Follow-Up Care and 6-Month Continuation Rates for Long-Acting Reversible Contraceptives in Adolescents and Young Adults: A Retrospective Chart Review.

Abstract

Describe follow-up care patterns and continuation rates during the first 6months after initiating a long-acting reversible contraceptive (LARC) device among adolescent and young adult women. Retrospective chart review among patients who had an intrauterine device (IUD) or subdermal implant placed between January 2015 and December2016. Urban adolescent specialty care clinic. Women ages 13-23years. Follow-up encounters were defined as scheduled and unscheduled phone calls, outpatient clinic visits, or emergency department visits during the 6months after device placement. Continuation was defined as not having the device removed or expelled during the 6months after initiation. Frequencies were calculated, and logistic regression was used to determine predictors of follow-up encounters and continuation. Among the 177 patients, 180 LARC devices were placed. Most were 13-17years of age (56%), non-Hispanic black (64%), publicly insured (57%), and had an IUD placed (57%). Most (86%) had 1 or more clinical encounters during the 6months: 70% attended a scheduled encounter and 53% had an unscheduled encounter. Approximately half (45%) attended the scheduled 2-week office visit; only 6% attended the 6-month office visit. The 6-month LARC continuation rate was 92% (n=166), with most discontinuations among IUD users (n=12; 7%). LARC continuation rates were high in our study population. Most adolescent and young adult women have at least 1 follow-up encounter in the 6months after LARC placement. Clinical practices should be prepared to address issues that arise during follow-up encounters, whether in person or by phone.