TY - JOUR T1 - Patient or Clinician: Duration of Use of Intrauterine Devices Based on Who Initiated Discussion of Placement JF - The Journal of the American Board of Family Medicine JO - J Am Board Fam Med SP - 24 LP - 28 DO - 10.3122/jabfm.2016.01.150192 VL - 29 IS - 1 AU - Tammy Chang AU - Michelle H. Moniz AU - Melissa A. Plegue AU - Kathryn Sage Shaffer AU - Heather B. Vance AU - Katherine J. Gold Y1 - 2016/01/01 UR - http://www.jabfm.org/content/29/1/24.abstract N2 - Background: 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.Methods: 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.Results: IUDs placed after patient-initiated discussions were used for 473 days longer than those placed after clinician-initiated discussions (P < .001).Conclusion: 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. ER -