Background: Intimate partner violence (IPV) is an important health problem affecting women of all ages, but is often not addressed during healthcare visits.
Purpose: To use electronic records of diagnoses and telephone advice calls to describe the clinical patterns of midlife women experiencing IPV.
Materials and methods: Using case-control methodology, women with an ICD9 diagnosis of IPV were chosen from those enrolled in 2005-2006 in Kaiser Permanente Northern California (KPNC) and matched on visit date, age, and facility with women without such a diagnosis. The study population was divided into subsets: ages 45-53 years (318 cases, 1588 controls); ages 54-64 years (200 cases, 1000 controls). Diagnoses and symptoms reported by phone that were significantly related to the cases compared with the controls were identified using multivariate logistic regression.
Results: Among women aged 45-53 years, diagnoses of anxiety (odds ratio [OR] = 2.05) and of psychiatric problems (OR = 1.65) and calls for head injury (OR = 3.17), mental health problems (OR = 2.46), and sexually transmitted diseases (OR = 2.40) were associated with IPV. Among women aged 54-64 years, diagnoses of anxiety (OR = 1.74) and other psychiatric problems (OR = 1.76), injuries (other than head and neck) (OR = 1.57), urinary tract infection (UTI; OR = 2.31), headache (OR = 2.06), and calls for mental health problems (OR = 4.16) were associated with IPV. Among all women aged 45-64 years, history of prior IPV was strongly associated with subsequent diagnosis of IPV.
Conclusions: Information available in the electronic health record of women who have been identified as experiencing IPV can be used to identify patterns of symptoms and diagnosis among midlife women. These patterns can potentially be used to improve identification of IPV in this age group. In addition to screening of all women for IPV, the presence of psychiatric problems, injuries, headache, and UTI and prior experience of IPV should prompt additional focused clinical inquiry about IPV in midlife women.