Your browser doesn't support javascript.
loading
Evidence-based selection of candidates for the levonorgestrel intrauterine device (IUD).
Callegari, Lisa S; Darney, Blair G; Godfrey, Emily M; Sementi, Olivia; Dunsmoor-Su, Rebecca; Prager, Sarah W.
Afiliação
  • Callegari LS; the Departments of Obstetrics and Gynecology and Family Medicine and the Departments of Epidemiology and Department of Health Services, School of Public Health, University of Washington, Seattle; the Departments of Medical Informatics and Clinical Epidemiology and Obstetrics and Gynecology, Oregon Health & Science University, Portland.
J Am Board Fam Med ; 27(1): 26-33, 2014.
Article em En | MEDLINE | ID: mdl-24390883
ABSTRACT

BACKGROUND:

Recent evidence-based guidelines expanded the definition of appropriate candidates for the levonorgestrel-releasing intrauterine system (LNG-IUS). We investigated correlates of evidence-based selection of candidates for the LNG-IUS by physicians who offer insertion.

METHODS:

We conducted a mixed-mode (online and mail) survey of practicing family physicians and obstetrician-gynecologists in Seattle.

RESULTS:

A total of 269 physicians responded to the survey (44% response rate). Of the 217 respondents who inserted intrauterine devices, half or fewer routinely recommended the LNG-IUS to women who are nulliparous, younger than 20 years old, or have a history of sexually transmitted infections (STIs). In multivariable analyses, training/resident status was positively associated with recommending the LNG-IUS to women <20 years old (adjusted odds ratio [aOR], 3.6; 95% confidence interval [CI], 1.6-8.0) and women with history of STI (aOR, 3.7; 95% CI, 1.6-8.4). Perceived risk of infection or infertility was negatively associated with recommending the LNG-IUS to nulliparous women (aOR, 0.2; 95% CI, 0.1-0.5) and women with a history of STI (aOR, 0.3; 95% CI, 0.1-0.8).

CONCLUSIONS:

Many family physicians and obstetrician-gynecologists who insert the LNG-IUS are overly restrictive in selecting candidates, although those who train residents are more likely to follow evidence-based guidelines. Interventions that address negative bias and perceptions of risks, in addition to improving knowledge, are needed to promote wider use of the LNG-IUS.
Assuntos
Palavras-chave

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Qualitative_research Limite: Female / Humans / Male Idioma: En Ano de publicação: 2014 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Qualitative_research Limite: Female / Humans / Male Idioma: En Ano de publicação: 2014 Tipo de documento: Article