Current practice of continence advisors in the UK: results from an online survey CA Leo¹ ², Y Maeda¹, B Collins¹, J Hodgkinson¹ ², J Murphy², CJ Vaizey¹ 1. Sir Alan Parks Physiology Unit, St Mark’s Hospital, Harrow, Middlesex, United Kingdom 2. Academic Surgical Unit, St. Mary’s Hospital, Imperial College London, United Kingdom Introduction Faecal incontinence is a common symptom, that occurs predominantly in the elderly population. Between 1 and 18% of people have reported experiencing this condition (1,2) Specialist teams provide support and medical advice for patients with bowel or bladder incontinence There are over 400 continence advisors in UK Aims To investigate the current practice and the services offered by continence advisors in the UK Methods An online survey was constructed as a platform to deliver the questionnaire All UK-based continence advisors were contacted by email, phone calls and letters to be invited to participate in the study A voucher of £50 was used as an incentive to participate Results (continued) 159 (*87.3%) continence advisors recommend Coloplast® Anal Plug and 78 (*47.%) recommend Renew™ Anal Insert (Figure 1 & 3) 167 (*75.5%) perform a digital rectal examination, 159 (*94%) feel confident to do this; 131 (*61.2%) can diagnose rectal prolapse and of these, 114 (*80.8%) feel confident making this diagnosis (Figure 2) 207 (*93%) instruct patients to perform pelvic floor / anal sphincter exercises 188 (*84%) teach urge resistance techniques 29 (*19%) prescribe Shreddies© pants (Figure 4) Up to 70% offer patients dietary advice 125 (*57%) felt that they have not been adequately trained to provide a bowel continence service. * expressed as percentage of responders to each question Conclusion Majority of the continence advisors in the UK treat both urinary and faecal incontinence They provide comprehensive management of faecal incontinence 43% of the continence advisors feel that they require further training and greater support is necessary References Perry S et al. Leicester MRC Incontinence Study Team. Prevalence of faecal incontinence in adults aged 40 years or more living in the community. Gut. 2002 Apr;50(4):480-4. Madoff RD et al. Faecal incontinece in adults. Lancet. 2004 Aug 14-20;364(9434):621-32. Association for Continence Advice: driving excellence in bladder and bowel care. http://www.aca.uk.com. Accessed in October 2015 and in August 2016. Figure 1: continence advisors prescribe Coloplast© and Renew™ Anal Insert 2B Figure 2: do continence advisors feel confident to do a digital rectal examination or diagnose a rectal prolapse? Results 448 UK-based continence advisors were contacted and invited to complete the questionnaire; 228 (50.8%) advisors responded 150 (76.9%) advisors reported treat both faecal and urinary incontinence Figure 3: Renew™ Anal Insert Figure 4: Shreddies© panties are prescribed by 10% of the continence advisors interviewed The Pouch Disease Activty Index {Sandborn W.J., 1994} A total score of <7 = remission A total score of >7 = active disease