Patient or Clinician: Duration of Use of Intrauterine Devices Based on Who Initiated Discussion of Placement.
retrospective_cohort · Level III
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- Record sourced from PubMed, PMID 26769874.
- Also identified by DOI 10.3122/jabfm.2016.01.150192.
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Abstract
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.