Primary care based intervention for women experiencing domestic violence probably cost-effective

June 25, 2012

One in four women in the UK experience domestic violence during their lifetime, often resulting in injuries and an increased risk of chronic physical and mental illness.  A programme of training and support for GPs, practice nurses and GP receptionists to improve the response of primary care to women experiencing domestic violence could be cost-effective, according to new research published today in BMJ Open.

The aim of the study was to find out if IRIS (Identification and Referral to Improve Safety), a training and support intervention to improve the response of to women experiencing (DV), is cost-effective. The research team was led by Gene Feder, Professor of Primary Health Care in the University of Bristol’s School of Social and Community Medicine together with academics from Queen Mary, University of London; University of Exeter and the University of Technology Sydney.

Currently, most doctors have no training in how to deal with patients experiencing domestic violence, yet abused women identify doctors as the professionals from whom they would most like to seek support. 

The Increasing Referral to Improve Safety (IRIS) trial tested the effectiveness of the training and support intervention for general practice teams, including training within the practice, a prompt to ask about DV embedded in the electronic medical record, a care pathway including referral to a specialist DV agency, and continuing contact from that agency.

In a previous paper, the researchers reported an increased rate of referrals of women to specialist DV agencies from 24 general practices that received the IRIS programme with 24 general practices not receiving the programme (143,868 eligible women patients). The trial did not measure outcomes for women beyond referral to specialist domestic violence agencies. In this paper the trial outcomes were extrapolated to estimate the long-term health care and societal costs and benefits using data from other trials and epidemiological studies.

Gene Feder said: “Our research found that the IRIS programme is likely to be cost-effective and possibly cost saving.  This is crucial evidence for the commissioning of this type of programme for improving the general practice response to domestic violence. However, we need a better understanding of the trajectory of abuse and of the benefit of domestic violence advocacy to support our findings.”

Angela Devine, health economist at Queen Mary, University of London was a co-researcher. She added: "Unfortunately, domestic violence is very common and GP surgeries are often where women are treated for the resulting physical and . Sometimes this happens without staff knowing that domestic violence is the cause. This study shows that training staff at general practices seems to be a cost-effective way to help tackle the problem."

This is the first economic evaluation of a domestic violence intervention in the context of a randomised controlled trial. The study found that the IRIS programme is likely to be cost-effective and possibly cost saving from a societal perspective and a health care perspective in the UK. The relatively modest costs of the primary care-based intervention and its projected long term cost benefits means this is likely to be the case in other developed economies.

Explore further: Study shows how general practice can substantially improve care for women experiencing domestic violence

More information: ‘Cost-effectiveness of Increasing Referral to Improve Safety (IRIS), a domestic violence training and support programme for primary care: a modelling study based on a randomised controlled trial’ by Angela Devine, Anne Spencer, Sandra Eldridge, Richard Norman, Gene Feder in BMJ Open 22 June 2012.

Related Stories

Study shows how general practice can substantially improve care for women experiencing domestic violence

October 14, 2011
One in four women in the UK have experienced physical or sexual abuse from their husband or a partner. A programme of training and support for GPs, practice nurses and GP receptionists can substantially increase the identification ...

The role of GPs in helping women experiencing domestic violence

July 7, 2011
The research will be presented today at the 40th Annual Scientific Meeting of the Society of Academic Primary Care, hosted this year by the University of Bristol's Academic Unit of Primary Health Care.

Health care providers need training to recognize signs of domestic violence, says nursing expert

June 7, 2011
Despite billions of dollars spent on health care each year, the United States ranks 27th out of 33 developed countries for life expectancy at birth. Leading causes of infant mortality are complications related to pre-term ...

Recommended for you

Different types of alcohol elicit different emotional responses

November 22, 2017
Different types of alcohol elicit different emotional responses, but spirits are most frequently associated with feelings of aggression, suggests research published in the online journal BMJ Open.

Air pollution linked to poorer quality sperm

November 22, 2017
Air pollution, particularly levels of fine particulate matter (PM2.5), is associated with poorer quality sperm, suggests research published online in Occupational & Environmental Medicine.

Sunrise and sunset guide daily activities of city-dwellers

November 21, 2017
Despite artificial lightning and social conventions, the dynamics of daylight still influence the daily activities of people living in modern, urban environments, according to new research published in PLOS Computational ...

Older men need more protein to maintain muscles

November 21, 2017
The amount of protein recommended by international guidelines is not sufficient to maintain muscle size and strength in older men, according to a new study.

Exercising and eating well are greater contributors to health than standing at work

November 21, 2017
By now you've probably heard the edict from the health community: Sitting is the new smoking. Perhaps you've converted to a standing desk, or maybe you have a reminder on your phone to get up once an hour and walk around ...

Motorcycle crashes cause five times as many deaths as car accidents, six times the health costs

November 20, 2017
Motorcycle accidents are costly in terms of lives and health care costs. Compared with car accidents, motorcycle accidents cause 3 times the injuries, 6 times the medical costs and 5 times the deaths, found new research in ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.