Patient or Clinician: Duration of Use of Intrauterine Devices Based on Who Initiated Discussion of Placement.

BACKGROUND

Although safe and effective, intrauterine devices (IUDs) are underutilized in the United States. The objective of this study was to determine whether patient- and clinician-initiated discussions were associated with the duration of Mirena (52 mg levonorgestrel-releasing) IUD use.

METHODS

Retrospective chart review identified Mirena IUDs that were placed and removed for reasons other than the desire for pregnancy from January 1, 2005, to January 1, 2012, at 1 academic center (n = 148). Multivariable linear regression examined the independent association between duration of use and source of discussion initiation.

RESULTS

IUDs placed after patient-initiated discussions were used for 473 days longer than those placed after clinician-initiated discussions (P < .001).

CONCLUSION

Patient-initiated discussions of Mirena IUDs are associated with a significantly longer duration of use. Patient influences outside the clinical encounter may be important in optimizing use.