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Long-Acting Reversible Contraception

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61. Opportunity, satisfaction, and regret: Trying long-acting reversible contraception in a unique scientific circumstance. (PubMed)

Opportunity, satisfaction, and regret: Trying long-acting reversible contraception in a unique scientific circumstance. Increased use of long-acting reversible contraception (LARC) can reduce unintended pregnancies. However, significant barriers exist to LARC uptake, particularly high up-front costs. In North Carolina in 2014, we interviewed thirty-four purposively selected participants (aged 20-30 years) enrolled in a partially randomized patient preference trial to learn about (...) their experiences with and attitudes toward contraception in this unique trial context. Cost of LARC was important in participants' decision-making. Experiencing an unintended pregnancy motivated women to switch to LARC. No participants who tried LARC, even those who experienced side effects, regretted it. Several participants regretted discontinuing their LARC. Concerns about insertion and removal did not influence future willingness to try LARC. Participants discussed the importance of affordability

2018 Women & health

62. Access to long-acting reversible contraception among US publicly- funded health centers. (PubMed)

Access to long-acting reversible contraception among US publicly- funded health centers. Access to a full range of contraceptive methods, including long-acting reversible contraception (LARC), is central to providing quality family planning services. We describe health center-related factors associated with LARC availability, including staff training in LARC insertion/removal and approaches to offering LARC, whether onsite or through referral.We analyzed nationally representative survey data (...) collected during 2013-2014 from administrators of publicly funded U.S. health centers that offered family planning. The response rate was 49.3% (n=1615). In addition to descriptive statistics, we used multivariable logistic regression to identify health center characteristics associated with offering both IUDs and implants onsite.Two-thirds (64%) of health centers had staff trained in all three LARC types (hormonal IUD, copper IUD, implant); 21% had no staff trained in any of those contraceptive methods

2017 Contraception

63. Condom Use and Incident Sexually Transmitted Infection after Initiation of Long-Acting Reversible Contraception. (PubMed)

Condom Use and Incident Sexually Transmitted Infection after Initiation of Long-Acting Reversible Contraception. Use of more effective contraception may lead to less condom use and increased incidence of sexually transmitted infection.The objective of this study was to compare changes in condom use and incidence of sexually transmitted infection acquisition among new initiators of long-acting reversible contraceptives to those initiating non-long-acting reversible contraceptive methods.This (...) is a secondary analysis of the Contraceptive CHOICE Project. We included 2 sample populations of 12-month continuous contraceptive users. The first included users with complete condom data (baseline, and 3, 6, and 12 months) (long-acting reversible contraceptive users: N = 2371; other methods: N = 575). The second included users with 12-month sexually transmitted infection data (long-acting reversible contraceptive users: N = 2102; other methods: N = 592). Self-reported condom use was assessed at baseline

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2017 American Journal of Obstetrics and Gynecology

64. Using a multi-state Learning Community as an implementation strategy for immediate postpartum long-acting reversible contraception. (PubMed)

Using a multi-state Learning Community as an implementation strategy for immediate postpartum long-acting reversible contraception. Implementation strategies are imperative for the successful adoption and sustainability of complex evidence-based public health practices. Creating a learning collaborative is one strategy that was part of a recently published compilation of implementation strategy terms and definitions. In partnership with the Centers for Disease Control and Prevention and other (...) partner agencies, the Association of State and Territorial Health Officials recently convened a multi-state Learning Community to support cross-state collaboration and provide technical assistance for improving state capacity to increase access to long-acting reversible contraception (LARC) in the immediate postpartum period, an evidence-based practice with the potential for reducing unintended pregnancy and improving maternal and child health outcomes. During 2015-2016, the Learning Community

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2017 Implementation Science

65. Practice Bulletin No. 186 Summary: Long-Acting Reversible Contraception: Implants and Intrauterine Devices. (PubMed)

Practice Bulletin No. 186 Summary: Long-Acting Reversible Contraception: Implants and Intrauterine Devices. Intrauterine devices and contraceptive implants, also called long-acting reversible contraceptives (LARC), are the most effective reversible contraceptive methods. The major advantage of LARC compared with other reversible contraceptive methods is that they do not require ongoing effort on the part of the patient for long-term and effective use. In addition, after the device is removed (...) , the return of fertility is rapid (1, 2). The purpose of this Practice Bulletin is to provide information for appropriate patient selection and evidence-based recommendations for LARC initiation and management. The management of clinical challenges associated with LARC use is beyond the scope of this document and is addressed in Committee Opinion No. 672, Clinical Challenges of Long-Acting Reversible Contraceptive Methods (3).

