Management of faecal incontinence in residential aged care

Guinane, John; Crone, Rosie

doi:10.31128/afp-08-17-4301

Cited by 2 publications

(3 citation statements)

References 25 publications

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“…The five‐fold increase in use of macrogol, a laxative, is potentially related to side‐effects of other medicine use (e.g. opioids), 43 and reflects the changes in its PBS restriction level in 2007. Atorvastin and perindropril, which were the two most commonly prescribed medicines in the Australian PBS in 2015, have also increased in use in the cohort of people in long‐term care 35 .…”

Section: Discussionmentioning

confidence: 99%

Health status and healthcare trends of individuals accessing Australian aged care programmes over a decade: the Registry of Senior Australians historical cohort

Inacio

Lang

Bray

et al. 2021

Internal Medicine Journal

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Background: Understanding the health profile, service and medicine use of Australians in the aged care sector will help inform appropriate service provision for our ageing population.Aims: To examine the 2006-2015 trends in (i) comorbidities and frailty of individuals accessing aged care, and (ii) health services, medicine use and mortality after entry into long-term care.Methods: Cross-sectional and population-based trend analyses were conducted using the Registry of Senior Australians. Results: From 2006 to 2015, 509 944 individuals accessed permanent residential care, 206 394 home care, 283 014 respite and 124 943 transition care. Over this time, the proportion of individuals accessing permanent residential care with high frailty scores (≥0.3) increased (19.7-49.7%), as did the proportion with 5-9 comorbidities (46.4-54.5%), with similar trends observed for those accessing other services. The median number of medicines dispensed in the year after entering permanent residential care increased from 9 (interquartile range (IQR) 6-12) to 10 (IQR 7-14), while remaining stable in home care (2006: 9, IQR 5-12, 2015). Short-term (within 100 days) mortality in those accessing permanent care was higher in 2006 (15.6%, 95% CI 15.2-16.0) than 2015 (14.6%, 95% CI 14.3-14.9). Longer term (101-1095 days, 2006: 44.3%, 95% CI 43.7-45.0, 2015) mortality was higher in 2015 compared to 2006. Mortality in individuals accessing home care did not change. Conclusion:The health of older Australians accessing aged care programmes has declined while frailty increased, with an increasing use of medicine and worse long-term mortality in some. Funding and care models need to adapt to this changing profile.

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Section: Discussionmentioning

confidence: 99%

Health status and healthcare trends of individuals accessing Australian aged care programmes over a decade: the Registry of Senior Australians historical cohort

Inacio

Lang

Bray

et al. 2021

Internal Medicine Journal

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“…21 Current FI management resources available from the RACGP are targeted at aged care patients in residential institutions. 22 , 23 The presumed association between FI and aged care may explain why GPs with a specialty interest in aged care had better self-rated knowledge, skills, and confidence to manage FI in the study.…”

Section: Discussionmentioning

confidence: 94%

“…Indeed, the current RACGP 'Guidelines for Activities in General Practice' dedicates an entire chapter to the topic of urinary incontinence, but makes no reference to FI (21). Current FI management resources available from the RACGP are targeted to aged care patients in residential institutions (22,23). The presumed association between FI and aged care may explain why GPs with a specialty interest in aged care had better self-rated knowledge, skills, and confidence to manage FI in our study.…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

Knowledge, skills, and barriers to management of faecal incontinence in Australian primary care: a cross-sectional study

Soares²,

Koneru

et al. 2021

BJGP Open

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BackgroundGeneral practitioners (GPs) play an important role in diagnosis and management of patients with faecal incontinence (FI). However, their confidence and ability in this role are unknown.AimThis study aimed to investigate the knowledge, skills, and confidence of GPs to manage FI in primary care, and identify barriers to optimal management.Design & settingA cross-sectional study using self-administered questionnaires of GPs attending health education seminars across Australian capital cities.MethodMain outcome measures included: (i) clinical exposure to and previous training in FI; (ii) knowledge and skills in screening, diagnosing, and managing FI; and (iii) barriers and facilitators to optimising care. Associations between demographics, training and knowledge and skills were assessed.ResultsSome 1,285 of 1,469 GPs (87.5%) participated (mean 47.7 years [SD 11.3]). The vast majority reported poor clinical exposure to (88.5%) and training in FI management (91.3%). Subjectively, 69.7% rated their knowledge and skills in screening, assessing, and treating FI as sub-optimal. The most commonly reported (i) barrier to FI care was ‘insufficient skills’ (56.1%) and (ii) facilitators were improved referral pathways (84.6%) and increased training (67.9%). GPs with more training had better knowledge (OR 24.62, 95% CI 13.32–45.51) and skills (OR 13.87, 95% CI 7.94–24.24) in managing FI.ConclusionsClinical exposure to and training in FI amongst GPs was poor. Accordingly, knowledge, skills, and confidence to manage FI was sub-optimal. GPs recognise the importance of FI and that increased training/education and formalisation of referral pathways may improve the care of patients with FI in primary care.

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Management of faecal incontinence in residential aged care

Cited by 2 publications

References 25 publications

Health status and healthcare trends of individuals accessing Australian aged care programmes over a decade: the Registry of Senior Australians historical cohort

Health status and healthcare trends of individuals accessing Australian aged care programmes over a decade: the Registry of Senior Australians historical cohort

Knowledge, skills, and barriers to management of faecal incontinence in Australian primary care: a cross-sectional study

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