Adapting domestic violence intervention for behaviour change in pharmacist consultations with women clients

Background. Domestic violence and abuse (DVA) is a public health problem with devastating consequences for women’s health. Identification and Referral to Improve Safety (IRIS) is an evidence-based intervention for behaviour change in GP interactions with patients presenting with DVA indicators. Evidence suggests that request for emergency contraception (EC) may indicate DVA. As UK pharmacists supply 50% of all EC, they may be ideally placed to implement an adapted IRIS.
Aims and Objectives. To adapt IRIS for behaviour change in pharmacist consultations with female clients.
Methods. (i) Systematic review and case-control study in Clinical Practice Research Datalink on the association between DVA and EC use; (ii) interviews with pharmacists about the feasibility and acceptability of an adapted IRIS (n=20).
Results. We found a positive association between DVA and EC use (OR between 1.5 (95% CI 1.1-2.0) and 6.5 (95% CI 4.2-10.2)). Pharmacists were confident in providing public health services but lacked skills and confidence in identifying and responding to DVA. Pharmacists welcomed training on DVA, alongside organisation and system-level support, and public awareness raising on the role of community pharmacies in multisector response to DVA.
Discussion. Informed by the evidence synthesis, MRC framework and Behaviour Change Wheel, we will develop a programme theory and logic model for the adapted IRIS intervention. Professional and service user stakeholders will participate at two consultations to refine the intervention.
Conclusion. Our systematic, theory driven adaptation of IRIS to a new setting and professional group has the potential to increase intervention acceptability, feasibility, and behaviour change.