There is substantial under-recording of maltreatment and abuse within UK primary care records, according to a study published in BMJ Open.
The study analysed longitudinal records from The Health Improvement Network (THIN) between 1 January 1995 and 31 December 2018.
Records of almost 12 million eligible patients from 787 contributing practices were examined. Childhood maltreatment and domestic abuse (women only) were defined as the presence of a recorded Read code.
The incidence rate (IR, 60.1 [95% CI, 54.3-66.0] per 100,000 child years) and prevalence (416.1 [95% CI, 401.3-430.9] per 100,000 child population) of childhood maltreatment rose until 2017. The adjusted incidence rate ratio (aIRR) was greater in patients from the most deprived backgrounds (aIRR, 5.14; 95% CI, 4.57-5.77 compared with least deprived) and from an ethnic minority community (black [aIRR, 1.25; 95% CI, 1.04-1.49] compared with white).
When examining domestic abuse in women, in 2017, the IR was 34.5 (95% CI, 31.4-37.7) per 100,000 adult years and prevalence was 368.7 (95% CI, 358.7-378.7) per 100,000 adult population. Similarly, the IR was highest in the lowest socio-economic class (aIRR, 2.30; 95% CI, 2.71-3.30) and in ethnic minorities (South Asian: aIRR, 2.14; 95% CI, 1.92-2.39 and black: aIRR; 1.64; 95% CI, 1.42-1.89).
“Despite recent improvements in recording, there is still a substantial under-recording of maltreatment and abuse within UK primary care records, compared with currently existing sources of childhood maltreatment and domestic abuse data,” the authors say. They call for approaches to improve recording and detection of childhood maltreatment and domestic abuse within medical records.
Chandan JS, Gokhale KM, Bradbury-Jones C, Nirantharakumar K, Bandyopadhyay S, Taylor J. Exploration of trends in the incidence and prevalence of childhood maltreatment and domestic abuse recording in UK primary care: a retrospective cohort study using 'the health improvement network' database. BMJ Open. 2020;10(6):e036949. doi: 10.1136/bmjopen-2020-036949. PMID: 32499272. Full text.
This article originally appeared on Univadis, part of the Medscape Professional Network.