2017 Obstetrics and Gynecology

66. Practice Bulletin No. 186: Long-Acting Reversible Contraception: Implants and Intrauterine Devices. (PubMed)

Practice Bulletin No. 186: Long-Acting Reversible Contraception: Implants and Intrauterine Devices. Intrauterine devices and contraceptive implants, also called long-acting reversible contraceptives (LARC), are the most effective reversible contraceptive methods. The major advantage of LARC compared with other reversible contraceptive methods is that they do not require ongoing effort on the part of the patient for long-term and effective use. In addition, after the device is removed (...) , the return of fertility is rapid (1, 2). The purpose of this Practice Bulletin is to provide information for appropriate patient selection and evidence-based recommendations for LARC initiation and management. The management of clinical challenges associated with LARC use is beyond the scope of this document and is addressed in Committee Opinion No. 672, Clinical Challenges of Long-Acting Reversible Contraceptive Methods (3).

2017 Obstetrics and Gynecology

67. Comparing Long-Acting Reversible Contraception Insertion Rates in Women with Medicaid vs. Private Insurance in a Clinic with a Two-visit Protocol. (PubMed)

Comparing Long-Acting Reversible Contraception Insertion Rates in Women with Medicaid vs. Private Insurance in a Clinic with a Two-visit Protocol. This study examined whether women with Medicaid are less likely to receive long-acting reversible contraception (LARC) in a clinic requiring two visits for insertion.LARC insertion and pregnancy rates were compared among women with Medicaid vs. private insurance, along with other predictors, in a retrospective chart review (N=447).Univariately, fewer

2017 Contraception

68. Long-acting Reversible Contraception Among Homeless Women Veterans With Chronic Health Conditions: A Retrospective Cohort Study. (PubMed)

Long-acting Reversible Contraception Among Homeless Women Veterans With Chronic Health Conditions: A Retrospective Cohort Study. US women Veterans are at increased risk of homelessness and chronic health conditions associated with unintended pregnancy. Veterans Health Administration (VHA) provision of long-acting reversible contraception (LARC) can assist in healthy pregnancy planning.To evaluate perinatal risk factors and LARC exposure in ever-homeless women Veterans.A retrospective cohort

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2017 Medical Care

69. Inpatient Postpartum Long-Acting Reversible Contraception: Care That Promotes Reproductive Justice. (PubMed)

Inpatient Postpartum Long-Acting Reversible Contraception: Care That Promotes Reproductive Justice. Inpatient insertion of long-acting reversible contraceptives (LARC) (intrauterine devices and implants) is increasingly offered to women immediately after childbirth. Enthusiasm for this approach stems from robust safety, effectiveness, and cost-effectiveness data and responsiveness to women's needs and preferences. Although clinical evidence for immediate postpartum LARC is well-established (...) , the ethical implications of enhancing access to this care have not been fully considered. Contraceptive policies and practices often embody a tension between fostering liberal availability and potentially coercive promotion of some methods. Historical contraceptive policies and contemporary disparities in LARC use point to the need to consider whether health policies and health care practices support all women's reproductive wishes. Immediate postpartum LARC services need to be designed and implemented

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2017 Obstetrics and Gynecology

70. Long-Acting Reversible Contraception Initiation With a 2- to 3-Week Compared With a 6-Week Postpartum Visit. (PubMed)

Long-Acting Reversible Contraception Initiation With a 2- to 3-Week Compared With a 6-Week Postpartum Visit. To evaluate whether a department policy changing the scheduling of the postpartum visit from 6 weeks to 2-3 weeks after delivery is associated with higher long-acting reversible contraception initiation at the postpartum visit.We conducted a quasiexperimental before-after study to evaluate long-acting reversible contraception initiation, specifically an intrauterine device (...) after delivery to assess contraception use and repeat pregnancies.We enrolled 586 participants between December 2014 and November 2015, of whom 512 women (256 in each cohort) continued to meet eligibility criteria after delivery. Long-acting reversible contraception initiation rates at the postpartum visit were lower in the 2- to 3-week (16.5%, 95% CI 12.2-21.8) compared with the 6-week group (31.1%, 95% CI 25.2-37.7, P<.01), primarily as a result of patient and health care provider preferences

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2017 Obstetrics and Gynecology

71. Revolving Loan Fund: A Novel Approach to Increasing Access to Long-Acting Reversible Contraception Methods in Community Health Centers. (PubMed)

