Summary of NICE evidence relating to domestic abuse and emergency departments.
Introduction
NICE have completed a review of evidence regarding the effectiveness of domestic abuse interventions in health settings. There
are many studies citied in the evidence NICE have collected regarding domestic abuse and emergency departments. Many are
from America and other countries so the findings may not be directly transferrable to the UK. Frustratingly, the research topics are
very rarely – “How does domestic abuse impact on demand for accident and emergency services?” The research is more
usually focused on other issues like the effectiveness of methods for screening service users for domestic abuse. The studies
rarely distinguish between whether the service user being interviewed is attending A&E because of an injury caused by a domestic
abuse incident or whether they are a life time victim of domestic abuse who is attending A&E for an injury caused somehow else.
This means that while life time prevalence of domestic abuse among emergency department users is identified the reason for
attendance at A&E is not identified by the studies. The table below summarises the evidence.
The 26% figure quoted at the Police Summit in July is from Rhodes et al (2006) and is the lifetime prevalence of domestic abuse
found among a sample of women attending A&E in the USA.
Study
Rhodes, K. V., Drum, M., Anliker, E., Frankel, R. M.,
Howes, D. S., & Levinson, W. (2006).
Lowering the threshold for discussions of domestic
violence: A randomized controlled trial of computer
screening. Archives of Internal Medicine, 166(10), 11071114.
Svavarsdottir, E.K. (2010). Detecting intimate partner
abuse within clinical settings: self-report or an interview.
Scandinavian Journal of Caring Sciences, 24(2), 224232.
Trautman, D. E., McCarthy, M. L., Miller, N., Campbell,
Country of study
Life time
experience of
domestic abuse
Last 12 month
experience of
domestic abuse
Reason for
attendance is
domestic
abuse
USA
21% to 26%
Iceland
49.5%
17.5%
10.8%
USA
19%
6.3%
J. C., & Kelen, G. D. (2007). Intimate partner violence
and emergency department screening: computerized
screening versus usual care. Annals of Emergency
Medicine, 49(4), 526-534.
Choo, E.K., Nicolaidis, C., Newgard, C.D., Hall, M.K.,
Lowe, R.A., McConnell, M.K., & McConnell, K.J. (2012).
Association between emergency department resources
and diagnosis of intimate partner violence. European
Journal of Emergency Medicine, 19(2), 83-88.
Ernst, A., Weiss, S., Goldstein, L., Hall, J., & Clark, R.
(2007). Computer versus paper format for intimate
partner violence (IPV) screening. Academic Emergency
Medicine, 14(5), S44-S44.
MacMillan, H.L., Wathen, C.N., Jamieson, E., Boyle, M.,
McNutt, L.A., Worster, A., Lent, B., Webb, M, &
McMaster Violence Against Women Research
Group.(2006). Approaches to screening for intimate
partner violence in health care settings: A randomized
trial. The Journal of the American Medical Association
296(5), 530-536.
Rhodes, K.V., Lauderdale, D.S., He, T., Howes, D.S., &
Levinson, W. (2002). "Between me and the computer":
Increased detection of intimate partner violence using a
computer questionnaire. Annals of Emergency
Medicine, 40(5), 476-484.
USA
0.25% Un
prompted
disclosure
Multi-country
literature search.
7.2% to 2% - of
A&E activity for
women related
to acute cases
of domestic
violence.
Canada
USA
4.1% to 17.7%
33% emotional
abuse, 15%
physical abuse.