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Patient Barriers to Discontinuing Long-Acting Reversible Contraception
Kacie R Fox1, Alyssa M Kameoka2, Shandhini Raidoo1
1Department of Obstetrics, Gynecology & Women's Health, John A. Burns School of Medicine, University of Hawaii, 1319 Punahou St. #824, Honolulu, HI, 96826, USA.
Objectives:
To describe how frequently a national sample of patients with experience discontinuing or desiring discontinuation of long-acting reversible contraception (LARC) experienced barriers to discontinuation.
Methods:
We conducted an online survey of individuals ages 18 to 50 in the United States who had previously used and discontinued or attempted to discontinue LARC. We recruited respondents using the Amazon platform MTurk. Respondents provided demographic information and answered questions regarding their experience discontinuing LARC, including reasons removal was deferred or denied. We analyzed frequency of types of barriers encountered and compared these by demographic factors.
Results:
Of the 376 surveys analyzed, 99 (26%) described experiencing at least one barrier to removal. Barriers were disproportionately reported by those who had public health insurance, a history of abortion, and a history of birth compared to those who did not report barriers to removal. They also more frequently identified as Latinx, Asian, or Middle Eastern. Most barriers were provider-driven and potentially modifiable.
Conclusions For Practice:
Barriers to LARC discontinuation are common and may be provider- or systems-driven. Providers should be mindful of biases in their counseling and practices to avoid contributing to these barriers.
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