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USPSTF: Screen for intimate partner violence, but evidence insufficient for elder abuse

The USPSTF gave a B-level recommendation to screening for intimate partner violence in women of reproductive age and for women who screen positive, provide or refer to ongoing support services.

The task force, however, found insufficient evidence to recommend screening for abuse and neglect in all older or vulnerable adults.

The recommendations recently appeared in JAMA.

“[Intimate partner violence] and abuse of older or vulnerable adults are common in the United States but often remain undetected,” task force members wrote.

“In addition to the immediate effects of intimate partner violence, such as injury and death, there are other health consequences, many with long-term effects, including development of mental health conditions such as depression, posttraumatic stress disorder, anxiety disorders, substance abuse, and suicidal behavior; sexually transmitted infections; unintended pregnancy; and chronic pain and other disabilities,” the task force added.

The task force also noted that abused elders, in the long term, are at higher risk for adverse psychological consequences and nursing home placement.

The recommendations were based on 30 studies comprising 14,959 patients. Though new evidence has come to light in the 5 years since the last USPSTF report on intimate partner violence and elder abuse, the new recommendations mirror the 2013 recommendations, according to the task force.

Researchers provided insight into where evidence into these clinical matters is deficient.

“Future studies could assess whether screening specific groups results in improved health outcomes. [We] included [randomized clinical trials] of screening enrolled women of childbearing age, but none enrolled women from prenatal settings or reported outcomes separately for women screened during pregnancy. Screening studies should report on harms over a sufficient period after screening to assess potential psychosocial harms. In addition, research is needed to assess the accuracy of screening tools in men, as well as the benefit and harms of interventions for men who experience intimate partner violence,” Cynthia Feltner, MD, MPH, of the Evidence-based Practice Center at the University of North Carolina at Chapel Hill and colleagues wrote. “No randomized clinical trials of screening or interventions for older and vulnerable adults were identified in this review. Studies of screening tools also are lacking.”

The American Academy of Family Physicians, American College of Obstetricians and Gynecologists, American Academy of Pediatrics and American Academy of Neurology endorse screening for intimate partner violence, the task force stated. – by Janel Miller

Disclosures: Please see the studies for the authors’ relevant financial disclosures.