Abstract
Study Objective
To assess attendance of an initial follow-up visit after long-acting reversible contraception
(LARC) insertion and whether follow-up was associated with a higher likelihood of
method continuation in adolescents and young adults (AYAs).
Design
Retrospective chart review including patients receiving LARC (etonogestrel 68 mg implant,
levonorgestrel 52 mg intrauterine device, or copper intrauterine device) between January
1, 2014, and August 1, 2017.
Setting
An urban adolescent center providing primary care and reproductive health services.
Participants: A total of 331 patients 13-28 years of age.
Interventions
Attendance of a follow-up visit 4-8 weeks after LARC insertion.
Main Outcome Measures
Follow-up was defined as visits addressing LARC method or routine physical examinations
in the adolescent center or affiliated school-based health clinics. Continuation and
discontinuation were defined as documented presence or removal, respectively, of device
at various time points. Descriptive analyses, χ2 test, Fisher exact test, t test, and survival analysis were used.
Results
Approximately one-third (29.3%) of the patients attended a follow-up visit. Follow-up
was associated with a higher likelihood of LARC removal in the first year (hazard
ratio [HR] = 2.10, 95% confidence interval [CI] 1.33-3.32). At 500 days post-insertion
and beyond, there was no difference in LARC continuation between AYAs who followed-up
and those who did not (HR = 1.07, 95% CI 0.67-1.71).
Conclusion
Few AYAs attended an initial follow-up visit after LARC placement. These visits were
associated with an increased likelihood of LARC removal in the first year; however,
this association was not observed long term. More information is needed to determine
how to approach follow-up this population.
Key Words
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Article info
Publication history
Published online: January 21, 2021
Footnotes
The authors declare that they have no conflicts of interest.
Results of this work were selected for poster presentation at the 2020 annual meeting of the Society for Adolescent Health and Medicine scheduled for March 11, 2020. Due to the COVID-19 pandemic, the meeting was cancelled, and the poster was made available via an online platform.
Identification
Copyright
© 2021 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.
