Theodora A M Teunissen, Antoinette L M Lagro-Janssen, Demi Sturkenboom, Reinier P Akkermans, Annemarie A Uijen
{"title":"长效可逆避孕药的停用：荷兰全科医生的一项回顾性研究。","authors":"Theodora A M Teunissen, Antoinette L M Lagro-Janssen, Demi Sturkenboom, Reinier P Akkermans, Annemarie A Uijen","doi":"10.1080/13625187.2024.2415361","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Aim: </strong>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.</p><p><strong>Design and setting: </strong>Retrospective cohort study utilising data from a Dutch primary care research network.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>The discontinuation rates of LARCs are high. Better counselling might prevent premature discontinuation.</p>","PeriodicalId":1,"journal":{"name":"Accounts of Chemical Research","volume":null,"pages":null},"PeriodicalIF":16.4000,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Discontinuation of long-acting reversible contraception: a retrospective Dutch study in general practice.\",\"authors\":\"Theodora A M Teunissen, Antoinette L M Lagro-Janssen, Demi Sturkenboom, Reinier P Akkermans, Annemarie A Uijen\",\"doi\":\"10.1080/13625187.2024.2415361\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Aim: </strong>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.</p><p><strong>Design and setting: </strong>Retrospective cohort study utilising data from a Dutch primary care research network.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>The discontinuation rates of LARCs are high. 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Discontinuation of long-acting reversible contraception: a retrospective Dutch study in general practice.
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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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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