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Clinical Practice

Provision of intrauterine contraceptive device sizes better suited to younger women based on outcomes at 1 year

Andrew Kong, Pam Barnes and Hannat Akintomide
British Journal of General Practice 2022; 72 (722): 450-452. DOI: https://doi.org/10.3399/bjgp22X720689
Andrew Kong
Park Medical Group, Newcastle upon Tyne.
Roles: General practice specialty training registrar
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Pam Barnes
Sexual Health Services, Newcastle upon Tyne Hospitals NHS Foundation Trust, New Croft Centre, Newcastle upon Tyne.
Roles: Specialty doctor
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Hannat Akintomide
Sexual Health Services, Newcastle upon Tyne Hospitals NHS Foundation Trust, New Croft Centre, Newcastle upon Tyne.
Roles: Specialty doctor
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WHY IS CHANGE NEEDED?

Younger-aged intrauterine contraception (IUC) users — adolescents and those in their 20s — often experience higher rates of unwanted effects and discontinuation compared with their older counterparts.1 This has mainly been attributed to pain and bleeding in the first year of use.1 Smaller IUC devices are theoretically expected to be associated with less pain and bleeding.2 However, evidence for smaller-sized (width <30 mm) devices is limited in comparison with standard-sized (width ≥30 mm) devices.

Some IUC providers are aware that smaller IUC devices may be associated with fewer unwanted effects, but a lack of formal guidance may hinder their provision to younger women.

HOW DID WE GO ABOUT IMPLEMENTING CHANGE?

The team embarked on a project to determine which devices currently available in their sexual health service may be better suited to younger women and how these devices could be identified and provided. A systematic review of relevant publications, a local comparative case review, and a secondary analysis of a large subset of existing data were undertaken (Figure 1).3–5 The large dataset was from the European Active Surveillance Study for Intrauterine Devices (EURAS-IUD study), a multinational prospective cohort study involving more than 30 different IUC device brands.6

Figure 1.

Project summary including charts to support intrauterine contraception device type provision. HMB = heavy menstrual bleeding. IUD = copper intrauterine device. IUS = levonorgestrel intrauterine system.

The systematic review revealed limited evidence investigating …

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British Journal of General Practice: 72 (722)
British Journal of General Practice
Vol. 72, Issue 722
September 2022
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Provision of intrauterine contraceptive device sizes better suited to younger women based on outcomes at 1 year
Andrew Kong, Pam Barnes, Hannat Akintomide
British Journal of General Practice 2022; 72 (722): 450-452. DOI: 10.3399/bjgp22X720689

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Provision of intrauterine contraceptive device sizes better suited to younger women based on outcomes at 1 year
Andrew Kong, Pam Barnes, Hannat Akintomide
British Journal of General Practice 2022; 72 (722): 450-452. DOI: 10.3399/bjgp22X720689
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    • WHY IS CHANGE NEEDED?
    • HOW DID WE GO ABOUT IMPLEMENTING CHANGE?
    • IMPLEMENTING CHANGE AND OUTCOMES
    • ADVICE FOR PRACTITIONERS CONSIDERING CHANGE
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More in this TOC Section

  • Ketamine misuse: an update for primary care
  • Ear wax management in primary care: what the busy GP needs to know
  • REM sleep behaviour disorder: the importance of early identification in primary care
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