Identifying and responding to domestic violence in General Practice during the COVID-19 pandemic

Conference:

SAPC ASM 2021 - virtual

Talk Code:

3D.4

Presenter:

Elizabeth Emsley

Twitter:

@EmsleyDr

Co-authors:

Caroline Coope, Emma Williamson, Jessica Roy, Gene Feder, Eszter Szilassy

Author institutions:

Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol

Problem

Identifying and responding to patients experiencing or perpetrating domestic violence and abuse (DVA) and their children is vital in General Practice (GP). Evidence suggests that while the prevalence of DVA has increased during the COVID-19 pandemic, the imposition of severe lockdown measures has led to a significant reduction in GP DVA identifications and referrals to specialist services. IRIS+, which stands for Enhanced Identification and Referral to Improve Safety, is an integrated primary care system-level training and support intervention. IRIS+ enhances and extends the original IRIS model to all patients affected by DVA. The model involves tailored training for non-IRIS trained and IRIS trained GP practices about DVA and a referral pathway for survivors, perpetrators and their children. The IRIS+ feasibility stage II study tests the feasibility and acceptability of IRIS+ in England and Wales. In this paper we aim to establish the impact of the COVID-19 pandemic response on DVA identification and response in IRIS+ trained GP practices.

Approach

We will analyse the impact of the COVID-19 pandemic lockdown measures on the identification and response to DVA in one inner city IRIS+ trained GP practice in England by analysing the GP Electronic Medical Record (EMR). In a blinded search we will identify, describe and compare disclosures of DVA recorded in the EMR during the period of the IRIS+ intervention, prior to the COVID-19 pandemic (1st June 2019 to 22nd March 2020) and during the COVID-19 pandemic period (23rd March 2020 to 31st December 2020). For DVA disclosures recorded in the EMR we will also compare signposting and referral to IRIS+, and whether this was accepted by patients prior to and during the pandemic. For DVA disclosures recorded in the EMR we will consider consultation type, reason for consultation and outcomes of the consultation.We will also perform a thematic analysis of interviews with 11 GP health care professionals from England and Wales, including GPs, practice nurses and health visitors. The analysis will consider the impact of the COVID-19 pandemic lockdown measures on the identification and response to DVA in IRIS+ trained GP practices in England and Wales.

Findings

Study data collection is in progress and we will present the early findings of the effect of the COVID-19 pandemic response on DVA identification and referral in IRIS+ trained, with a focus on one inner-city practice. We will also describe emerging themes from interviews with GP healthcare professionals regarding the impact of the COVID-19 pandemic response on DVA disclosures.

Consequences

This study will improve our understanding of the primary care response to DVA including during a period of national lockdown and restriction measures.

Submitted by:

Elizabeth Emsley

Funding acknowledgement:

I am an NIHR funded Academic Clinical Fellow. IRIS+ is part of the REPROVIDE programme (Reaching Everyone Programme of Research On Violence in diverse Domestic Environments), an independent research programme funded by the National Institute for Health Research (Programme Grants for Applied Research), (RP-PG-0614-20012). The views expressed in this abstract/paper are those of the authors and not necessarily those of the National Institute for Health Research or the Department of Health and Social Care.