Condition category
Not Applicable
Date applied
Date assigned
Last edited
Retrospectively registered
Overall trial status
Recruitment status
No longer recruiting
Publication status

Plain English Summary

Not provided at time of registration

Trial website

Contact information



Primary contact

Prof Gene Feder


Contact details

Community Based Medicine
25/27 Belgrave Road
United Kingdom

Additional identifiers

EudraCT number number

Protocol/serial number


Study information

Scientific title

Primary care Identification and Referral to Improve Safety of women experiencing domestic violence: a randomised controlled trial



Study hypothesis

Will a training and support programme for general practices increase the identification and referral to domestic violence agencies of women survivors of domestic violence?

Ethics approval

Ethics approval received from the NHS National Research Ethics Service - South East Research Ethics Committee on the 27th July 2007 (ref: 07/MRE01/65).

Study design

Cluster randomised controlled trial; unit of randomisation is practices.

Primary study design


Secondary study design

Randomised controlled trial

Trial setting

Not specified

Trial type


Patient information sheet


Domestic violence referrals in General Practices


Practices in Hackney and Bristol will be randomly allocated to the intervention and control group.

The intervention is designed to address the barriers to making a general practice domestic violence "competent" and improves the quality of care for survivors of abuse. This will entail two 2-hour multi-disciplinary training sessions with clinicians using case studies and role-play in relation to asking about violence and responding appropriately.

This will be followed by periodic reinforcement sessions feeding back practice data on disclosure and referral and encouraging discussion about improving the quality of care. The clinicians include General Practitioners (GPs) and directly employed practice staff (practice nurses and counsellors) and those employed by trusts (midwives, health visitors, district nurses). We will also engage administrative staff in a session that will highlight their role in data handling and confidentiality.

Feedback of anonymous disclosure and referral data can be done at practice meetings at which the program would be a regular agenda item. In each intervention practice we will identify a "champion" for the project. They can be from any of the clinical disciplines and will have the agreement of the practice to attend additional training about domestic violence and integrating this into the work of the practice. The advocate-educator will, in conjunction with the practice champion, meet with smaller groups of clinicians to address problems that have arisen around identification, support and referral.

The control group is made up of 12 general practices in Bristol and 12 in London.

The educational and support intervention will be continuous over the year of follow-up from first educational session. Intervention and control practices will be followed up for one year.

Intervention type



Not Specified

Drug names

Primary outcome measure

Recording in the medical record identification of women who have experienced or are experiencing domestic violence, measured at 3 months, 6 months, 9 months and one year.

Secondary outcome measures

1. Referral of women who have experienced or are experiencing domestic violence to specialist domestic violence agencies and/or practice based counselling
2. Knowledge, beliefs, and practices of health care professionals with regards to domestic violence (Physician REadiness to Manage Intimate partner violence Survey [PREMIS] questionnaire to participating clinicians)
3. Expectations and experiences of clinicians targeted by the intervention (interviews with purposive sample of clinicians in intervention practices

All secondary outcomes will be measured at 3 months, 6 months, 9 months and one year.

Overall trial start date


Overall trial end date


Reason abandoned (if study stopped)


Participant inclusion criteria

General practices within City and Hackney or Bristol Primary Care Trust (PCT) if they record consultations electronically and their systems allow the use of screen prompts.

Participant type


Age group

Not Specified


Not Specified

Target number of participants

48 practices (24 in Hackney and 24 in Bristol)

Participant exclusion criteria

Practices will be excluded if:
1. They do not use electronic medical records
2. Their systems do not allow the use of screen prompts
3. They have already had significant training in identification of women experiencing domestic violence and established a referral pathway to an advocacy service

Recruitment start date


Recruitment end date



Countries of recruitment

United Kingdom

Trial participating centre

Community Based Medicine
United Kingdom

Sponsor information


The Health Foundation (UK)

Sponsor details

90 Long Acre
United Kingdom

Sponsor type




Funder type


Funder name

The Health Foundation (UK) (ref: 6421/4601)

Alternative name(s)

Funding Body Type

Funding Body Subtype


Results and Publications

Publication and dissemination plan

Not provided at time of registration

Intention to publish date

Participant level data

Not provided at time of registration

Basic results (scientific)

Publication list

1. 2010 protocol in:
2. 2011 results in

Publication citations

  1. Protocol

    Gregory A, Ramsay J, Agnew-Davies R, Baird K, Devine A, Dunne D, Eldridge S, Howell A, Johnson M, Rutterford C, Sharp D, Feder G, Primary care identification and referral to improve safety of women experiencing domestic violence (IRIS): protocol for a pragmatic cluster randomised controlled trial., BMC Public Health, 2010, 10, 54, doi: 10.1186/1471-2458-10-54.

  2. Results

    Feder G, Davies RA, Baird K, Dunne D, Eldridge S, Griffiths C, Gregory A, Howell A, Johnson M, Ramsay J, Rutterford C, Sharp D, Identification and Referral to Improve Safety (IRIS) of women experiencing domestic violence with a primary care training and support programme: a cluster randomised controlled trial., Lancet, 2011, 378, 9805, 1788-1795, doi: 10.1016/S0140-6736(11)61179-3.

Additional files

Editorial Notes

16/01/2018: internal review.