This study uses data from clinical trials of intrauterine devices to examine the effect of reducing the recommended number of IUD follow-up visits. Over 11,000 follow-up forms were analyzed to estimate the number of health problems that would have escaped detection if women with no or mild symptoms had not made recommended revisits. Less than one percent of woman-visits with no or only mild symptoms had an underlying health risk that could have gone undetected if the follow-up visits that were made in the clinic trial setting had not been made. The results from this analysis suggest that a reduction in the number of recommended follow-up visits is safe, when measured according to selected conditions. Additional research is necessary to determine whether any revisits should be recommended in the absence of signs or symptoms.
PIP: International Program in Population and Family Planning, Pathfinder International, and other organizations providing support to family planning organizations in developing countries, generally recommend that women who use intrauterine devices (IUDs) go for an initial revisit at four to six weeks postinsertion, a second revisit at one year, and subsequent revisits at yearly intervals. However, ministries of health and family planning organizations in developing countries generally recommend more frequent revisits. This study examined the effect of reducing the recommended number of IUD follow-up visits using data from clinical trials of the TCu380A and other widely used IUDs conducted by Family Health International (FHI) during 1986-89. The clinical studies were conducted in 13 clinics in 9 countries (Cameroon, Egypt, El Salvador, Mexico, Pakistan, Peru, Philippines, Sri Lanka, and Venezuela) among sexually active and healthy women aged 18-40. Over 11,000 follow-up forms were analyzed to estimate the number of health problems that would escape detection if women with no or mild symptoms had not made recommended visits. Less than 1% of woman-visits with no or only mild symptoms had an underlying health risk that could have gone undetected if the follow-up visits that were made in the clinic trial setting had not been made. Results suggest that a reduction in the number of recommended follow-up visits is safe, when measured according to selected conditions. Clinic policy and practice in family planning probably could move toward encouraging fewer recommended follow-up visits, while simultaneously encouraging those who feel they need assistance to seek medical attention. Additional research is, however, needed to determine whether any revisits should be recommended in the absence of sign and symptoms.