RT Journal Article
SR Electronic
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
FD American Board of Family Medicine
SP 24
OP 28
DO 10.3122/jabfm.2016.01.150192
VO 29
IS 1
A1 Tammy Chang
A1 Michelle H. Moniz
A1 Melissa A. Plegue
A1 Kathryn Sage Shaffer
A1 Heather B. Vance
A1 Katherine J. Gold
YR 2016
UL http://www.jabfm.org/content/29/1/24.abstract
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.