终止长效可逆避孕:一项荷兰回顾性研究在通用医疗实践中
Theodora A M Teunissen1, Antoinette L M Lagro-Janssen1, Demi Sturkenboom1
1Department of Primary and Community Care, Research Institute for Medical Innovation, Radboud University Medical Centre, Nijmegen, the Netherlands.
在荷兰,长效可逆避孕药 (LARC) 停用率很高,有25.9%的使用者在2.5年内停止使用. 建议改善咨询,以减少这些有效避孕方法的过早停用.
科学领域:
- 生殖健康 生殖健康
- 避孕研究研究 避孕研究
- 公共卫生政策 公共卫生政策
背景情况:
- 在荷兰,长效可逆避孕 (LARC) 的使用正在增加.
- 在全球范围内记录了高率的LARC方法过早停止治疗.
- 关于荷兰人口中LARC戒断的有限的综合数据存在.
研究的目的:
- 确定各种LARC方法在使用前2.5年内停止使用的速度和原因.
- 为了识别与LARC治疗过早停药相关的患者特征.
主要方法:
- 使用荷兰初级保健研究网络 (2017-2019) 数据的回顾性队列研究 (2017-2019).
- 包括642名患有LARC的妇女和2.5年的随访期.
- 使用了描述性分析,卡普兰-梅尔和后勤回归.
主要成果:
- 在2.5年内,整体停药率为25.9%.
- 停药率因方法而异:22% (LNG-IUS 52mg),25% (LNG-IUS 19.5mg),39% (铜IUD) 和47% (植入物) 的情况.
- 主要原因包括出血变化 (68%),疼痛 (32%) 和情绪变化 (24%). 30-34岁和虐待史增加了戒断风险,而高等教育降低了这一风险.
结论:
- 在荷兰,LARC方法的过早停药率很高.
- 通过加强患者咨询来解决出血模式和疼痛等原因,可能会提高延续率.
- 患者的年龄,虐待史和教育水平等因素与停药有关,这凸显了个性化护理的必要性.
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