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Outcomes of domestic violence screening at an acute London trust: are there missed opportunities for intervention?

Outcomes of domestic violence screening at an acute London trust: are there missed opportunities for intervention?
Outcomes of domestic violence screening at an acute London trust: are there missed opportunities for intervention?
Objectives: domestic violence screening is advocated in some healthcare settings. Evidence that it increases referral to support agencies or improves health outcomes is limited. This study aimed to (1) investigate the proportion of hospital patients reporting domestic violence, (2) describe characteristics and previous hospital attendances of affected patients and (3) assess referrals to an in-house domestic violence advisor from Camden Safety Net.

Design: a series of observational studies.

Setting: three outpatient clinics at the Royal Free London NHS Foundation Trust.

Participants: 10?158 patients screened for domestic violence in community gynaecology, genitourinary medicine (GUM) and HIV medicine clinics between 1 October 2013 and 30 June 2014. Also 2253 Camden Safety Net referrals over the same period.

Main outcome measures: (1) Percentage reporting domestic violence by age group gender, ethnicity and clinic. (2) Rates of hospital attendances in the past 3?years for those screening positive and negative. (3) Characteristics, uptake and risk assessment results for hospital in-house domestic violence referrals compared with Camden Safety Net referrals from other sources.

Results: of the 10?158 patients screened, 57.4% were female with a median age of 30?years. Overall, 7.1% reported ever-experiencing domestic violence, ranging from 5.7% in GUM to 29.4% in HIV services. People screening positive for domestic violence had higher rates of previous emergency department attendances (rate ratio (RR) 1.63, 95% CI 1.09 to 2.48), emergency inpatient admissions (RR 2.27, 95% CI 1.37 to 3.84) and day-case admissions (RR 2.03, 95% CI 1.23 to 3.43) than those screening negative. The 77 hospital referrals to the hospital-based domestic violence advisor during the study period were more likely to be taken up and to be classified as high risk than referrals from elsewhere.

Conclusions: selective screening for domestic violence in high-risk hospital clinic populations has the potential to identify affected patients and promote good uptake of referrals for in-house domestic violence support
0959-8138
e009069
Warren-Gash, Charlotte
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Bartley, Angela
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Bayly, Jude
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Dutey-Magni, Peter
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Edwards, Sarah
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Madge, Sara
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Miller, Charlotte
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Nicholas, Rachel
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Radhakrishnan, Sheila
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Sathia, Leena
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Swarbrick, Helen
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Blaikie, Dee
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Rodger, Alison
af928914-8be9-4009-99ed-20109b3b3d97
Warren-Gash, Charlotte
0217eb35-7098-4b34-980d-4fce5e160cb3
Bartley, Angela
52aeb6ff-c620-4f7e-9b3d-6121a3d296da
Bayly, Jude
56183c08-4518-4609-8084-28dc828f6442
Dutey-Magni, Peter
f2713e93-3179-4f7d-82cd-dcd415f1d06c
Edwards, Sarah
88dc324e-5fd5-443a-bd2a-4df90c8b312c
Madge, Sara
ffb8c137-83e5-4421-9027-5453593623c4
Miller, Charlotte
08445d44-4ba3-4815-b036-be5dd35f31b9
Nicholas, Rachel
7c309549-674f-492a-8dfb-deca6901fd01
Radhakrishnan, Sheila
b4479cd0-0762-434c-a08b-be54da04944c
Sathia, Leena
8d2d9a3f-b944-4b07-97cd-6e36f363d496
Swarbrick, Helen
5a12eefe-8316-416b-bd8a-ee0124d716c0
Blaikie, Dee
7bc16d2b-d5ba-4d19-93d5-807dd2e15d55
Rodger, Alison
af928914-8be9-4009-99ed-20109b3b3d97

Warren-Gash, Charlotte, Bartley, Angela, Bayly, Jude, Dutey-Magni, Peter, Edwards, Sarah, Madge, Sara, Miller, Charlotte, Nicholas, Rachel, Radhakrishnan, Sheila, Sathia, Leena, Swarbrick, Helen, Blaikie, Dee and Rodger, Alison (2016) Outcomes of domestic violence screening at an acute London trust: are there missed opportunities for intervention? British Medical Journal, 6 (1), e009069. (doi:10.1136/bmjopen-2015-009069). (PMID:26729380)

Record type: Article

Abstract

Objectives: domestic violence screening is advocated in some healthcare settings. Evidence that it increases referral to support agencies or improves health outcomes is limited. This study aimed to (1) investigate the proportion of hospital patients reporting domestic violence, (2) describe characteristics and previous hospital attendances of affected patients and (3) assess referrals to an in-house domestic violence advisor from Camden Safety Net.

Design: a series of observational studies.

Setting: three outpatient clinics at the Royal Free London NHS Foundation Trust.

Participants: 10?158 patients screened for domestic violence in community gynaecology, genitourinary medicine (GUM) and HIV medicine clinics between 1 October 2013 and 30 June 2014. Also 2253 Camden Safety Net referrals over the same period.

Main outcome measures: (1) Percentage reporting domestic violence by age group gender, ethnicity and clinic. (2) Rates of hospital attendances in the past 3?years for those screening positive and negative. (3) Characteristics, uptake and risk assessment results for hospital in-house domestic violence referrals compared with Camden Safety Net referrals from other sources.

Results: of the 10?158 patients screened, 57.4% were female with a median age of 30?years. Overall, 7.1% reported ever-experiencing domestic violence, ranging from 5.7% in GUM to 29.4% in HIV services. People screening positive for domestic violence had higher rates of previous emergency department attendances (rate ratio (RR) 1.63, 95% CI 1.09 to 2.48), emergency inpatient admissions (RR 2.27, 95% CI 1.37 to 3.84) and day-case admissions (RR 2.03, 95% CI 1.23 to 3.43) than those screening negative. The 77 hospital referrals to the hospital-based domestic violence advisor during the study period were more likely to be taken up and to be classified as high risk than referrals from elsewhere.

Conclusions: selective screening for domestic violence in high-risk hospital clinic populations has the potential to identify affected patients and promote good uptake of referrals for in-house domestic violence support

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Accepted/In Press date: 23 November 2015
Published date: 4 January 2016
Organisations: Clinical & Experimental Sciences

Identifiers

Local EPrints ID: 397250
URI: https://eprints.soton.ac.uk/id/eprint/397250
ISSN: 0959-8138
PURE UUID: 60f35f86-9be8-4dc0-9910-f716c4f4128d
ORCID for Peter Dutey-Magni: ORCID iD orcid.org/0000-0002-8942-9836

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Date deposited: 24 Jun 2016 15:23
Last modified: 10 Dec 2019 01:27

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Contributors

Author: Charlotte Warren-Gash
Author: Angela Bartley
Author: Jude Bayly
Author: Sarah Edwards
Author: Sara Madge
Author: Charlotte Miller
Author: Rachel Nicholas
Author: Sheila Radhakrishnan
Author: Leena Sathia
Author: Helen Swarbrick
Author: Dee Blaikie
Author: Alison Rodger

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