Primary care-based interventions for intimate partner violence: a systematic review.
BACKGROUND
Primary care providers are uniquely positioned to respond to patients' disclosure of intimate partner violence (IPV). However, the research on primary care-based IPV interventions has not been systematically synthesized, making it difficult for providers, policymakers, and researchers to understand how to effectively intervene in the primary care setting. This systematic review summarizes primary care-based interventions for patients experiencing IPV.


METHODS
PubMed, PsycINFO, and CINAHL were searched from their start through September 2012; this search was augmented by bibliographic review and consultation with experts. Eligible studies included English-language, peer-reviewed articles that assessed patient-level impact of IPV interventions that originated from patients' visits to a primary care provider.


RESULTS
Of 80 potentially eligible studies, 17 met eligibility criteria. The majority of interventions recruited women from reproductive care sites. Interventions tended to be brief, delivered by nonphysicians, and focused on empowerment, empathetic listening, discussion of the cycle of violence and safety, and referral to community-based resources. Thirteen studies demonstrated at least one intervention-related benefit. Six of 11 articles measuring IPV persistence found reductions in future violence; two of five measuring safety-promoting behaviors found increases; and six of ten measuring IPV/community resource referrals found enhanced use. Some studies also documented health improvements.


CONCLUSIONS
The majority of studies demonstrated patient-level benefit subsequent to primary care IPV interventions, with IPV/community referrals the most common positively affected outcome.
Division of General Pediatrics, Boston Medical Center, Boston, Massachusetts. Electronic address: Megan.Bair-Merritt@bmc.org.
Megan H
MH
Bair-Merritt
Center for Women and Newborns, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Annie
A
Lewis-O'Connor
Johns Hopkins University, Baltimore, Maryland.
Swati
S
Goel
Oregon Health and Science University, Portland, Oregon.
Paula
P
Amato
Academy on Violence and Abuse, Shakopee, Minnesota.
Tasneem
T
Ismailji
Department of Internal Medicine , University of Oklahoma School of Community Medicine, Tulsa, Oklahoma.
Martina
M
Jelley
University of Southern California, School of Social Work, Los Angeles, California.
Patricia
P
Lenahan
Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, Pennsylvania; Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, Pennsylvania; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania.
Peter
P
Cronholm
D002986:Clinical Trials as Topic / Q000379:methods / Q000639:trends; D003419:Crisis Intervention; D017579:Domestic Violence; D006801:Humans; D017063:Outcome Assessment, Health Care; D011320:Primary Health Care