Violence and abuse towards general practice staff by patients and the public: a scoping review

Abstract

Background: General practice is the gatekeeper to secondary care in many countries. This unique role may expose general practice staff to violence and abuse by patients and the public, yet violence and abuse in secondary care receives more attention than that in general practice. Existing reviews on primary care do not distinguish the perpetrators of violence.

Aim: To analyse the evidence on: (a) the extent, characteristics, and impact of violence and abuse by patients or the public towards general practice staff and (b) the practices relating to violence and abuse prevention and support in general practice at individual and organisational levels.

Design and setting: This scoping review followed the updated Joanna Briggs Institute guidelines and the Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews guidelines.

Method: Six bibliographic databases, Google, and Google Scholar were systematically searched. Deduplicated citations (N = 19 519) were independently screened by two reviewers. Data were extracted with a bespoke extraction form.

Results: Fifty studies from 24 countries were included. Past-year rates for violence and abuse by patients and the public towards general practice staff ranged from 13.8% to 90.3% and career-long estimates were from 18.3% to 91.0%. Long waiting times and unmet patient demands were the most common reasons. It had an impact on staff mental health, turnover intention, and service capacity. No evaluated prevention or support interventions were reported.

Conclusion: Violence and abuse towards general practice staff is widespread, having an impact on both individuals and service delivery. However, interventions are underresearched.

Keywords: abuse; family medicine; general practice; primary health care; safety; workplace violence.