Abstract
Introduction: Intimate Partner Violence (IPV) is a global epidemic which 30% of women experience world-wide. Domestic violence has serious health consequences, with an estimated cost of 1.7 billion annually to the NHS. However, healthcare professionals remain uncertain on how to manage IPV. In 2007, the Identification and Referral to Improve Safety (IRIS) was introduced within primary care to address this shortcoming. The aim of this project is to analyse the impact of IRIS, whilst discussing the extension into secondary care. Materials and Methods: A literature review was conducted using PubMed, Cochrane Library and Google scholar. The official IRIS publication list for randomized controlled trial data. Results: General practices with IRIS displayed a threefold increase in the identification of IPV and sevenfold increase in referrals. IRIS is cost-effective and under the NICE threshold of £20,000 per quality-adjusted life year gained. Additionally, a systematic review illustrated that one in six women presenting to the fracture clinic experienced IPV within the last year. Conclusions: The implementation of IRIS into general practice proved to be cost-effective. Orthopaedic fracture clinics are at the forefront of dealing with IPV, and therefore an adapted IRIS programme within this setting has potential in the prevention of IPV.
Highlights
The effectiveness of the Identification and Referral to Improve Safety (IRIS) programme was assessed by comparing the proportion of Intimate Partner Violence (IPV) patients identified and referred amongst general practicses with and without the
The results showed that IRIS was cost-effective in 61% of simulations using the quality adjusted life year (QALY) threshold of £20,000 [43]
Introducing an adapted version of IRIS programme into secondary care could address the reported lack of specialist training within the environment
Summary
Intimate Partner Violence (IPV) is one of the most common forms of family violence, along with Domestic Violence and Abuse (DVA) [1]. It includes multiple types of physical, psychological and sexual abuse, such as physical violence, threats, intimidation, isolation, emotional abuse, economic coercion, manipulation and the assertion of privilege [1]. IPV has been found to be a widespread phenomenon in every country around the world [2]. Even in developed counties such as the UK, the problem is so common and widespread that it has almost become an invisible form of crime and an everyday story in many households [2]
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