PT  - JOURNAL ARTICLE
AU  - Chang, Tammy
AU  - Moniz, Michelle H.
AU  - Plegue, Melissa A.
AU  - Shaffer, Kathryn Sage
AU  - Vance, Heather B.
AU  - Gold, Katherine J.
TI  - Patient or Clinician: Duration of Use of Intrauterine Devices Based on Who Initiated Discussion of Placement
AID  - 10.3122/jabfm.2016.01.150192
DP  - 2016 Jan 01
TA  - The Journal of the American Board of Family
                Medicine
PG  - 24--28
VI  - 29
IP  - 1
4099  - http://www.jabfm.org/content/29/1/24.short
4100  - http://www.jabfm.org/content/29/1/24.full
SO  - J Am Board Fam Med2016 Jan 01; 29
AB  - 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.