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U.S. Preventative Services Task Force: Primary care clinicians should screen for domestic violence

Women of child-bearing age may soon find their primary care clinician asking new sets of questions designed to screen for signs of intimate partner violence after a new series of recommendations from the U.S. Preventative Services Task Force.

The recommendations are a departure from previous assessments by the group, who in 2004 had found insufficient evidence to support such screenings.

So why the change of course now?

In making their recommendation, the task force cited new evidence demonstrating a “low risk, moderate benefit” to health providers screening their patients for intimate partner violence, a term that includes physical violence, sexual abuse, psychological abuse, stalking and reproductive coercion.  They also pointed to effective and easy-to-use screening tools available to physicians.  The ultimate goal is to help more women reach the interventions needed to extricate themselves from the cycle of abuse.

According to University of Minnesota Physicians pediatrician and domestic violence expert Iris Borowsky, M.D., Ph.D., an associate professor within the Medical School’s Division of General Pediatrics and Adolescent Health, the latest recommendations actually mirror existing recommendations made by other major medical organizations in the past.

“Studies have indicated that patients, including victims of domestic violence, want to be asked about domestic violence and aren’t offended by the questions, as long as clinicians ask them in a confidential and empathetic way,” Borowsky said.  “Additionally, studies indicate that victims of domestic violence may be have to be asked several times before ultimately disclosing the issue, so clinicians should ask the questions routinely and more than once.”

For now, the task force applied their recommendations only to women 14-46 who don’t show signs physical or sexual abuse, although the American Congress of Obstetricians and Gynecologists had previously recommended such screening for women of all ages.

Borowsky welcomed the new recommendations but points out that determining the best screening methodologies will require further examination.

“We definitely need more research on how to most effectively screen and respond to DV in the clinical setting, but doctors have a unique and important role to play in addressing this major public health issue,” said Borowsky.

Health Talk readers, you tell us in the comment box below: are the new recommendations a good idea?

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