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Long-Acting Reversible Contraception

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121. Eliminating Health Disparities in Unintended Pregnancy with Long-Acting Reversible Contraception (LARC). (PubMed)

Eliminating Health Disparities in Unintended Pregnancy with Long-Acting Reversible Contraception (LARC). Significant public health disparities exist surrounding teen and unplanned pregnancy in the United States. Women of color and those with lower education and socioeconomic status are at much greater risk of unplanned pregnancy and the resulting adverse outcomes. Unplanned pregnancies reduce educational and career opportunities and may contribute to socioeconomic deprivation and widening (...) income disparities. Long-acting reversible contraception (LARC), including intrauterine devices and implants, offer the opportunity to change the default from drifting into parenthood to planned conception. LARC methods are forgettable; once placed, they offer highly effective, long-term pregnancy prevention. Increasing evidence in the medical literature demonstrates the population benefits of use of these methods. However, barriers to more widespread use of LARC methods persist and include

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2016 American Journal of Obstetrics and Gynecology

122. It’s time to expand the use of long-acting, reversible contraceptives

It’s time to expand the use of long-acting, reversible contraceptives It's time to expand the use of long-acting, reversible contraceptives It’s time to expand the use of long-acting, reversible contraceptives | | February 10, 2016 24 Shares Quick: Which U.S. state has the highest rate of unintended pregnancy? I’ll reveal below, but I learned the answer and several other surprising facts in an with Mark Edwards, the co-founder of , a non-profit advocacy organization that provides technical (...) assistance to health enterprises (medical practices, clinics, public health departments) in the use of long-acting, reversible contraceptives (known in the trade as ). LARC consists of two options: (intrauterine devices) and — which are small, match-sized, plastic rods that deliver a slow, steady dose of hormone to prevent pregnancy. They are planted in the upper arm of women to provide another form of hassle-free contraception. Both of these methods can be discontinued at any time, at which point

2016 KevinMD blog

123. "I don't know enough to feel comfortable using them:" Women's knowledge of and perceived barriers to long acting reversible contraceptives on a college campus. (PubMed)

"I don't know enough to feel comfortable using them:" Women's knowledge of and perceived barriers to long acting reversible contraceptives on a college campus. To assess multiple dimensions of long-acting reversible contraception (LARC) knowledge and perceived multi-level barriers to LARC use among a sample of college women.We conducted an Internet-based study of 1982 female undergraduates at a large mid-western university. Our 55-item survey used a multi-level framework to measure young (...) % of LARC knowledge items correctly (mean 10.4, range 0-20), and scores differed across sociodemographic groups (p values<.04). Factors associated with scores in multivariable models included race/ethnicity, program year, sorority participation, religious affiliation and service attendance, employment status, sexual orientation and contraceptive history. Perceived barriers to IUDs included the following: not wanting a foreign object in body (44%), not knowing enough about the method (42%), preferring

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2016 Contraception

124. Committee Opinion No 672 Summary Clinical Challenges of Long-Acting Reversible Contraceptive Methods. (PubMed)

Committee Opinion No 672 Summary Clinical Challenges of Long-Acting Reversible Contraceptive Methods. Long-acting reversible contraceptive methods are the most effective reversible contraceptives and have an excellent safety record. Although uncommon, possible long-acting reversible contraceptive complications should be included in the informed consent process. Obstetrician-gynecologists and other gynecologic care providers should understand the diagnosis and management of common clinical

2016 Obstetrics and Gynecology

125. Committee Opinion No 672: Clinical Challenges of Long-Acting Reversible Contraceptive Methods. (PubMed)

Committee Opinion No 672: Clinical Challenges of Long-Acting Reversible Contraceptive Methods. Long-acting reversible contraceptive methods are the most effective reversible contraceptives and have an excellent safety record. Although uncommon, possible long-acting reversible contraceptive complications should be included in the informed consent process. Obstetrician-gynecologists and other gynecologic care providers should understand the diagnosis and management of common clinical challenges

