Patient views on the routine use of a two-item screening tool for domestic abuse in general practice: a UK-based cross-sectional study.

Abstract

Domestic abuse (DA) is underdiagnosed by the medical community. The National Institute for Health and Care Excellence (NICE) does not recommend DA screening in primary care. The enduring use of remote consultations since COVID-19, coupled with the sensitive nature and increasing prevalence of DA, necessitates review of the NICE guideline, which was developed pre-pandemic primarily for face-to-face consultations. To explore NHS patient experiences and views on routine DA screening in primary care. Data were collected from 6967 NHS patients using an anonymous 29-item eSurvey that included information on accessible support services. Logistic regression analysis from 4253 responders explored the association between the validated WAST-short questions and previous exposure to abuse. Almost half of the responders confirmed having experienced DA, whereas 6.1% declined disclosure. About two-thirds of responders agreed it would be beneficial to routinely screen DA in general practice using a short, validated tool. Logistic regression analysis adjusted for age, sex, and ethnicity suggested those with a history of abuse had 11.52 times higher odds of having tension in the relationship and 9.72 times higher odds of having difficulty working out arguments compared with those with no history of DA. Similarly, those who answered 'would rather not say' had 6.42 times higher odds of having tension in the relationship, and 4.31 times higher odds of having difficulty working out arguments. The routine use of the already established WAST-short in primary care could help identify and potentially tackle DA. Training health and social care professionals in administering the brief, non-threatening DA screening questionnaire would help raise awareness, and identify and support victims.