RT Journal Article SR Electronic T1 Evidence-Based Selection of Candidates for the Levonorgestrel Intrauterine Device (IUD) JF The Journal of the American Board of Family Medicine JO J Am Board Fam Med FD American Board of Family Medicine SP 26 OP 33 DO 10.3122/jabfm.2014.01.130142 VO 27 IS 1 A1 Lisa S. Callegari A1 Blair G. Darney A1 Emily M. Godfrey A1 Olivia Sementi A1 Rebecca Dunsmoor-Su A1 Sarah W. Prager YR 2014 UL http://www.jabfm.org/content/27/1/26.abstract AB Background: Recent evidence-based guidelines expanded the definition of appropriate candidates for the levonorgestrel-releasing intrauterine system (LNG-IUS). We investigated correlates of evidence-based selection of candidates for the LNG-IUS by physicians who offer insertion. Methods: We conducted a mixed-mode (online and mail) survey of practicing family physicians and obstetrician-gynecologists in Seattle. Results: A total of 269 physicians responded to the survey (44% response rate). Of the 217 respondents who inserted intrauterine devices, half or fewer routinely recommended the LNG-IUS to women who are nulliparous, younger than 20 years old, or have a history of sexually transmitted infections (STIs). In multivariable analyses, training/resident status was positively associated with recommending the LNG-IUS to women <20 years old (adjusted odds ratio [aOR], 3.6; 95% confidence interval [CI], 1.6–8.0) and women with history of STI (aOR, 3.7; 95% CI, 1.6–8.4). Perceived risk of infection or infertility was negatively associated with recommending the LNG-IUS to nulliparous women (aOR, 0.2; 95% CI, 0.1–0.5) and women with a history of STI (aOR, 0.3; 95% CI, 0.1–0.8). Conclusions: Many family physicians and obstetrician-gynecologists who insert the LNG-IUS are overly restrictive in selecting candidates, although those who train residents are more likely to follow evidence-based guidelines. Interventions that address negative bias and perceptions of risks, in addition to improving knowledge, are needed to promote wider use of the LNG-IUS.