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Frequency of 6-week follow-up appointment scheduling after intrauterine device insertion
  1. Abigail Bernard,
  2. Catherine L Satterwhite,
  3. Madhuri Reddy
  1. School of Medicine, University of Kansas, Kansas City, Missouri, USA
  1. Correspondence to Abigail Bernard, School of Medicine, University of Kansas, Kansas City, MO 66160, USA; abernard3{at}kumc.edu

Abstract

Introduction Long-acting reversible contraception (LARC) is widely recommended to reduce unintended pregnancy in the USA. As intrauterine device (IUD) use increases, evaluating the role of post-insertion follow-up is important.

Methods A retrospective patient record review was conducted to assess the follow-up experience of women who had an IUD placed at the University of Kansas Medical Center from 1 January to 30 June 2015. Data were collected on patient demographics, IUD placement, follow-up visit attendance, and outcomes in the 12 months following placement. The primary outcome of interest was the proportion of patients who attended a 6-week follow-up visit. Secondary outcomes included adverse events detected at the 6-week visit and IUD removal within a year of placement.

Results Among 380 women who had an IUD inserted, physician documentation of a recommended 6-week follow-up visit was present in 91.3% of patient medical records. Two-thirds (66.6%) of patients receiving a recommendation returned for a follow-up visit. Of the 380 women who had an IUD placed, 66 (17.4%) had their IUD removed within 1 year of placement. Of those, 50 women attended the 6-week follow-up visit and 16 did not (19.8% vs 12.6%, p=0.08). Of the IUD removals, 14 occurred at the 6-week visit. After excluding IUD removals which occurred at the 6-week visit, attending a 6-week follow-up visit was not associated with IUD removal or retention (p=0.52).

Conclusion Despite recommendations to forgo the 6-week follow-up visit, visits were still common, with no demonstrated value added.

  • long-acting reversible contraception
  • intrauterine device insertion
  • iud
  • iud removal

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Footnotes

  • Contributors AB and CLS planned the study. MR provided clinical study oversight and facilitated access to electronic medical records. AB collected the data. AB and CLS performed data analysis. AB prepared the manuscript, and CLS and MR provided manuscript feedback. AB submitted the manuscript. CLS oversaw all study processes and outcomes.

  • Funding This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

  • Competing interests None declared.

  • Ethics approval Institutional Review Board (IRB)

  • Provenance and peer review Not commissioned; externally peer reviewed.

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