The IRIS Programme is effective even outside a clinical trial, when implemented in ‘real world’ General Practices, according to the study “Improving the healthcare response to domestic violence and abuse in UK primary care: interrupted time series evaluation of a system-level training and support programme”. The study, funded by the National Institute for Health Research (NIHR) and published in BMC Medicine in March 2020, has just been awarded the “2020 Royal College of General Practitioners’ Research Paper of the Year”.
Led by Dr Alex Sohal from Queen Mary University of London in collaboration with Medina Johnson, Annie Howell and Dr Estela Barbosa from IRISi, Professor Gene Feder and Dr Natalia Lewis from the University of Bristol’s Centre for Academic Primary Care (CAPC) and others, the research found that the IRIS Programme improves considerably the response of GPs to Domestic Violence and Abuse: after being trained by the initiative, 205 general practices in London reached a 30-fold increase in referrals for women identified as possible victims of DVA.
IRIS (Identification & Referral to Improve Safety) is a specialist domestic violence and abuse (DVA) training, support and referral programme for General Practices that started as a randomised controlled trial led by Professor Feder. In 2017, after being positively evaluated, became the flagship programme of IRISi, a social enterprise focused on improving the healthcare response to gender-based violence.
“To December 2020, over 22,000 women were recognised by their GP as being affected by domestic violence and abuse and referred into their local IRIS programme for specialist support. During the last four years, we have expanded our services and we are currently successfully delivering the IRIS Programme to over 40 areas across the UK, which means that the initiative is reaching patients in around 15% of the general practices across England and Wales. This study provides us with a very good proposal to decision-makers when negotiating the funding needed to enable the local commissioning of the IRIS programme. We are not only supporting women, but we are also doing it in a very effective way”, explains Medina Johnson, CEO at IRISi.
RCGP Research Paper of the Year
The RCGP Research Paper of the Year gives recognition to an individual or group of researchers who have undertaken and published an exceptional piece of research relating to general practice or primary care.
The three categories are Clinical Research, Health Services Research (including Implementation and Public Health) and Medical Education with relevance to primary care. Papers are scored on the criteria of originality, impact, contribution to the reputation of general practice, scientific approach and presentation. The reviewing panel felt that this paper, submitted to Category 2 (Health Services Research) was particularly relevant in the light of COVID restrictions and widespread reports of increased domestic violence during ‘lockdowns’.
Professor Feder said: “In this study, we wanted to find out if a programme that improves care in a randomised controlled trial would continue to benefit patients when implemented in everyday general practice. Happily, the answer was a resounding ‘yes’. The evidence from this study is a compelling argument for further commissioning of IRIS nationally in the UK.”
Alex Sohal said: “This is revolutionary research as it’s about changing the world, including the GP consultation – our research shows clinician behaviour can be changed: improved listening, identifying and discussion of patients’ experiences of domestic violence & abuse in relation to their health. This happened when clinicians were supported by IRIS – Identification & Referral to Improve Safety – a system-level intervention – that’s equivalent to a Rapid Access Chest Pain Clinic to which GPs can refer patients with chest pain.”
Winning paper: Improving the healthcare response to domestic violence and abuse in UK primary care: interrupted time series evaluation of a system-level training and support programme by Alex Hardip Sohal, Gene Feder, Kambiz Boola, Anna Dowrick, Richard Hooper, Annie Howell, Medina Johnson, Natalia Lewis, Clare Robinson, Sandra Eldridge and Chris Griffiths. Published in BMC Medicine. March 2020.