The Identification and Referral to Improve Safety Programme and the Prevention of Intimate Partner Violence

Abstract

Introduction: Intimate Partner Violence (IPV) is a global epidemic which 30% of women experience world-wide. Domestic violence has serious health consequences, with an estimated cost of 1.7 billion annually to the NHS. However, healthcare professionals remain uncertain on how to manage IPV. In 2007, the Identification and Referral to Improve Safety (IRIS) was introduced within primary care to address this shortcoming. The aim of this project is to analyse the impact of IRIS, whilst discussing the extension into secondary care. Materials and Methods: A literature review was conducted using PubMed, Cochrane Library and Google scholar. The official IRIS publication list for randomized controlled trial data. Results: General practices with IRIS displayed a threefold increase in the identification of IPV and sevenfold increase in referrals. IRIS is cost-effective and under the NICE threshold of GBP 20,000 per quality-adjusted life year gained. Additionally, a systematic review illustrated that one in six women presenting to the fracture clinic experienced IPV within the last year. Conclusions: The implementation of IRIS into general practice proved to be cost-effective. Orthopaedic fracture clinics are at the forefront of dealing with IPV, and therefore an adapted IRIS programme within this setting has potential in the prevention of IPV.

Keywords: domestic violence and abuse; fracture clinic; identification and referral to improve safety; intimate partner violence; public health; sexual health.

Figure 1

Epidemiology of injuries associated with IPV as a % (n = 144).

Figure 2

Composition of Head and Neck injuries as a % (n = 58).

Figure 3

Composition of Musculoskeletal injuries as a % (n = 40).

Figure 4

Composition of skin injuries as a % (n = 32).

Figure 5

Composition of chest injuries as a % (n = 11).

Figure 6

Composition of Gastrointestinal injuries as a % (n = 3).