Objectives: To develop consensus clinical guidelines on GP management of the whole family when IPV is present
Methods: We undertook a systematic review of existing guidelines (1999-2004). Each guideline was assessed using AGREE criteria (Appraisal of Guidelines for Research and Evaluation). We retained guidelines if they fulfilled 4 of 6 criteria. Two of us independently scored the guidelines according to AGREE criteria. We retained recommendations with consensus across 3+ guidelines and drafted new recommendations where there were gaps. We then invited 8 experts from 3 continents with published expertise around primary care management of victims, perpetrators or children in families experiencing IPV to participate. All agreed. Via surveys and international teleconferences, we sought consensus around all recommendations using an adapted Delphi process and accepted those with a mean of 7-9. We then undertook a limited consultation with stakeholders in each participating country (England, Canada, Netherlands, Canada and the US). Final consensus guidelines are in press.
Principal findings:
Only 9 of 52 identified guidelines met AGREE criteria. We will discuss the controversy around recommendations for screening/case-finding of victims, perpetrators or children. We will also present consensus recommendations for GP management of victims and those addressing major gaps in management of the male partner, children, couples and in the clinic.
Discussion: To date, little advice has addressed the serious dilemmas GPs face when dealing with the victim, her partner and the rest of the family. More research is required to provide evidence for interventions in general practice to better manage this health damaging problem in families.
Implications for policy, delivery or practice: With no evidence to inform policy, service delivery or good practice, consensus guidelines are vital to guide current GP practice around this prevalent problem. The consensus from these guidelines will inform both GP education, service delivery and good practice.