Patient or Clinician: Duration of Use of Intrauterine Devices Based on Who Initiated Discussion of Placement

J Am Board Fam Med. 2016 Jan-Feb;29(1):24-8. doi: 10.3122/jabfm.2016.01.150192.

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.

Keywords: Intrauterine Devices; Physician–Patient Relations; Social Networks.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Communication
  • Contraceptive Agents, Female / administration & dosage
  • Contraceptive Agents, Female / adverse effects
  • Counseling
  • Female
  • Humans
  • Intrauterine Devices, Medicated / adverse effects
  • Intrauterine Devices, Medicated / statistics & numerical data*
  • Levonorgestrel / administration & dosage
  • Linear Models
  • Medical Records
  • Patient Preference / psychology
  • Patient Preference / statistics & numerical data*
  • Physician-Patient Relations
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Pregnancy
  • Retrospective Studies
  • Time Factors
  • United States

Substances

  • Contraceptive Agents, Female
  • Levonorgestrel