Knowledge and Training of Intrauterine Devices Among Primary Care Residents: Implications for Graduate Medical Education

Sridhar, Aparna; Forbes, Elizabeth; Mooney, Kelly; Rible, Radhika

doi:10.4300/jgme-d-14-00010.1

Cited by 11 publications

(9 citation statements)

References 13 publications

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“…18 Thus, the lack of information received by women from family planning professionals reflects the lack of knowledge among these professionals about the safety of IUDs as a contraceptive method for nulliparous women. [19][20][21][22] A study that evaluated the attitude, knowledge, and practice on IUD use showed that less than half (46%) of reproductive health physicians considered this contraceptive method to be indicated for nulliparous women. 19 For a long time, nulliparous women and adolescents constituted a group of patients for whom IUDs were contraindicated 23 and, although the American College of Obstetricians and Gynecologists, in 2012, recommend that IUDs should be considered the first choice of contraceptive for adolescents, 10,11 its prescription is still low.…”

Section: Discussionmentioning

confidence: 99%

Continued Compliance and Degree of Satisfaction in Nulligravida and Parous Women with Intrauterine Contraceptive Devices

Scavuzzi

Souza

Amorim

2016

Rev Bras Ginecol Obstet

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Section: Discussionmentioning

confidence: 99%

Continued Compliance and Degree of Satisfaction in Nulligravida and Parous Women with Intrauterine Contraceptive Devices

Scavuzzi

Souza

Amorim

2016

Rev Bras Ginecol Obstet

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“…41 In the Nordic countries, the UK and France, IUS use has gradually increased, 42 whereas in other countries, the IUS appears to be underused, in part due to a lack of primary care providers trained in device insertion. 43,44 As our sensitivity analysis indicates that an increase in LNG-IUS insertions in primary care will lead to lower costs for society, IUS treatment in primary care should be encouraged more. In secondary care, EA is internationally increasingly performed at the outpatient department under local anaesthesia, reducing the cost of the ablation strategy.…”

Section: Discussionmentioning

confidence: 99%

The levonorgestrel intrauterine system versus endometrial ablation for heavy menstrual bleeding: a cost‐effectiveness analysis

Brink

Beelen

Herman

et al. 2021

BJOG

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Objective: To evaluate the costs and non-inferiority of a strategy starting with the LNG-IUS compared to endometrial ablation (EA) in the treatment of heavy menstrual bleeding (HMB).Design: Cost-effectiveness analysis from a societal perspective alongside a multicentre randomised noninferiority trial.Setting: General practices and gynaecology departments in the Netherlands.Population: 270 women with HMB, aged ≥34 years old, without intracavitary pathology or future child wish.Methods: Randomisation to a strategy starting with the LNG-IUS (n=132) or EA (n=138). The incremental cost-effectiveness ratio (ICER) was estimated.Main outcome measures: Direct medical costs and (in)direct non-medical costs were calculated. The primary outcome was menstrual blood loss after 24 months, measured with the mean Pictorial Blood Assessment Chart (PBAC)-score (non-inferiority margin 25 points). A secondary outcome was successful blood loss reduction (PBAC-score ≤75 points).Results: Total costs per patient were €2,285 in the LNG-IUS strategy and €3,465 in the EA strategy (difference: €1,180). At 24 months mean PBAC-scores were 64.8 in the LNG-IUS group (N=115) and 14.2 in the EA group (N=132); difference 50.5 points (95% CI: 4.3-96.7). In the LNG-IUS group, 87% of women had a PBAC-score ≤75 points versus 94% in the EA group (RR 0.93, 95% CI: 0.85-1.01). The ICER was €23 (95% CI: €5-€111) per PBAC-point. Conclusions:A strategy starting with the LNG-IUS was cheaper than starting with EA, but non-inferiority could not be demonstrated. The LNG-IUS is reversible and less invasive and can be a cost-effective treatment option, depending on the success rate women are willing to accept.

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“…Since some previous studies have found that knowledge about IUDs are not a major barrier among Jamaican women, access to clinics which provide contraception could be the main barrier to the use of IUDs and other LARCs [11,12]. It has also been observed by studies conducted in other countries that a rather important barrier to IUD use is a lack of healthcare providers (HCPs) who are trained in how to perform an IUD insertion [2,[13][14][15]. Knowledge and attitudes about IUDs among the sexually active female population in Jamaica could also be a factor.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of an intrauterine device informative intervention among post-natal women in Western Jamaica

et al. 2021

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Introduction Intrauterine devices are the most effective long-acting reversible contraceptives, but in many developing countries, such as Jamaica, these devices remain underutilized. Methods A cross-sectional informative intervention was conducted among women ≥ 18 years of age attending postnatal clinics in western Jamaica from May to August 2018. Data were collected using an investigator-administered questionnaire/pre-test followed by a 12-slide PowerPoint® presentation and a post-test. Results Most of the 299 women who participated were 18–29 years of age, with a mean age of 27.1 (SD ± 6.1) years. Most had their first pregnancy between ages 18 and 24 years, with mean age at first pregnancy of 20.2 (SD ± 4.0) years. Only 3.0% of participants reported current use of an intrauterine device; 3.5% reported using an intrauterine device in the past. For nearly every measure of knowledge of intrauterine devices, there was a significant change in the proportion of participants who got the correct answer from the pre-test to the post-test. The mean summed pre-test knowledge score was 9.54 (SD ± 3.46) and the post-test score was 15.23 (SD ± 1.92); the possible total score is 18. The difference between the mean scores (5.69 points) was also significant. Conclusion The intervention resulted in significant change in knowledge of intrauterine devices among the women and cleared up many misconceptions that may have contributed to reluctance of women to use intrauterine devices. Women of reproductive age in Jamaica should be counseled on contraceptive methods including intrauterine devices so that these devices can be considered in their contraceptive choices.

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Knowledge and Training of Intrauterine Devices Among Primary Care Residents: Implications for Graduate Medical Education

Cited by 11 publications

References 13 publications

Continued Compliance and Degree of Satisfaction in Nulligravida and Parous Women with Intrauterine Contraceptive Devices

Continued Compliance and Degree of Satisfaction in Nulligravida and Parous Women with Intrauterine Contraceptive Devices

The levonorgestrel intrauterine system versus endometrial ablation for heavy menstrual bleeding: a cost‐effectiveness analysis

Effectiveness of an intrauterine device informative intervention among post-natal women in Western Jamaica

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