Patient or Clinician: Duration of Use of Intrauterine Devices Based on Who Initiated Discussion of Placement

Journal of the American Board of Family Medicine : JABFM
Tammy ChangKatherine J Gold

Abstract

Although safe and effective, intrauterine devices (IUDs) are underutilized in the United States. The objective of this study was to determine whether patient- and clinician-initiated discussions were associated with the duration of Mirena (52 mg levonorgestrel-releasing) IUD use. Retrospective chart review identified Mirena IUDs that were placed and removed for reasons other than the desire for pregnancy from January 1, 2005, to January 1, 2012, at 1 academic center (n = 148). Multivariable linear regression examined the independent association between duration of use and source of discussion initiation. IUDs placed after patient-initiated discussions were used for 473 days longer than those placed after clinician-initiated discussions (P < .001). Patient-initiated discussions of Mirena IUDs are associated with a significantly longer duration of use. Patient influences outside the clinical encounter may be important in optimizing use.

Citations

Sep 25, 2017·Current Opinion in Obstetrics & Gynecology·Gillian B Schivone, Laura L Glish
Jul 23, 2021·Obstetrics and Gynecology·UNKNOWN American College of Obstetricians and Gynecologists’ Committee on Health Care for Underserved Women,and the Contraceptive Eq

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