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Domestic violence training programmes for GPs increase referrals

Domestic violence training programmes for general practice can greatly increase the referral of women to domestic violence advocacy organisations, new research has shown.

The study, published in the Lancet, which included an analysis of 51 GP practices in Bristol and Hackney, found that GPs and practice nurses given specialist training in domestic violence were far more likely to refer women to advocacy organisations.

Of the 51 practices, 24 received a training programme, which included two two-hour multidisciplinary training sessions, a prompt within the medical record to ask about abuse, and a referral pathway to a named domestic violence advocate, if that was what the woman wanted.  

A further twenty four practices did not take part in the programme, while three dropped out prior to the trial beginning.   

The analysis looked at referral rates a year after the second training session, and found the recorded referral rate in the intervention practices was 22 times higher than in the comparison group (223 referrals vs 12). However this improvement was from a low baseline. 

Intervention practices also recorded around three times the number of women disclosing domestic violence (641 vs 236).

Study lead Professor Gene Feder said: ‘The substantial difference in referrals is strong evidence that the intervention improves the response of clinicians to women experiencing domestic violence and enables access to domestic violence advocacy that can reduce re-victimisation and improve quality of life and possibly mental health outcomes.

‘Our findings reduce the uncertainty about the benefit of domestic violence training and support interventions in primary care settings, particularly outside north America, and show that screening is not a necessary condition for benefit.'

‘Worldwide, clinicians within primary care and other health-care settings are not responding adequately to domestic violence. In this study, we show the effectiveness of a brief intervention of training and support with a simple referral pathway to domestic violence advocacy.'