Revolving Loan Fund: A Novel Approach to Increasing Access to Long-Acting Reversible Contraception Methods in Community Health Centers. The aim of this study was to assess the impact of a revolving loan fund (RLF) on timing of device insertion and long-acting reversible contraception (LARC) access among a high-risk urban population at 3 Boston community health centers.Three health centers were identified to implement a RLF. Each clinic received $5000 from the RLF to purchase LARC devices. Data

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2017 Journal of Public Health Management and Practice

72. Knowledge of and concerns about long-acting reversible contraception among women in medication-assisted treatment for opioid use disorder. (PubMed)

Knowledge of and concerns about long-acting reversible contraception among women in medication-assisted treatment for opioid use disorder. To assess interest in, concerns about and knowledge of long-acting reversible contraceptives (LARC) among women in medication-assisted treatment (MAT) for opioid use disorder who were at risk for unintended pregnancy.Women in MAT completed a survey on contraceptive use, attitudes and knowledge, including LARC methods, as part of eligibility screening (...) of implants relative to other reversible methods.Participants reported relatively low interest in LARCs. Many women had unspecified reasons for not using LARCs. Participants also lacked information about LARC safety and effectiveness, especially with regard to implants.Women in medication-assisted treatment for opioid use disorder are at high risk of unintended pregnancy, yet contraceptive use is low and use of less effective methods is common. Women in MAT may benefit from efforts to increase knowledge

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2017 Contraception

73. Long-Acting Reversible Contraception for Adolescents: A Review. (PubMed)

Long-Acting Reversible Contraception for Adolescents: A Review. Adolescents have higher rates of unintended pregnancies than any other age group. Contraceptive implants and intrauterine devices (IUDs) are long-acting reversible contraceptives (LARCs) that are known to be highly effective in preventing pregnancy. New devices have recently been approved for use in adolescents, yet pediatricians may be less familiar with how to counsel adolescents about implants and IUDs.LARC methods should (...) be described in basic terms to adolescents, including hormone dose, method of insertion, and method of pregnancy prevention. Clinicians should appreciate the developmental stages of adolescents, discuss the most effective methods of contraception, and ensure confidentiality from their parents. Short-acting contraception methods (eg, oral contraceptives) can be used as a temporary bridge to provide coverage until a LARC method can be placed. The most common adverse effect of LARC is nuisance bleeding, which

2017 JAMA pediatrics

74. The relationship between area deprivation and prescription of long-acting reversible contraception in women of reproductive age in Lothian, Scotland, UK. (PubMed)

The relationship between area deprivation and prescription of long-acting reversible contraception in women of reproductive age in Lothian, Scotland, UK. Reducing unplanned pregnancy in Scotland is a key government objective. Long-acting reversible contraception (LARC) is a cost-effective way to reduce unintended pregnancy. Abortion and teenage pregnancy rates are highest in the most deprived areas. One possible explanation could be contraceptive prescribing inequality. This study examined (...) the relationship between area deprivation measured by the Scottish Index of Multiple Deprivation and LARC prescription.Using Scottish electronic prescribing data from primary care and sexual and reproductive health clinics, this study analysed female Lothian residents with a valid postcode aged 16-49 years who received a contraceptive prescription from 1 April 2012 to 31 March 2014. Prescription of LARC (intrauterine, implant or injectable contraceptive) compared with non-LARC (oral pill, patch, ring

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2017 Journal of Family Planning and Reproductive Health Care

75. Inpatient Postpartum Long-Acting Reversible Contraception and Sterilization in the United States, 2008-2013. (PubMed)

Inpatient Postpartum Long-Acting Reversible Contraception and Sterilization in the United States, 2008-2013. To measure rates of long-acting reversible contraception (LARC), including intrauterine devices and contraceptive implants, and tubal sterilization during delivery hospitalizations and correlates of their use.This retrospective cohort study used the 2008-2013 National Inpatient Sample, a publicly available all-payer database. We identified delivery hospitalizations with the International (...) 22,667,204 delivery hospitalizations. Long-acting reversible contraception insertion increased from 1.86 per 10,000 deliveries (2008-2009) to 13.5 per 10,000 deliveries (2012-2013; P<.001); tubal sterilization remained stable (711-683 per 10,000 deliveries; P=.24). In multivariable analysis adjusting for all predictors, compared with neither LARC nor sterilization, LARC use was highest among women with medical comorbidities (count per 10,000 deliveries: 15.04, standard error 2.11, adjusted odds ratio

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2017 Obstetrics and Gynecology

