Still no support for primary care intimate partner violence screening
medwireNews: An Australian study has found no evidence of improvement in primary outcomes for women who are screened and counselled for intimate partner violence (IPV) in primary care.
The findings add to a growing body of evidence, including two other large studies in Canada and the USA, against the practice, leading researchers to call for the development of alternative approaches.
"More research is urgently needed into how to increase identification of women who experience IPV and into what interventions would help women achieve safer, healthier lives," say study author Kelsey Hegarty (University of Melbourne, Carlton, Victoria) and colleagues.
The study involved 52 doctors and 272 of their female patients who responded in a postal survey of 20,000 women that they had felt fearful of their partner in the prior 12 months.
Doctors were randomly assigned to manage an intervention or a control group to whom they provided usual care. In the intervention group, doctors attended training in healthy relationships counselling and offered between one to six counselling sessions to women who were identified for IPV in their care. All doctors received an IPV information pack and all women received a list of support providers.
Twelve months after completing the initial survey, there was no difference between the groups with regard to quality of life, safety plans or behaviours, or mental health Short Form-12 scores.
However, fewer women in the intervention group had depressive symptoms (hospital anxiety and depression scale score ≥8: 41 vs 58% control group) and, at 6 months, more women in the intervention group recalled having been asked about their or their children's safety by their doctor (32 vs 13% and 37 vs 18%, respectively).
Writing in a linked comment, Rachel Jewkes, from the Medical Research Council in South Africa, says that the findings do not diminish the important role for primary care physicians in the care of women experiencing IPV.
However, "the time has come to conclude that routine identification of abused women and provision of a standard intervention is not the answer," Jewkes says. "We need to develop and test new directions for health-service responses."
medwireNews (www.medwirenews.com) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2013
By Kirsty Oswald, medwireNews Reporter