Discontinuation of long-acting reversible contraception: a retrospective Dutch study in general practice.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2024-10-18 DOI:10.1080/13625187.2024.2415361

Theodora A M Teunissen, Antoinette L M Lagro-Janssen, Demi Sturkenboom, Reinier P Akkermans, Annemarie A Uijen

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Abstract

Background: In the Netherlands, the use of long-acting reversible contraception (LARC) methods increases. Studies show high premature discontinuation rates of LARCs, but comprehensive insights into the Dutch situation remain limited.

Aim: The aim of this study is to determine (1) the rate and reasons of discontinuation of different types of LARC in the first 2.5 years of use and (2) what patient characteristics are associated with premature discontinuation.

Design and setting: Retrospective cohort study utilising data from a Dutch primary care research network.

Methods: We included all women who received a LARC between 2017 and 2019 with a 2.5-year follow-up period. We performed a descriptive analysis, Kaplan Meier and logistic regression analysis to answer the research questions.

Results: We included 642 women. In total, 166 women (25.9%) discontinued their LARC within 2.5 years. Discontinuation rates were 22% for levonorgestrel intra-uterine systems (LNG-IUS) 52 mg, 25% for LNG-IUS 19.5 mg, 39% for copper IUDs and 47% for subdermal implants. Common reasons for discontinuation were: alterations in bleeding pattern (68%), abdominal pain (32%), headache or mood fluctuation (24%) and a preference for natural contraceptive methods (23%). Factors associated with discontinuation for reasons other than pregnancy wish were: age between 30 and 34 years old (OR 5.1, 95% CI [1.26-20.48]) and a history of sexual, physical and/or psychological abuse (OR 3.16, 95% CI [1.60-6.23]). A high educational level (OR 0.33, 95% CI [0.12-0.89]) was associated with a lower risk of discontinuation.

Conclusion: The discontinuation rates of LARCs are high. Better counselling might prevent premature discontinuation.

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长效可逆避孕药的停用：荷兰全科医生的一项回顾性研究。

背景：在荷兰，长效可逆避孕法（LARC）的使用率不断上升。研究表明，LARC 的过早停用率很高，但对荷兰情况的全面了解仍然有限。目的：本研究旨在确定（1）不同类型的 LARC 在使用最初 2.5 年内的停用率和原因，以及（2）与过早停用相关的患者特征：利用荷兰初级保健研究网络的数据进行回顾性队列研究：我们纳入了所有在 2017 年至 2019 年期间接受 LARC 的女性，随访期为 2.5 年。我们进行了描述性分析、卡普兰-梅耶尔分析和逻辑回归分析，以回答研究问题：我们纳入了 642 名妇女。共有 166 名妇女（25.9%）在 2.5 年内中止了 LARC。52毫克左炔诺孕酮宫内节育器（LNG-IUS）的停用率为22%，19.5毫克LNG-IUS的停用率为25%，铜质宫内节育器的停用率为39%，皮下埋植剂的停用率为47%。常见的停药原因包括：出血模式改变（68%）、腹痛（32%）、头痛或情绪波动（24%）以及倾向于自然避孕方法（23%）。除希望怀孕外，与因其他原因中止避孕相关的因素有：年龄在 30 至 34 岁之间（OR 值为 5.1，95% CI [1.26-20.48]），有性虐待、身体虐待和/或心理虐待史（OR 值为 3.16，95% CI [1.60-6.23]）。高教育水平（OR 0.33，95% CI [0.12-0.89]）与较低的停药风险相关：结论：LARCs 的停用率很高。结论：LARCs 的停用率很高，更好的咨询可防止过早停用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.

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