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Study that demonstrated the effectiveness of the IRIS domestic violence and abuse programme wins RCGP Research Paper of the Year award

14 October 2021

A study that demonstrated the ‘real world’ effectiveness (outside a clinical trial) of IRIS, a specialist domestic violence and abuse training, support and referral programme for general practice teams, has won the 2020 Royal College of General Practitioners’ Research Paper of the Year award.

The National Institute for Health Research funded study, published in BMC Medicine in March 2020, was led by Dr Alex Sohal from Queen Mary University of London in collaboration with Professor Gene Feder and Dr Natalia Lewis from the University of Bristol’s Centre for Academic Primary Care (CAPC) and others.

The study found that implementation of the IRIS programme led to a 30-fold increase in domestic violence and abuse referrals for women across 205 general practices in London.

IRIS (Identification & Referral to Improve Safety) had previously been positively evaluated in a randomised controlled trial, led by Professor Feder. It is now the flagship programme of IRISi, a social enterprise established in 2017 by Professor Feder and IRISi’s CEO, Medina Johnson.

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.”

Medina Johnson said: “Up to December 2020, over 22,000 women have been recognised 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, we are doing it in a very effective way."

Study lead, Dr Alex Sohal from Queen Mary University of London, said: “This work shows that implementation of the IRIS programme surprisingly remains highly effective at scale in day to day general practice. It allows GPs to engage constructively with DVA rather than turning their back on this vulnerable group of patients.”

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. This year, the RCGP invited submissions reporting COVID-19 research to each category.

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’.

They said: “This programme of work, building on the IRIS trial, provides evidence that a system-level programme that embeds direct referral pathways to specialist domestic violence and abuse (DVA) agencies within health services, underpinned by face-to-face training of clinicians and their teams, including on-going reinforcement strategies, improves the case identification and referrals for DVA. This study exemplifies the need for recognition, support and compassion for this vulnerable group of patients.”

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.

Related news

Professor Trevor Thompson, Head of Primary Care Teaching at the Centre for Academic Primary Care, Bristol Medical School, was co-author of the winning paper in the Medical Education category, ‘Revealing the reality of undergraduate GP teaching in UK medical curricula: a cross-sectional questionnaire study’ published in the British Journal of General Practice.

Further information

About the Centre for Academic Primary Care, University of Bristol
The Centre for Academic Primary Care (CAPC) at the University of Bristol is a leading centre for primary care research in the UK, one of nine forming the NIHR School for Primary Care Research. It sits within Bristol Medical School, an internationally recognised centre of excellence for population health research and teaching. Follow us on Twitter: @capcbristol.

About the National Institute for Health Research
The National Institute for Health Research (NIHR) is the nation's largest funder of health and care research. The NIHR:

  • funds, supports and delivers high quality research that benefits the NHS, public health and social care
  • engages and involves patients, carers and the public in order to improve the reach, quality and impact of research
  • attracts, trains and supports the best researchers to tackle the complex health and care challenges of the future
  • invests in world-class infrastructure and a skilled delivery workforce to translate discoveries into improved treatments and services
  • partners with other public funders, charities and industry to maximise the value of research to patients and the economy.

The NIHR was established in 2006 to improve the health and wealth of the nation through research, and is funded by the Department of Health and Social Care. In addition to its national role, the NIHR supports applied health research for the direct and primary benefit of people in low- and middle-income countries, using UK aid from the UK government.

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