January 23, 2013 — Physicians should screen women of childbearing age for intimate partner violence and refer women who show signs of abuse for intervention services, according to a recommendation released on Monday by the U.S. Preventive Services Task Force, the Los Angeles Times reports (Morin, Los Angeles Times, 1/21).
USPSTF made the guidelines a level "B" recommendation, meaning "there is high certainty that the net benefit is moderate or there is moderate certainty that the net benefit is moderate to substantial." Under the Affordable Care Act (PL 111-148), health plans are required to cover services with this level of recommendation without cost-sharing (Norman, CQ HealthBeat, 1/22).
The new recommendation, which was published in the Annals of Internal Medicine, updates a 2004 statement in which the task force said there was not enough evidence to recommend screening women for intimate partner violence, which includes physical violence, sexual abuse, psychological abuse, stalking and reproductive coercion.
However, a new review of more than a dozen studies and interviews with more than 30,000 people found that screening women for abuse with a list of standard questions showed a "moderate net benefit," while the risks associated with disclosing the abuse were minimal, the task force said. If abuse is detected, physicians should refer women to intervention services, such as counseling, home visits, information cards, community service referrals and mentor programs, the panel added.
The guidelines apply to female patients ages 14 through 46 who do not display obvious signs of physical or sexual abuse that would otherwise provoke suspicion (Los Angeles Times, 1/21). In response to comments on a draft of the guidelines that was released in June , the final recommendation acknowledged that men also are abused and expressed the need for more study of intimate partner violence among women older than childbearing age and the elderly (CQ HealthBeat, 1/22).
Some health care providers said that Monday's recommendation could encourage medical organizations to adopt a more standardized protocol for screening for intimate partner violence. The American College of Obstetricians and Gynecologists advises that all women be screened, while the American Medical Association encourages physicians to ask all patients about abuse as part of a medical history but does not suggest a specific list of questions (Los Angeles Times, 1/21).