Frequency of 6-week follow-up appointment scheduling after intrauterine device insertion. Issue 1 (16th November 2017)

• Record Type: Journal Article
• Authors: Bernard, Abigail; Satterwhite, Catherine L; Reddy, Madhuri
• Is Part Of: BMJ sexual & reproductive health. Volume 44:Issue 1(2018)
• Page Start: 33
• Page End: 36
• Publication Date: 2017-11-16
• Subjects: long-acting reversible contraception -- intrauterine device insertion -- iud -- iud removal; Reproductive health -- Periodicals; Sexual health -- Periodicals; Birth control -- Periodicals; Contraception -- Periodicals; 613.905
• DOI: 10.1136/bmjsrh-2017-101791
• Languages: English
• ISSNs: 2515-1991

Abstract

Abstract : Introduction: Long-acting reversible contraception (LARC) is widely recommended to reduce unintended pregnancy in the USA. As intrauterine device (IUD) use increases, evaluating the role of post-insertion follow-up is important. Methods: A retrospective patient record review was conducted to assess the follow-up experience of women who had an IUD placed at the University of Kansas Medical Center from 1 January to 30 June 2015. Data were collected on patient demographics, IUD placement, follow-up visit attendance, and outcomes in the 12 months following placement. The primary outcome of interest was the proportion of patients who attended a 6-week follow-up visit. Secondary outcomes included adverse events detected at the 6-week visit and IUD removal within a year of placement. Results: Among 380 women who had an IUD inserted, physician documentation of a recommended 6-week follow-up visit was present in 91.3% of patient medical records. Two-thirds (66.6%) of patients receiving a recommendation returned for a follow-up visit. Of the 380 women who had an IUD placed, 66 (17.4%) had their IUD removed within 1 year of placement. Of those, 50 women attended the 6-week follow-up visit and 16 did not (19.8% vs 12.6%, p=0.08). Of the IUD removals, 14 occurred at the 6-week visit. After excluding IUD removals which occurred at the 6-week visit, attending a 6-week follow-up visit was not associated with IUD removal or retention (p=0.52). Conclusion: Despite recommendations to forgo the 6-week follow-up visit, visits were still common, with no demonstrated value added.