2016 Obstetrics and Gynecology

126. Committee Opinion No. 670 Summary: Immediate Postpartum Long-Acting Reversible Contraception. (PubMed)

Committee Opinion No. 670 Summary: Immediate Postpartum Long-Acting Reversible Contraception. Immediate postpartum long-acting reversible contraception (LARC) has the potential to reduce unintended and short-interval pregnancy. Women should be counseled about all forms of postpartum contraception in a context that allows informed decision making. Immediate postpartum LARC should be offered as an effective option for postpartum contraception; there are few contraindications to postpartum

2016 Obstetrics and Gynecology

127. Committee Opinion No. 670: Immediate Postpartum Long-Acting Reversible Contraception. (PubMed)

Committee Opinion No. 670: Immediate Postpartum Long-Acting Reversible Contraception. Immediate postpartum long-acting reversible contraception (LARC) has the potential to reduce unintended and short-interval pregnancy. Women should be counseled about all forms of postpartum contraception in a context that allows informed decision making. Immediate postpartum LARC should be offered as an effective option for postpartum contraception; there are few contraindications to postpartum intrauterine

2016 Obstetrics and Gynecology

128. What qualities of long-acting reversible contraception do women perceive as desirable or undesirable? A systematic review. (PubMed)

What qualities of long-acting reversible contraception do women perceive as desirable or undesirable? A systematic review. Little research examining qualities of contraception that make them attractive or unattractive to users, particularly young women, exists. The aim of this study is to systemically review the evidence regarding desirable and undesirable qualities of long-acting reversible contraception (LARC), including intrauterine devices, the implant and the injection, as perceived (...) characteristics; and (5) perceptions and misbeliefs. Fit and forget, high efficacy and long-term protection were considered the top desirable qualities of LARC. Undesirable qualities varied among the LARC methods; however, irregular bleeding, painful insertion and removal procedure, weight gain and location in the body were among those most commonly reported. The contraceptive benefits of LARC, including their high efficacy and longevity, are generally considered to be positive qualities by women, while

2016 Sexual Health

129. Trends in Long-Acting Reversible Contraception Use in Adolescents and Young Adults: New Estimates Accounting for Sexual Experience. (PubMed)

Trends in Long-Acting Reversible Contraception Use in Adolescents and Young Adults: New Estimates Accounting for Sexual Experience. The purposes of the analysis were to compare long-acting reversible contraception (LARC) use estimates that include all reproductive age women with estimates that are limited to women at risk for unintended pregnancy and to examine trends for adolescents (15-19 years) and young adults (20-24 years).Using the 2006-2010 and 2011-2013 National Surveys of Family Growth

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2016 The Journal of Adolescent Health

130. Uptake of long-acting, reversible contraception in three remote Aboriginal communities: a population-based study. (PubMed)

Uptake of long-acting, reversible contraception in three remote Aboriginal communities: a population-based study. To assess the use, effectiveness and acceptance of prescribed contraception in three remote Western Australian Aboriginal communities.Mixed method study, including retrospective file review of contraception methods for 566 regular female Aboriginal patients, 1 November 2010 - 1 September 2014, and semi-structured interviews with 20 Aboriginal women.Primary care clinics in three (...) remote Aboriginal communities.Number of episodes of contraceptive use, effectiveness and continuation rates of prescribed contraceptive use; personal experiences, attitudes towards and beliefs about contraception options.34% of women had used contraception, ranging from 15% of women aged younger than 15 years to 55% of women aged 15-19 years. The most common forms of contraception at the census date were long-acting reversible contraceptives (LARCs): 77% of women using contraception had

2016 Medical Journal of Australia

131. Immediate Postpartum Long Acting Reversible Contraception: The Time Is Now (PubMed)

Immediate Postpartum Long Acting Reversible Contraception: The Time Is Now 27913231 2018 06 08 2018 11 13 1879-0518 95 4 2017 04 Contraception Contraception Immediate postpartum long-acting reversible contraception: the time is now. 335-338 S0010-7824(16)30511-X 10.1016/j.contraception.2016.11.007 Moniz Michelle M Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA (...) of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA. eng P30 DK092926 DK NIDDK NIH HHS United States Journal Article 2016 11 29 United States Contraception 0234361 0010-7824 0 Contraceptive Agents, Female IM Adult Contraceptive Agents, Female Female Humans Long-Acting Reversible Contraception Postpartum Period 2016 06 21 2016 11 11 2016 11 22 2016 12 4 6 0 2018 6 9 6 0 2016 12 4 6 0 ppublish

