LOS ANGELES - Women of childbearing age should undergo screening for domestic violence and other forms of abuse while visiting their doctor or clinic, according to a recommendation published online Monday by an influential panel of medical experts that advises the federal government.
That recommendation, published in the Annals of Internal Medicine, marks a significant change from 2004, when the U.S. Preventive Services Task Force found insufficient evidence to support screenings for so-called Intimate Partner Violence, or IPV.
Citing new evidence, the task force now says screening women for IPV with a list of standard questions showed a "moderate net benefit," while the risks associated with disclosing abuse were small.
If abuse is confirmed, physicians should provide patients with, or refer them to, intervention services, the panel said. Such services include counseling, home visits, information cards, community service referrals and mentor programs.
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The guidelines apply only to women age 14 to 46 who do not show obvious signs of physical or sexual abuse that would otherwise prompt questions from health-care providers. Although the report acknowledged that women of childbearing age are not the only people who suffer abuse, evidence is still insufficient to recommend broader screenings, the authors said.
"The bottom line is that more research is needed on how primary-care clinicians can effectively screen and protect all populations, including older and vulnerable adults, middle-aged women, men and children from abuse and violence," said Dr. David Grossman, a Seattle pediatrician and task force member.
In a separate draft statement, task force members said there wasn't enough evidence to recommend how clinicians could prevent abuse among children without obvious symptoms.
IPV includes physical violence, sexual abuse, psychological abuse, stalking and reproductive coercion - intimidation that increases the risk of unplanned pregnancy.
The Centers for Disease Control and Prevention estimate that nearly 31 percent of women and 26 percent of men have experienced IPV. Immediate health consequences include injury, death, sexually transmitted diseases, unintended pregnancy, psychological distress and premature births.
