Cochrane Incontinence should generate questions amenable to systematic review with relevance to FI stakeholder topic uncertainties.