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Single-Visit Long-Acting Reversible Contraception (LARC) Insertion Practices Before and After Implementation of
Gretchen S Sauer1, Mary D Carmody2,3, Lindsey Yates4
1Department of Obstetrics and Gynecology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire.
Background:
We sought to characterize changes in single-visit long-acting reversible contraception (LARC) placement before and after the start of the COVID-19 pandemic in North Carolina.
Methods:
We utilized an interrupted time series analysis to characterize single-visit LARC placement after the start of the pandemic across a state-wide health care system.
Results:
Within our cohort of 4591 patients receiving a LARC, 70.36% received single-visit LARC before and 66.98% after the start of the pandemic (odds ratio [OR] = 0.85; 95% confidence interval [CI], 0.75 - 0.97). There was a slight monthly decrease in the likelihood of single-visit LARC after the pandemic started (0.001, 95% CI: -0.004 - 0.005).
Limitations:
Limitations include the electronic health record data-based abstraction of variables, as well as the inability to assess patient preferences in visit scheduling.
Conclusions:
Rapid increases in telehealth were associated with slight decreases in single-visit LARC placement. Further study is needed to better understand patient goals and experiences, as well as clinical and public health impacts surrounding the use of telehealth for contraceptive care.
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