Real-world use of antispasmodic drugs during IUD insertion - insights from the large observational study EURAS-LCS12.

Introduction: Antispasmodic drugs are used to facilitate the insertion of intrauterine devices (IUD), and to decrease uterine cramping during the procedure. Evidence supporting these benefits is scarce, and little is known about the prevalence of antispasmodic use before IUD insertion.

Methods: EURAS-LCS12 is an ongoing non-interventional cohort study in ten European countries. Information is gathered from health care professionals (HCP) and IUD users via questionnaires at the time of IUD insertion. Patterns of antispasmodics before IUD insertion, by participating country, were assessed using descriptive methods.

Results: 96,024 users were included in the study, of which 2.7% (N = 2,565) received antispasmodics before IUD insertion, with notable differences observed between countries. Highest antispasmodic use was observed in France and Germany: in France, almost 50% of HCPs (68/144) gave antispasmodics at least once during the study period. In Germany, 16% of enrolling HCPs used antispasmodics at least once during the study period; two HCPs (0.8%) administered antispasmodics in 69% of all study participants.

Conclusion: Clinical practices for prescribing and administering antispasmodics during IUD insertion vary by country and seem to rely on local recommendations, or locally applicable best practices. The heterogeneous use of antispasmodics with uncertain benefits highlights the need for evidence-based recommendations.