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I'm Rob Logan, Ph.D. senior staff National Library of Medicine for Donald Lindberg, M.D, the Director of the U.S. National Library of Medicine.
Intimate-partner violence (IPV) advocacy services are the best resource to safely advise and provide advanced counseling to patients experiencing IPV, suggests an insightful perspective recently published in the New England Journal of Medicine.
The authors, from the Boston University Schools of Medicine and Public Health, explain one of the reasons physicians should refer IPV patients to advocacy agencies is to avoid the unintentional harm that can occur when IPV cases primarily are documented within a physician’s office. The authors suggest local advocacy agencies are better trained how to detail IPV cases without impacting future child custody hearings. The authors write (and we quote): ‘the manner in which IPV victimization is documented in patient records can have ramifications for child custody cases’ (end of quote).
The authors explain trained experts in IPV advocacy also are better prepared than other health care professionals to counsel patients on their safest, immediate course of action. The authors write (and we quote): ‘only trained experts in IPV advocacy are qualified to help victims determine their own best course to safety’ (end of quote).
At the same time the authors endorse the use of IPV advocacy agencies, the authors note patients benefit from routine IPV screening in a physician’s office — even when patients do not initially acknowledge IPV victimization. The authors recommend physicians use widely available, unobtrusive IPV screening instruments to start a dialogue with patients.
The authors explain it has become easier and less expensive for physicians to screen for IPV. The authors note IPV screening recently became part of a series of women’s health services that are covered without patient cost by the U.S. Affordable Care Act.
To provide some background, the authors report IPV is sadly widespread; about 36 percent of American women are raped, assaulted, or stalked by intimate partners at some point during their lifetime. The authors add about six percent of U.S. women experience IPV each year.
Interestingly, while the frequency of men who experience IPV is similar, the authors note women are almost four times more likely as men to be injured by a partner. Moreover, the authors report an array of recent research suggests IPV victimization significantly increases a woman’s risk of: gastrointestinal disorders, chronic pain, central nervous system symptoms, hypertension, and gynecologic problems.
The authors conclude (and we quote): ‘at a minimum, all primary care physicians should now be screening female patients 12 years of age or older for IPV’ (end of quote).
Besides other resources, the authors recommend the National Domestic Violence Hotline for both doctors and patients. The National Domestic Violence Hotline is available 1-800-799-SAFE, or online at: www.thehotline.org.
Meanwhile, MedlinePlus.gov’s domestic violence health topic page provides an overview of IPV and related issues (from the American Academy of Family Physicians) in the ‘start here’ section. A webpage devoted to understanding intimate partner violence (provided by the U.S. Centers for Disease Control and Prevention) is available within the ‘specific conditions’ section of MedlinePlus.gov’s domestic violence health topic page.
A list of organizations that offer assistance to IPV victims and their families across the U.S. (from the Office of Women’s Health, U.S. Department of Health and Human Services) is provided in the ‘directories’ section of MedlinePlus.gov’s domestic violence health topic page. The latter page contains a helpful web-based link to each agency — listed by state.
MedlinePlus.gov’s domestic violence health topic page also contains links to the latest pertinent journal research articles, which are available in the ‘journal articles’ section. Links to related clinical trials that may be occurring in your area are available in the ‘clinical trials’ section. From the domestic violence health topic page, you can sign up to receive email updates with links to new information as it becomes available on MedlinePlus.
To find MedlinePlus.gov’s domestic violence health topic page, type ‘domestic violence’ in the search box at the top of MedlinePlus.gov’s home page.
While we concede IPV is a sobering topic to discuss during the holiday season, IPV’s frequency and its treatment cost (estimated by the authors to be about $5.8 billion annually) are compelling — and merit some of the acknowledgement, leadership, and conversation that the New England Journal of Medicine perspective generates.
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