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2016 Contraception

132. Models of health behaviour predict intention to use long-acting reversible contraception (PubMed)

Models of health behaviour predict intention to use long-acting reversible contraception 27864572 2018 11 13 1745-5065 2016 Nov 18 Women's health (London, England) Womens Health (Lond) Models of health behaviour predict intention to use long acting reversible contraception use. 1745505716678231 Roderique-Davies Gareth G University of South Wales. McKnight Christine C Aneurin Bevan University Health Board. Jonn Bev B University of South Wales. Faulkner Susan S University of South Wales (...) . Lancastle Deborah D University of South Wales. eng Journal Article 2016 11 18 United States Womens Health (Lond) 101271249 1745-5057 2016 11 20 6 0 2016 11 20 6 0 2016 11 20 6 0 aheadofprint 27864572 1745505716678231 10.1177/1745505716678231 PMC5373259 Addict Behav. 2012 Jan;37(1):92-101 21945010 J Safety Res. 2004;35(1):115-23 14992852 J R Soc Med. 2007 Oct;100(10):465-8 17911129 Br J Health Psychol. 2001 Nov;6(Part 4):361-372 12614510 Contraception. 2011 May;83(5):453-8 21477689 Health Educ Res. 2007

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2016 Women's Health

133. Interdependent barriers to providing adolescents with long-acting reversible contraception (LARC): Qualitative insights from providers (PubMed)

Interdependent barriers to providing adolescents with long-acting reversible contraception (LARC): Qualitative insights from providers Long-acting reversible contraceptive (LARC) methods are the most effective form of reversible contraception but are underutilized by adolescents. The purpose of this study was to identify the context-specific barriers to providing adolescents with LARC that are experienced by pediatricians, family medicine physicians, and advanced practice nurses (APNs

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2016 Journal of pediatric and adolescent gynecology

134. Incidence of Discontinuation of Long-Acting Reversible Contraception among Adolescent and Young Adult Women Served by an Urban, Primary Care Clinic (PubMed)

Incidence of Discontinuation of Long-Acting Reversible Contraception among Adolescent and Young Adult Women Served by an Urban, Primary Care Clinic To estimate long-acting reversible contraception (LARC) discontinuation rates. Secondary aims were to determine risk factors for discontinuation, describe reasons for discontinuation, evaluate complications related to placement, and estimate pregnancy rates after discontinuation.We conducted a retrospective cohort study of LARC method use through

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2016 Journal of pediatric and adolescent gynecology

135. What Is New in Long-Acting Reversible Contraception?: Best Articles From the Past Year. (PubMed)

What Is New in Long-Acting Reversible Contraception?: Best Articles From the Past Year. This month we focus on current research in contraception and women choosing long-acting reversible contraception (LARC). Long-acting reversible contraception improves the health of women and their families. Dr. Stuart discusses four recent publications, which are concluded with a "bottom line" that is the take-home message. The articles highlighted can be used to support actions practitioners can take

2016 Obstetrics and Gynecology

136. Funding policies and postabortion long-acting reversible contraception: results from a cluster randomized trial. (PubMed)

Funding policies and postabortion long-acting reversible contraception: results from a cluster randomized trial. Almost one-half of women having an abortion in the United States have had a previous procedure, which highlights a failure to provide adequate preventive care. Provision of intrauterine devices and implants, which have high upfront costs, can be uniquely challenging in the abortion care setting.We conducted a study of a clinic-wide training intervention on long-acting reversible (...) long-acting contraceptive methods at almost twice the rate as women who paid for it themselves or with donated funds (adjusted hazard ratio, 1.94; 95% confidence interval, 1.10-3.43).The clinic-wide training increased long-acting reversible contraceptive counseling and selection but did not change initiation for abortion patients. Long-acting method use after abortion was associated strongly with funding. Restrictions on the coverage of abortion and contraceptives in abortion settings prevent

