USPSTF Recommends Primary Care Screening for Domestic Violence in Women

MedicalResearch.com Interview with:

John W. Epling, Jr., M.D., M.S.Ed Professor of Family and Community Medicine Virginia Tech Carilion School of Medicine Roanoke, VA USPSTF Task Force Member

Dr. Epling

John W. Epling, Jr., M.D., M.S.Ed
Professor of Family and Community Medicine
Virginia Tech Carilion School of Medicine
Roanoke, VA
USPSTF Task Force Member

MedicalResearch.com: What is the background for this study?

Response: Intimate partner violence, often known as domestic violence, can have devastating consequences to one’s health and wellbeing. It can lead to mental illness, substance abuse, unintended pregnancy, and even death. This is a serious public health issue in America: one in three men—and even more women—experience it in their lifetimes. Because this is such an important topic, and the last time we made a recommendation on it was in 2013, the U.S. Preventive Services Task Force reviewed the most recent evidence to determine how clinicians can help prevent the negative health effects of intimate partner violence.

MedicalResearch.com: What are the main findings?

Response: We found that clinicians can make a real difference for women suffering from intimate partner violence by helping identify them and getting them the support they need. As such, we recommend that primary care clinicians screen all women of reproductive age—which varies, but generally includes adolescence through the late 40s—for intimate partner violence and refer those who screen positive for ongoing services that provide a range of emotional, social, and behavioral supports.

Additionally, we looked at the most current evidence on screening men for intimate partner violence, as well as screening older and vulnerable adults. While abuse of these populations is a serious issue, there is not enough evidence on how clinicians can screen and intervene to reduce it. As a result, we are calling for more research on this subject.

MedicalResearch.com: What should readers take away from your report?

Response: People experiencing intimate partner violence often don’t tell others about it and don’t ask for help. That’s why it’s so important that clinicians know the role they can play in helping these people, particularly women of reproductive age. There are screening tools—specifically, short sets of questions about physical, emotional, and sexual abuse—that can detect intimate partner violence among women.  Women experiencing intimate partner violence can be referred for effective interventions and ongoing support service that can reduce physical and sexual violence as well as psychological abuse. These interventions generally focus on counselling and home visits; address multiple risk factors to provide a range of support; and are provided multiple times, rather than just once.

MedicalResearch.com: What recommendations do you have for future research as a result of this evidence review? 

Response: We identified several key gaps in the research on intimate partner violence. More evidence is needed in all areas related to detecting and treating intimate partner violence in men and in women beyond their reproductive age. We need to know more about the most effective characteristics of ongoing support services for reducing intimate partner violence and would like to see studies that offer ongoing support services to non-pregnant women. Additionally, more studies are needed in all areas related to detecting and treating abuse of older and vulnerable adults. Finally, we also need to know more about how to screen for and treat intimate partner violence in people in same-sex partnerships.  

MedicalResearch.com: Is there anything else you would like to add?

Response: Intimate partner violence is a common and devastating public health problem—but there are steps that can be taken by primary care clinicians to reduce its impact and help people in need. Anyone who is concerned about this issue, or who is wondering if they may be experiencing intimate partner violence, should talk to their doctor about it as soon as possible.

Additionally, there are resources available for clinicians who would like to know more about how they can help—such as the National Hotline on Domestic Violence, which identifies local programs and interventions meant to address intimate partner violence and get those who are suffering the support they need.

Citation:

Feltner C, Wallace I, Berkman N, et al. Screening for Intimate Partner Violence, Elder Abuse, and Abuse of Vulnerable Adults Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA.2018;320(16):1688–1701. doi:10.1001/jama.2018.13212

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