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Screening for partner violence failed to produce successful outcomes

Women screened for partner violence and who received a partner violence resource list did not experience significant differences regarding several outcomes, such as overall quality of life, general health and recurrence of partner violence, compared with women who received only the resource list, according to new research published in The Journal of the American Medical Association.

The researchers said although numerous professional and health care organizations, including the Institute of Medicine, have recommended screening to identify patients requiring special intervention, US and other government agencies have concluded that there is insufficient evidence to support this recommendation.

Joanne Klevens, MD, PhD, of the CDC, and colleagues from Chicago area hospitals conducted a randomized control trial to study the effect of computer-based partner violence screening and the distribution of partner violence resource lists to women seeking care in outpatient clinics. Three intervention groups were created: 909 women were screened using the Partner Violence Screen and given a list of local partner violence resources if screening was positive; 893 women were given the resource list without screening; and 898 women were assigned to a control group that was not screened and did not receive the list.

Quality of life was assessed using the Short-Form Health Survey, version 2, which measured eight subscales of mental and physical health during the past 4 weeks.

At 1-year follow-up, researchers found no significant differences in the physical health of women who were screened and received the violence resources list (95% CI, 46.1-47.4), women who received the resource list without screening (95% CI, 45.8-47.1) and the control group (95% CI, 46.5-47.8). There was no significant difference in the mental health of the first (95% CI, 47.5-49.1), second (95% CI, 47.2-48.9) and third groups (95% CI, 47-48.6). There were no differences in the number of days women were unable to work or complete housework and the number of hospitalizations or ambulatory care visits. Researchers also found no difference in the proportion of women who contacted a partner violence agency or a recurrence of partner violence among the three groups.

Among women who received the resource list, 66.5% remembered receiving it at 1-year follow-up, and 32.9% had shared the list with someone else. Results showed that 6.3% of all women used the list to contact services, and fewer than 4.4% contacted an agency that provides help to women hurt by a partner.

“The results of this study suggest providing a partner violence resource list with or without computerized screening of female adult patients in primary care settings does not result in significant benefits in terms of general health outcomes,” the researchers wrote. “These findings provide important information for clinicians and others to consider in light of recent professional recommendations calling for routine screening.”

Disclosure: Study researcher Laura S. Sadowski, MD, MPH, reported receiving consultancy fees from WHO. The other researchers report no relevant financial disclosures.