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The patient's partner or children older than three years should not be present.
The USPSTF indicates that current screening tools for IPV are sensitive and specific, that screening and intervention decrease abuse and harm to patients, and that there is a low risk of negative effects from screening.1516A 2014 Cochrane review contradicts the USPSTF and found insufficient evidence that routine screening improves outcomes.Some states, for instance, include IPV witnessed by children in their mandatory reporting requirements.For more information about state requirements, go to https://It included only one study that examined possible adverse effects.The authors justified their focus on screening alone by stating that it is unrealistic to have appropriate interventions available in a typical primary care setting.Review of current research, however, shows that even simple interventions, such as providing a wallet card that includes information on IPV, safety planning, or local domestic violence shelters, can improve outcomes.17Major medical bodies, including the American Academy of Family Physicians, the American Medical Association, and the American College of Obstetricians and Gynecologists, recommend routine screening for IPV and caution that waiting for more definitive research before addressing IPV puts women at risk.18Screening tools are limited by the patient's readiness to disclose the abuse.
Some patients may not feel ready to admit that they are in an abusive situation, or may fear retribution from the abuser even with assurances of confidentiality by the clinician.2Research shows that patients, with and without a history of IPV, favor physicians inquiring about IPV at wellness visits.
The World Health Organization has released guidelines to help physicians respond to IPV in women.1A = consistent, good-quality patient-oriented evidence; B = inconsistent or limited-quality patient-oriented evidence; C = consensus, disease-oriented evidence, usual practice, expert opinion, or case series.
For information about the SORT evidence rating system, go to https://org/afpsort A = consistent, good-quality patient-oriented evidence; B = inconsistent or limited-quality patient-oriented evidence; C = consensus, disease-oriented evidence, usual practice, expert opinion, or case series.
Intimate partner violence (IPV) is a prevalent worldwide health problem, affecting women more commonly than men.
It can include physical, emotional, sexual, and financial abuse, as well as control over contraception or pregnancy and medical care.
Although most physicians feel they should screen patients for IPV, only a small percentage actually do so, largely because they feel uncomfortable having such conversations.1722Physicians should begin by explaining why they are asking about IPV, whether it be part of screening at a wellness visit or in response to specific physical or mental health issues.