Promotion of Long-Acting Reversible Contraception Among Adolescents and Young Adults.
Somsook Santibenchakul, Mary Tschann, Alyssa Dee P Carlson and 2 others
PMID 30570219WHAT IT FOUND
LARC counseling was documented in 47.8% of eligible visits.
When patients decided to initiate LARC, 40.8% had a device placed at the same visit. Uptake was higher in younger than older patients.
Key findings
01LARC counseling was documented in 47.8% of eligible visits (215 of 450).
02Among visits with documented counseling, 45.6% had a LARC placement plan, and 40.8% of patients who decided to initiate had a device placed at the same visit.
03LARC uptake was significantly higher in women aged 14 to 19 years than in women aged 20 to 25 years (53.2% vs 44.9%, P = .03), with no significant difference by race.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was done in one hospital-based resident OB-GYN clinic, so the results may not apply to other clinics or patient groups. It counted LARC counseling only when documented in the chart, so counseling that happened but was not written down may have been missed. It used existing records and could not show that counseling or demographic factors caused LARC uptake. Race and ethnicity came from the electronic record and allowed only one category, which may not match how patients identify. Visits scheduled only for LARC insertion were excluded, so the analysis focused on counseling and new decisions rather than all LARC placements. Some patients had multiple visits, and the main analysis was per visit, although the team also checked results counting each patient once.
Declared interests
The authors report no conflicts of interest.
The easy way to misread this
Do not treat the documented counseling rate as proof that the other visits had no LARC counseling. The study counted only what was documented in charts, and documentation varied.