76. Long-acting reversible contraception: conflicting perspectives of advocates and potential users. (PubMed)

Long-acting reversible contraception: conflicting perspectives of advocates and potential users. 28432718 2018 12 11 2018 12 11 1471-0528 124 10 2017 Sep BJOG : an international journal of obstetrics and gynaecology BJOG Long-acting reversible contraception: conflicting perspectives of advocates and potential users. 1474-1476 10.1111/1471-0528.14699 Rowlands S S Centre of Postgraduate Medical Research and Education, Bournemouth University, Bournemouth, UK. Ingham R R Centre for Sexual Health (...) Research, University of Southampton, Southampton, UK. eng Journal Article 2017 06 05 England BJOG 100935741 1470-0328 0 Contraceptive Agents, Female AIM IM Contraception Behavior psychology Contraceptive Agents, Female therapeutic use Female Humans Long-Acting Reversible Contraception psychology Pregnancy 2017 04 18 2017 4 23 6 0 2018 12 12 6 0 2017 4 23 6 0 ppublish 28432718 10.1111/1471-0528.14699

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2017 BJOG

77. Comparing Effectiveness of Active and Passive Client Follow-Up Approaches in Sustaining the Continued Use of Long Acting Reversible Contraceptives (LARC) in Rural Punjab: A Multicentre, Non-Inferiority Trial. (PubMed)

Comparing Effectiveness of Active and Passive Client Follow-Up Approaches in Sustaining the Continued Use of Long Acting Reversible Contraceptives (LARC) in Rural Punjab: A Multicentre, Non-Inferiority Trial.

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2016 PLoS ONE

78. Long-Acting Reversible Contraceptive Placement Among Active-Duty U.S. Army Servicewomen. (PubMed)

Long-Acting Reversible Contraceptive Placement Among Active-Duty U.S. Army Servicewomen. To quantify uptake of long-acting reversible contraceptives (LARC)-intrauterine devices (IUDs) and hormonal implants-among U.S. Army active-duty female soldiers and identify characteristics associated with uptake.This retrospective cohort study used the Stanford Military Data Repository, which includes all digitally recorded health encounters for active-duty U.S. Army soldiers from 2011 to 2014. We analyzed (...) safety and reversibility in a population facing unique consequences for unintended pregnancies.

2017 Obstetrics and Gynecology

79. Long-Acting Reversible Contraception: An Important Solution to Reduce Unintended Pregnancy. (PubMed)

Long-Acting Reversible Contraception: An Important Solution to Reduce Unintended Pregnancy. 28284931 2018 01 26 2018 01 26 1097-6868 216 5 2017 05 American journal of obstetrics and gynecology Am. J. Obstet. Gynecol. Long-acting reversible contraception: an important solution to reduce unintended pregnancy. 539 S0002-9378(17)30415-5 10.1016/j.ajog.2017.03.004 Nelson Anita L AL Department of Obstetrics and Gynecology, Western University of Health Sciences, Pomona, CA; David Geffen School (...) of Medicine at UCLA, Los Angeles, CA. Kaunitz Andrew M AM Department of Obstetrics and Gynecology, University of Florida College of Medicine-Jacksonville, Jacksonville, FL. eng Journal Article Research Support, Non-U.S. Gov't 2017 03 08 United States Am J Obstet Gynecol 0370476 0002-9378 AIM IM Female Humans Long-Acting Reversible Contraception Pregnancy Pregnancy, Unplanned 2017 3 13 6 0 2018 1 27 6 0 2017 3 13 6 0 ppublish 28284931 S0002-9378(17)30415-5 10.1016/j.ajog.2017.03.004

2017 American Journal of Obstetrics and Gynecology

80. Exploring the Uptake of Long-Acting Reversible Contraception in South Dakota Women and the Importance of Provider Education (PubMed)

Exploring the Uptake of Long-Acting Reversible Contraception in South Dakota Women and the Importance of Provider Education Long-acting reversible contraception (LARC) methods, including the intrauterine device (IUD) and the birth control implant, are the most effective form of prescribed birth control for pregnancy prevention. However, uptake of this highly effective form of birth control is slow. The purpose of this study was to explore use of the LARC methods in South Dakota women prescribed (...) contraception and the importance of the provider in promoting this type of contraception.This was a cross-sectional study of female patients who had been prescribed contraception at one of five locations in a South Dakota hospital system. Records were obtained through electronic health records for a six-month period. Descriptive analysis was performed using chi-square with counts and percentages. Logistic regression was used to determine differences in LARC prescriptions by patient age and provider title.A

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2017 South Dakota medicine : the journal of the South Dakota State Medical Association

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