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2016 American Journal of Obstetrics and Gynecology Controlled trial quality: uncertain

137. Peer counselling for the promotion of long-acting, reversible contraception among teens: a randomised, controlled trial. (PubMed)

Peer counselling for the promotion of long-acting, reversible contraception among teens: a randomised, controlled trial. To evaluate the impact peer counselling has on same-day desire for long-acting, reversible contraception (LARC) among adolescents attending a family planning clinic.A randomised, controlled trial of 110 adolescent females attending an outpatient clinic for contraception in 2013. Adolescents received either brief peer counselling about LARC with routine contraceptive (...) counselling, or routine counselling alone. Bivariate analyses and multivariable logistic regression assessed the primary outcome of same-day desire for LARC and secondary outcomes of change in knowledge and attitudes regarding LARC.Peer counselling was well received and 70% reported that it was helpful in contraceptive decision-making. Peer counselling did not affect same-day desire for LARC, however, adolescents who received the intervention were more likely to report increased knowledge and positive

2016 The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception Controlled trial quality: predicted high

138. Long-Acting Reversible Contraception Counseling and Use for Older Adolescents and Nulliparous Women. (PubMed)

Long-Acting Reversible Contraception Counseling and Use for Older Adolescents and Nulliparous Women. The majority of pregnancies during adolescence are unintended, and few adolescents use long-acting reversible contraception (LARC) due in part to health care providers' misconceptions about nulliparous women's eligibility for the intrauterine device. We examined differences in LARC counseling, selection, and initiation by age and parity in a study with a provider's LARC training (...) intervention.Sexually active women aged 18-25 years receiving contraceptive counseling (n = 1,500) were enrolled at 20 interventions and 20 control clinics and followed for 12 months. We assessed LARC counseling and selection, by age and parity, with generalized estimated equations with robust standard errors. We assessed LARC use over 1 year with Cox proportional hazards models with shared frailty for clustering.Women in the intervention had increased LARC counseling, selection, and initiation, with similar

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2016 The Journal of Adolescent Health Controlled trial quality: uncertain

139. Factors influencing use of long-acting versus short-acting contraceptive methods among reproductive-age women in a resource-limited setting. (PubMed)

Factors influencing use of long-acting versus short-acting contraceptive methods among reproductive-age women in a resource-limited setting. Unplanned pregnancy remains a common problem in many resource-limited settings, mostly due to limited access to modern family planning (FP) services. In particular, use of the more effective long-acting reversible contraceptive (LARC) methods (i.e., intrauterine devices and hormonal implants) remains low compared to the short-acting methods (i.e., condoms (...) , hormonal pills, injectable hormones, and spermicides). Among reproductive-age women attending FP and antenatal care clinics in Uganda, we assessed perceptions and practices regarding the use of modern contraceptive methods. We specifically aimed to evaluate factors influencing method selection.We performed a mixed-methods cross-sectional study, in which we administered structured interviews to 180 clients, and conducted 4 focus group discussions (FGDs) with 36 clients and 8 in-depth personal

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2017 BMC Women's Health

140. Long-term hormonal contraceptive use is associated with a reversible suppression of antral follicle count and a break from hormonal contraception may improve oocyte yield (PubMed)

Long-term hormonal contraceptive use is associated with a reversible suppression of antral follicle count and a break from hormonal contraception may improve oocyte yield Unlike infertility, patients presenting for fertility preservation (FP) are often using combined hormonal contraceptives (CHC). We studied whether long-term (≥6 months) CHC use is associated with reversible suppression of antral follicle count (AFC).This is a longitudinal study of FP cycles from 2012 to 2016. We studied three (...) groups: those without CHC exposure (NO CHC), those with CHC usage with a CHC break (BREAK), and without a break (NO BREAK) prior to ovarian stimulation. We assessed ovarian reserve by AFC at initial consultation and discussed the possibility of CHC suppression of AFC. Patients chose between ovarian stimulation with no CHC break versus ovarian stimulation after a CHC break. AFC was measured serially in the BREAK group. We assessed whether AFC suppression was reversed in the BREAK group. Total oocyte

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2017 Journal of assisted reproduction and genetics

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