For a study, researchers sought to report on the Adolescent Medicine LARC Collaborative’s long-acting reversible contraception (LARC) experience and retention rates. LARC insertion data (682 implants and 681 IUDs) were gathered prospectively across three Adolescent Medicine offices from January 1, 2017, to December 31, 2019. Follow-up data until December 31, 2020, were added to guarantee that the cohort was followed for at least one year. Overall and per the Adolescent Medicine site, continuation rates were computed at 1, 2, and 3 years, as were descriptive statistics for LARC procedural complications and patient experience.
Complications from implant and IUD implantation were infrequent and mostly self-limiting, with no IUD-related uterine perforations. Uterine hemorrhage was the most often reported worry at follow-up (35% implant, 25% IUD), and it was a major reason for device removal early on (45% of implant removals, 32% of IUD removals). IUD malposition or ejection occurred after 6% of all insertions. At one year, the pooled implant continuation rate was 87% (range, 86% -91% across sites; P=.63), 66% at two years (range, 62% -84%; P=.01), and 42% at three years (range, 36% -60%; P=.004). At one year, the pooled IUD continuation rate was 88%(range, 87% -90% across sites; P=.82), 77% at two years (range, 76%-78%; P=.94), and 60% at three years (range, 57% -62%; P=.88).
LARC was successfully delivered in Adolescent Medicine clinical settings, with retention rates comparable to well-funded clinical studies. Because uterine hemorrhage is frequent following LARC implantation, counseling was essential. Future studies will look at whether medical therapy for LARC-related nuisance bleeding promotes patient retention in the Adolescent Medicine clinic.
Reference:www.jpeds.com/article/S0022-3476(21)01238-5/fulltext
